Assessment of Parathyroid Function in Clinical Practice: Which Parathyroid Hormone Assay Is Better?

Santini, Stefano Angelo; Carrozza, Cinzia; Vulpio, Carlo; Capoluongo, Ettore; Luciani, Giovanna; Lulli, Paola; Giardina, Bruno; Zuppi, Cecilia

doi:10.1373/clinchem.2003.030759

Cited by 18 publications

(11 citation statements)

References 18 publications

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“…The majority of these assays use a sandwich immunoassay with capture and detection antibodies that recognize unique epitopes of PTH. Many of these assays have been compared with one another, and they have shown some key differences (Cole et al, 2007, La'ulu and Roberts, 2010, Santini et al, 2004). The differences in reported values between assays can potentially be attributed to the different recognition elements used in the diagnostic tests.…”

Section: Operating Roommentioning

confidence: 99%

Point-of-care diagnostics for niche applications

Cummins

Ligler

Walker

2016

Biotechnology Advances

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Point-of-care or point-of-use diagnostics are analytical devices that provide clinically relevant information without the need for a core clinical laboratory. In this review we define point-of-care diagnostics as portable versions of assays performed in a traditional clinical chemistry laboratory. This review discusses five areas relevant to human and animal health where increased attention could produce significant impact: veterinary medicine, space travel, sports medicine, emergency medicine, and operating room efficiency. For each of these areas, clinical need, available commercial products, and ongoing research into new devices are highlighted.

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Section: Operating Roommentioning

confidence: 99%

Point-of-care diagnostics for niche applications

Cummins

Ligler

Walker

2016

Biotechnology Advances

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“…Current treatment guidelines suggest that in ESRD patients, nephrologists should aim to keep the circulating concentration of intact PTH in a range from 2 to 4 times the upper limit of the reference interval, although the form of PTH to be measured and the target concentration range remain controversial (25,42 ). The need for improved tools for managing renal patients is clear because the clinical methods currently used to measure renal osteodystrophy are indirect.…”

Section: Discussionmentioning

confidence: 99%

41Ca and Accelerator Mass Spectrometry to Monitor Calcium Metabolism in End Stage Renal Disease Patients

et al. 2005

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Background: Monitoring bone resorption with measurements of bone density and biochemical markers is indirect. We hypothesized that bone resorption can be studied directly by serial measurements of the ratio 41 Ca/Ca in serum after in vivo labeling of calcium pools with 41 Ca. We report the preparation of an intravenous 41 Ca dose suitable for humans, an analytical method for determining 41 Ca/Ca isotope ratios in biological samples, and studies in human volunteers. Methods:41 Ca was formulated and aliquoted into individual vials, and to the extent possible, the 41 Ca doses were tested according to US Pharmacopeia (USP) guidelines. A 10 nCi dose of 41 Ca was administered intravenously to 4 end stage renal disease (ESRD) patients on hemodialysis and 4 healthy control individuals. Distribution kinetics were determined over 168 days. Calcium was isolated with 3 precipitation steps and a cationexchange column, and 41 Ca/Ca ratios in serum were then measured by accelerator mass spectrometry. Results: The dosing solution was chemically and radiologically pure, contained <0.1 endotoxin unit/mL, and passed USP sterility tests. Quantification of 41 Ca/Ca ratios was linear from 6 ؋ 10 ؊14 to 9.1 ؋ 10 ؊10 . The run-to-run imprecision (as CV) of the method was 4% at 4.6 ؋ 10 ؊11 and 6% at 9.1 ؋ 10 ؊10 . The area under the curve of 41 Ca in the central compartment vs time was

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“…PTH circulates in the blood as a mixture of whole PTH (1-84) and N-and C-terminal fragments [25]. Certain C-terminal fragments, including PTH (7-84), a non-(1-84) PTH (defined as a large C-terminal fragment possessing a partially-preserved N-terminal structure), have been shown to offset the biological activity of PTH [24,26].…”

Section: Pharmacokinetic Properties Of Rhpth (1-84)mentioning

confidence: 99%

“…Certain C-terminal fragments, including PTH (7-84), a non-(1-84) PTH (defined as a large C-terminal fragment possessing a partially-preserved N-terminal structure), have been shown to offset the biological activity of PTH [24,26]. Since they undergo renal clearance, C-terminal fragments (with or without partially preserved N-terminal structures) accumulate in renal failure patients, and this has been linked to PTH resistance in these patients [15,25,26].…”

Section: Pharmacokinetic Properties Of Rhpth (1-84)mentioning

confidence: 99%

Recombinant Human Parathyroid Hormone (1–84): A Review in Hypoparathyroidism

Kim

Keating

2015

Drugs

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Full-length recombinant human parathyroid hormone [rhPTH (1-84); Natpara(®)] is approved in the USA as an adjunct to calcium and vitamin D therapy for control of hypocalcaemia in patients with hypoparathyroidism. This article reviews the clinical efficacy and tolerability of rhPTH (1-84) in hypoparathyroidism and summarizes its pharmacological properties. In a pivotal phase III trial, subcutaneous rhPTH (1-84) was effective in maintaining albumin-corrected total serum calcium levels while reducing/eliminating the need for oral calcium and active vitamin D. rhPTH (1-84) had a generally acceptable tolerability profile in this trial, with <3% of patients discontinuing treatment because of adverse events. Commonly occurring adverse reactions included hypocalcaemia, hypercalcaemia and hypercalciuria. As the first PTH replacement therapy for hypoparathyroid patients with hypocalcaemia, rhPTH (1-84) is an effective regimen, has generally acceptable tolerability and represents an important advance for the management of hypoparathyroidism.

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Assessment of Parathyroid Function in Clinical Practice: Which Parathyroid Hormone Assay Is Better?

Cited by 18 publications

References 18 publications

Point-of-care diagnostics for niche applications

Point-of-care diagnostics for niche applications

41Ca and Accelerator Mass Spectrometry to Monitor Calcium Metabolism in End Stage Renal Disease Patients

Recombinant Human Parathyroid Hormone (1–84): A Review in Hypoparathyroidism

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