TY - JOUR
T1 - High-Resolution Mass Spectrometry for the Measurement of PTH and PTH Fragments
T2 - Insights into PTH Physiology and Bioactivity
AU - Ulmer, Candice Z.
AU - Kritmetapak, Kittrawee
AU - Singh, Ravinder J.
AU - Vesper, Hubert W.
AU - Kumar, Rajiv
N1 - Publisher Copyright:
© 2022 American Society of Nephrology. All rights reserved.
PY - 2022/8
Y1 - 2022/8
N2 - Full-length parathyroid hormone (PTH 1-84) is crucial for the regulation of calcium and phosphate homeostasis and bone remodeling. PTH 1-84 is metabolized into various PTH fragments, which are measured with varying levels of efficiency by PTH immunoassays. These PTH fragments, which increase in serum as CKD progresses, could potentially modulate the effects of PTH 1-84 and contribute to CKD-associated bone disorders. To obtain a true biological representation of total PTH bioactivity, it necessary to measure not only PTH 1-84, but also PTH fragments that are present in circulation. Traditional second-generation PTH immunoassays collectively measure PTH 1-84, PTH fragments, and post-translationally modified PTH 1-84, making it difficult to accurately predict the character of underlying renal osteodystrophy. This review highlights current advances in methods available for PTH measurement and the clinical relevance of PTH fragments in CKD. We emphasize the usefulness of mass spectrometry as a potential reference method for PTH measurement.
AB - Full-length parathyroid hormone (PTH 1-84) is crucial for the regulation of calcium and phosphate homeostasis and bone remodeling. PTH 1-84 is metabolized into various PTH fragments, which are measured with varying levels of efficiency by PTH immunoassays. These PTH fragments, which increase in serum as CKD progresses, could potentially modulate the effects of PTH 1-84 and contribute to CKD-associated bone disorders. To obtain a true biological representation of total PTH bioactivity, it necessary to measure not only PTH 1-84, but also PTH fragments that are present in circulation. Traditional second-generation PTH immunoassays collectively measure PTH 1-84, PTH fragments, and post-translationally modified PTH 1-84, making it difficult to accurately predict the character of underlying renal osteodystrophy. This review highlights current advances in methods available for PTH measurement and the clinical relevance of PTH fragments in CKD. We emphasize the usefulness of mass spectrometry as a potential reference method for PTH measurement.
KW - chronic kidney disease
KW - hyperparathyroidism
KW - mass spectrometry
KW - mineral metabolism
KW - parathyroid hormone
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U2 - 10.1681/ASN.2022010036
DO - 10.1681/ASN.2022010036
M3 - Review article
C2 - 35396262
AN - SCOPUS:85135223245
SN - 1046-6673
VL - 33
SP - 1448
EP - 1458
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 8
ER -