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Calcium regulation
(c) Natalia Dachanidze
PARATHYROID HORMONE
• PTH is a peptide hormone which is synthesised
in the parathyroid glands.
• Its main function is to increase the
concentration of calcium in the blood plasma.
• Intact PTH (iPTH) is the biologically active form
and is secreted when the calcium level is low.
(c) Natalia Dachanidze
(c) Natalia Dachanidze
CALCITONIN
• Calcitonin (also known as thyrocalcitonin) is
produced in the thyroid gland and is the
antagonist of PTH.
• The production and secretion of calcitonin is
stimulated by an elevated calcium level and
results in a reduction in the calcium
concentration in the blood.
(c) Natalia Dachanidze
(c) Natalia Dachanidze
VITAMIN D
• Vitamin D exists in two forms: vitamin D2
which is acquired by consumption of plant foods
such as mushrooms and avocado, and vitamin
D3 which is obtained from animal food sources
or produced in skin exposed to ultraviolet B
radiation.
(c) Natalia Dachanidze
(c) Natalia Dachanidze
(c) Natalia Dachanidze
Introduction
• Total plasma [Ca++] = 2.5mmol/L
• Range is 2.0 to 2.5 mmol/L
• Very tightly controlled
Body
content
Bone intracellu
lar
extracellu
lar
Calcium 1300 gms 99% 1% 0.1%
(c) Natalia Dachanidze
Introduction
(c) Natalia Dachanidze
Factors affecting calcium concentration
1) Changes in plasma protein concentration
- Increased [protein] – increased total [Ca2+]
2) Changes in anion concentration
- Increased [anion] – increased fraction of Ca2+
that is complexed – decrease ionized [Ca2+]
3)Acid-base abnormality (pH)
(c) Natalia Dachanidze
Acid Base Abnormality
(c) Natalia Dachanidze
Functions of Calcium
• 1. Nerve and muscle functions
• Depolarization and muscle contaction
(c) Natalia Dachanidze
• Increase in intracellular Ca2+ concentration →
Ca2+ binds to troponin C → conformational
change in the troponin complex → moves
tropomyosin out of the way → permitting the
binding of actin to the myosin heads leading
cross-bridge formation and the muscle contracts
as a whole
(c) Natalia Dachanidze
Functions of Calcium
Cross bridge
cycling
(c) Natalia Dachanidze
Functions of Calcium
• 2. Homeostasis
-activation of clotting enzyme is the plasma
(c) Natalia Dachanidze
Functions of Calcium
• 3. Preserving bone density
- construction, formation and maintenance of
bone and teeth. This function helps reduce the
occurrence of osteoporosis
(c) Natalia Dachanidze
Functions of Calcium
• 4. Neurotransmitter release
- Directly proportional to the calcium level
- Arrival of action potential to axonal terminal
→opening of voltage gated calcium channels
→calcium influx into the terminal → transmitter
vesicle fuse with the release sites → exocytosis-
release of transmitters into the cleft
(c) Natalia Dachanidze
Functions of Calcium
• 5. Calcium assists in maintaining all cells and
connective tissues in the body and regulating
mitotic transition and cell division.
• 6. Essential component in the production of
enzyme and hormones that regulate digestion,
energy, and fat metabolism.
(c) Natalia Dachanidze
Calcium Homeostasis
• Blood calcium is tightly regulated by:
1) Principle organ systems:
Intestine
Bone
Kidney
2) Hormones:
Parathyroid hormone (PTH)
Vitamin D
Calcitonin
(c) Natalia Dachanidze
Calcium Homeostasis
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• There are 4 parathyroids glands, located on the
dorsal side of the thyroid
• The blood supply to the parathyroid glands is
from the thyroid arteries.
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• Chief cells secrete PTH
• Oxyphil cells – function unknown. Probably
degenerated chief cells
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• Mechanism
Increase in extracellular calcium concentration
→ Ca2+ binds to the receptor and activates
phospholipase C → increased levels of IP3/Ca2+
→ which inhibits PTH secretion.
When extracellular Ca2+ is decreased, there is
decreased Ca2+ binding to the receptor, which
stimulates PTH secretion.
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• Actions of PTH on bone, kidney and small
intestine
1) Actions on bone
- Overall effect : promote bone resorption and
increase calcium concentration
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• 2. Actions on kidneys
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
a) Inhibits PO4 reabsorption (inhibits Na-PO4
cotransport in PCT) – phosphaturia – less
complexed Ca-PO4 – increase plasma calcium
b) Stimulates calcium reabsorption
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
• 3. Actions on small intestine (indirect)
- Stimulates Ca2+ reabsorption via activation of
vitamin D.
(c) Natalia Dachanidze
Parathyroid Hormone (PTH)
(c) Natalia Dachanidze
Vitamin D
(c) Natalia Dachanidze
Vitamin D
• Actions of vitamin D
(c) Natalia Dachanidze
Calcitonin
• a straight-chain peptide with 32 amino acids.
• synthesized and secreted by the parafollicular
cells of the thyroid gland.
• major stimulus for calcitonin secretion is
increased plasma Ca2+ concentration
• The major action of calcitonin is to inhibit
osteoclastic bone resorption, which decreases
the plasma Ca2+ concentration.
(c) Natalia Dachanidze

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  • 2. PARATHYROID HORMONE • PTH is a peptide hormone which is synthesised in the parathyroid glands. • Its main function is to increase the concentration of calcium in the blood plasma. • Intact PTH (iPTH) is the biologically active form and is secreted when the calcium level is low. (c) Natalia Dachanidze
  • 4. CALCITONIN • Calcitonin (also known as thyrocalcitonin) is produced in the thyroid gland and is the antagonist of PTH. • The production and secretion of calcitonin is stimulated by an elevated calcium level and results in a reduction in the calcium concentration in the blood. (c) Natalia Dachanidze
  • 6. VITAMIN D • Vitamin D exists in two forms: vitamin D2 which is acquired by consumption of plant foods such as mushrooms and avocado, and vitamin D3 which is obtained from animal food sources or produced in skin exposed to ultraviolet B radiation. (c) Natalia Dachanidze
  • 9. Introduction • Total plasma [Ca++] = 2.5mmol/L • Range is 2.0 to 2.5 mmol/L • Very tightly controlled Body content Bone intracellu lar extracellu lar Calcium 1300 gms 99% 1% 0.1% (c) Natalia Dachanidze
  • 11. Factors affecting calcium concentration 1) Changes in plasma protein concentration - Increased [protein] – increased total [Ca2+] 2) Changes in anion concentration - Increased [anion] – increased fraction of Ca2+ that is complexed – decrease ionized [Ca2+] 3)Acid-base abnormality (pH) (c) Natalia Dachanidze
  • 12. Acid Base Abnormality (c) Natalia Dachanidze
  • 13. Functions of Calcium • 1. Nerve and muscle functions • Depolarization and muscle contaction (c) Natalia Dachanidze
  • 14. • Increase in intracellular Ca2+ concentration → Ca2+ binds to troponin C → conformational change in the troponin complex → moves tropomyosin out of the way → permitting the binding of actin to the myosin heads leading cross-bridge formation and the muscle contracts as a whole (c) Natalia Dachanidze
  • 15. Functions of Calcium Cross bridge cycling (c) Natalia Dachanidze
  • 16. Functions of Calcium • 2. Homeostasis -activation of clotting enzyme is the plasma (c) Natalia Dachanidze
  • 17. Functions of Calcium • 3. Preserving bone density - construction, formation and maintenance of bone and teeth. This function helps reduce the occurrence of osteoporosis (c) Natalia Dachanidze
  • 18. Functions of Calcium • 4. Neurotransmitter release - Directly proportional to the calcium level - Arrival of action potential to axonal terminal →opening of voltage gated calcium channels →calcium influx into the terminal → transmitter vesicle fuse with the release sites → exocytosis- release of transmitters into the cleft (c) Natalia Dachanidze
  • 19. Functions of Calcium • 5. Calcium assists in maintaining all cells and connective tissues in the body and regulating mitotic transition and cell division. • 6. Essential component in the production of enzyme and hormones that regulate digestion, energy, and fat metabolism. (c) Natalia Dachanidze
  • 20. Calcium Homeostasis • Blood calcium is tightly regulated by: 1) Principle organ systems: Intestine Bone Kidney 2) Hormones: Parathyroid hormone (PTH) Vitamin D Calcitonin (c) Natalia Dachanidze
  • 22. Parathyroid Hormone (PTH) • There are 4 parathyroids glands, located on the dorsal side of the thyroid • The blood supply to the parathyroid glands is from the thyroid arteries. (c) Natalia Dachanidze
  • 23. Parathyroid Hormone (PTH) • Chief cells secrete PTH • Oxyphil cells – function unknown. Probably degenerated chief cells (c) Natalia Dachanidze
  • 24. Parathyroid Hormone (PTH) • Mechanism Increase in extracellular calcium concentration → Ca2+ binds to the receptor and activates phospholipase C → increased levels of IP3/Ca2+ → which inhibits PTH secretion. When extracellular Ca2+ is decreased, there is decreased Ca2+ binding to the receptor, which stimulates PTH secretion. (c) Natalia Dachanidze
  • 25. Parathyroid Hormone (PTH) • Actions of PTH on bone, kidney and small intestine 1) Actions on bone - Overall effect : promote bone resorption and increase calcium concentration (c) Natalia Dachanidze
  • 26. Parathyroid Hormone (PTH) • 2. Actions on kidneys (c) Natalia Dachanidze
  • 27. Parathyroid Hormone (PTH) a) Inhibits PO4 reabsorption (inhibits Na-PO4 cotransport in PCT) – phosphaturia – less complexed Ca-PO4 – increase plasma calcium b) Stimulates calcium reabsorption (c) Natalia Dachanidze
  • 28. Parathyroid Hormone (PTH) • 3. Actions on small intestine (indirect) - Stimulates Ca2+ reabsorption via activation of vitamin D. (c) Natalia Dachanidze
  • 29. Parathyroid Hormone (PTH) (c) Natalia Dachanidze
  • 30. Vitamin D (c) Natalia Dachanidze
  • 31. Vitamin D • Actions of vitamin D (c) Natalia Dachanidze
  • 32. Calcitonin • a straight-chain peptide with 32 amino acids. • synthesized and secreted by the parafollicular cells of the thyroid gland. • major stimulus for calcitonin secretion is increased plasma Ca2+ concentration • The major action of calcitonin is to inhibit osteoclastic bone resorption, which decreases the plasma Ca2+ concentration. (c) Natalia Dachanidze