Development and Prevention of Morphologic and Ultrastructural Changes in Uremia-induced Hyperplastic Parathyroid Gland

The detailed ultrastructural changes of uremia-induced hyperplastic parathyroid gland and the effects of current medical treatments for secondary hyperparathyroidism were investigated. Marked enlargement of parathyroid cell with accumulation of mitochondria and lipids and a significant increase in the thickness of the pericapillary area with increased fibrosis and appearance of fibroblast like cells were noted in the hyperplastic gland caused by uremia and phosphate retention. These ultrastructural changes and biochemical findings indicating hyperparathyroidism were significantly suppressed by all of the treatment using phosphate restriction, calcitriol, and cinacalcet. The characteristic ultrastructural changes, including the morphologic evidence of nodule formation, were indicated.

[1]  M. Tokumoto,et al.  Activator protein 2alpha mediates parathyroid TGF-alpha self-induction in secondary hyperparathyroidism. , 2008, Journal of the American Society of Nephrology : JASN.

[2]  I. Hatamura,et al.  Direct Injection of Calcitriol or Its Analog Improves Abnormal Gene Expression in the Hyperplastic Parathyroid Gland in Uremia , 2007, American Journal of Nephrology.

[3]  T. Sakaguchi,et al.  Direct maxacalcitol injection into hyperplastic parathyroids improves skeletal changes in secondary hyperparathyroidism. , 2006, Kidney international.

[4]  N. Nagano,et al.  Sevelamer hydrochloride reverses parathyroid gland enlargement via regression of cell hypertrophy but not apoptosis in rats with chronic renal insufficiency. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[5]  H. Hirakata,et al.  Parathyroid growth and regression in experimental uremia. , 2006, Kidney international.

[6]  A. Ooshima,et al.  Biochemical and cellular effects of direct maxacalcitol injection into parathyroid gland in uremic rats. , 2004, Journal of the American Society of Nephrology : JASN.

[7]  K. O̸lgaard,et al.  Autoregulation in the parathyroid glands by PTH/PTHrP receptor ligands in normal and uremic rats. , 2003, Kidney international.

[8]  E. Slatopolsky,et al.  Reversal of Secondary Hyperparathyroidism by Phosphate Restriction Restores Parathyroid Calcium‐Sensing Receptor Expression and Function , 2002, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[9]  M. Tokumoto,et al.  Reduced p21, p27 and vitamin D receptor in the nodular hyperplasia in patients with advanced secondary hyperparathyroidism. , 2002, Kidney international.

[10]  A. Dusso,et al.  p21WAF1 and TGF-α mediate parathyroid growth arrest by vitamin D and high calcium , 2001 .

[11]  E. Slatopolsky,et al.  Parathyroid hyperplasia in uremic rats precedes down-regulation of the calcium receptor. , 2001, Kidney international.

[12]  H. Takagi,et al.  Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. , 1997, Seminars in surgical oncology.

[13]  J. Gogusev,et al.  Depressed expression of calcium receptor in parathyroid gland tissue of patients with hyperparathyroidism. , 1997, Kidney international.

[14]  H. Takagi,et al.  Clonal Analysis of Nodular Parathyroid Hyperplasia in Renal Hyperparathyroidism , 1996, World Journal of Surgery.

[15]  J. Silver,et al.  Parathyroid cell proliferation in normal and chronic renal failure rats. The effects of calcium, phosphate, and vitamin D. , 1995, The Journal of clinical investigation.

[16]  E. Ritz,et al.  Intermittent versus continuous administration of 1,25-dihydroxyvitamin D3 in experimental renal hyperparathyroidism. , 1993, Kidney international.

[17]  K. Kurokawa,et al.  Decreased 1,25-dihydroxyvitamin D3 receptor density is associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. , 1993, The Journal of clinical investigation.

[18]  B. Weigold.  [The parathyroid glands]. , 1987, Bildgebung = Imaging.

[19]  J. E. Moreira,et al.  Ultrastructural changing of the rat parathyroid gland under various fixation methods. , 1985, Anatomischer Anzeiger.

[20]  C. Capen,et al.  Effects of uremia and vitamin D on bone and the ultrastructure of thyroid parafollicular cells and parathyroid chief cells in the rat , 1974, Virchows Archiv. B, Cell pathology.

[21]  E. Altenähr.  Ultrastructural pathology of parathyroid glands. , 1972, Current topics in pathology. Ergebnisse der Pathologie.

[22]  Lever Jd.  Fine structural appearances in the rat parathyroid. , 1957 .

[23]  J. Lever.  Fine structural appearances in the rat parathyroid. , 1957, Journal of anatomy.

[24]  J. Rosof.  An experimental study of the histology and cytology of the parathyroid glands in the albino rat , 1934 .