Calcitonin

Cells involved in calcitonin secretion arise from neural crest. During embryogenesis, these migrate to ultimobranchial body, derived from the last branchial pouch. In submammalian vertebrates these ultimobranchial body are discrete organ; in mammals they fuse with thyroid gland as C-cells. Mol wt= !"" #as $ amino acids #as #alf life=%"min &here are two calcitonin genes and . &he gene produces both calcitonin and Calcitonin gene related peptide 'C()*+. &he produces only C()* in C,-. C()* serves as neurotransmitter for some taste and other sensory pathway. Secretion is stimulated by -agonists, dopamine, estrogen (astrin .in /ollinger 0llison syndrome and pernicious anemia, calcitonin is increased due to increased gastrin levels1. (astrin is most potent stimulator. CC2, glucagon, secretin. Actions Calcitonin lowers the serum calcium level. 3cts through serpentine receptors found in 4idney and bone. &he receptor is homologous to *&#)-% receptor. Directly inhibits the osteoclasts. Increases Ca e5cretion in urine. Hormones affecting Ca metabolism *&# 6%, $! D#CC increases Ca by- mobili7ing Ca from bone, absorption from 4idney, intestine Calcitonin inhibit bone resorption and increase Ca e5cretion in urine. (lucocorticoids- decrease Ca level by inhibiting osteoclast, but cause osteoporosis and decrease bone formation by inhibiting protein synthesis in osteoblasts. Decrease Ca, *89 absorption from intestine and increase e5cretion in urine. Decrease in plasma Ca increases *&# and thus bone resorption. (rowth #ormone- increases Ca e5cretion in urine but increases Ca absorption from intestine causing positive Ca balance. I(:-% stimulate protein synthesis in bone &hyroid hormone cause hypercalcemia, hypercalciuria and also osteoporosis 0strogens prevent osteoporosis by direct effect on osteoblasts Insulin increase bone formation..&hus in diabetes bone loss may also occur1 Clinical &here are no deficiencies or e5cess disorder of calcitonin. *eople with total thyroidectomy and no calcitonin have normal Ca level.

Calcium is not easily absorbed in intestine, but is aided by ;itamin D for absorption. <hereas *hosphate is easily absorbed in intestine. 3lmost the entire amount is absorbed and e5creted in urine. ="> Calcium is lost in feces and only %"> lost in urine. ,ormal *lasma Ca?? is =-%%mg> ,ormal *lasma *89@is $-9mg> '3dult+; 9-!mg> 'Child+ Calcium in plasma is present in formsA 9"> in combination with plasma protein %"> unioni7ed calcium !"> as ioni7ed diffusible calcium 'active form+ Role of Vit D in Calcium absorption -un

Cholecalciferol ';itamin D + Biver

D-Dehydrocholesterol

:eedbac4 Inhibition

$! #ydro5y cholecalciferol 2idney %,$!- Dihydro5yCholecalciferol .Intestinal 0pithelium1 Calcium Cinding *rotein *arathyroid #ormone

Calcium 3l4aline stimulated 3&*ase *hosphatase Inhibit

Intestinal 3bsorption of Calcium

*lasma Ca?? concentration