The effect of iodosteviol glycoside on hormonal status and the level of proinflammatory cytokines in experimental hypothyroidism

Aim. Study of the hormonal status and the level of pro-inflammatory cytokines in the blood plasma in experimental hypothyroidism and the effect of the organoiodine complex with rebaudioside A. Materials and methods. Endemic thyroid dysfunction was modeled in sexually mature male white rats by daily intragastric administration of thiamazole for 21 days at a dose of 25 mg / kg. In the blood serum, the content of thyrotropin, total and free thyroxine, total triiodothyronine, testosterone, luteinizing, follicle-stimulating and parathyroid hormones, corticosterone, interleukins-1-beta and -6, tumor necrosis factor-alpha was studied. The animals were divided into four groups of 10 each: control, experimental, comparison and main. Results. The development of hypothyroidism was characterized by an increase in the content of thyroid-stimulating, luteinizing, follicle-stimulating and parathyroid hormones, as well as pro-inflammatory cytokines. At the same time, testosterone levels decreased, while corticosterone levels were within physiological fluctuations. Conclusion. The use within 30 days of the recovery period after the development of hypothyroidism of the iodosaccharide complex based on steviol glycoside rebaudioside A used in the food industry daily at a dose of 25 mg / kg of rat weight led to the normalization of the content of the studied hormones and cytokines in the blood plasma, characterizing the effectiveness of the new organoiodine product.

Successful pregnancy outcome in a case of idiopathic primary hypoparathyroidism with seizure disorder: a case report

Hypoparathyroidism, a disorder of low parathyroid hormones resulting in hypocalcemia and hyperphosphatemia, is relatively a rare occurrence in pregnancy. Nevertheless, it has been reported to cause significant maternal and neonatal morbidity and even mortality in severe cases. Dynamic changes in serum calcium during pregnancy superimposed with the inherent defect in the parathyroid gland and calcium metabolism in these patients make it even more difficult to monitor and manage the patient. We report a case of idiopathic primary hypoparathyroidism with seizure disorder, managed with aggressive monitoring and timely decision making, resulting in a favorable outcome.

P0872EFFECT OF PARATHYROID HORMONE OSCILLATIONS ON BONE HEALTH: FROM OSTEO-ANABOLISM TO CATABOLISM

Background and Aims In patients with chronic kidney disease or primary hyperparathyroidism, chronically elevated parathyroid hormones (PTH) levels exert catabolic effects on the bone. In contrast, PTH oscillations (as seen in healthy subjects) or daily application of teriparatide (a form of PTH consisting of the N-terminal 34 amino acids; it is used to treat osteoporosis) promote bone formation. These differential responses have important clinical and therapeutic implications. Although the anabolic effects of PTH (and teriparatide) cycling are widely accepted, the underlying osteo-anabolic dynamics are not well understood. Method A recently developed mechanistic physiology-based model quantitating the interrelations of osteoclasts, osteoblasts and osteocytes on bone remodeling is used (Cherif et al., ΝΔΤ 2018, 33 (συππλ. 1): 165–166). The model incorporates cell-to-cell signaling pathways (i.e., RANK-RANKL-OPG), intracellular pathways, cytokines (i.e. TGFβ), PTH, sclerostin, and endocrine and paracrine feedbacks. Using the validated model, we explore the effect of altered PTH (teriparatide) administration regimen (e.g., dosing frequency and amplitude) on bone catabolism and anabolism, respectively. Results As in previous studies, the model accurately predicts differential responses of osteo-anabolic and catabolic effects of continuously and intermittently elevated PTH (teriparatide) levels, respectively. In addition, we observe that intermittent administration of PTH with a high frequency and amplitude induces bone catabolism similar to that seen in pathologies with continuously elevated PTH (i.e. primary or secondary hyperparathyroidism). We see a more than 3-fold change from baseline in osteoclastic over osteoblastic activities, resulting in a bone efflux of calcium and phosphate. Low PTH frequency with high dosing amplitude induces both osteoclastic and osteoblastic activities, but the net result is bone anabolism. Further, Fig. 1 shows a nonlinear region where high osteoblastic activities exceed osteoclastic resorption. These findings suggest the existence of optimal PTH (teriparatide) frequency-amplitude combinations that enhance anabolic gains, beyond which there can be a detrimental effect on bone. Conclusion Our results suggest that both frequency and amplitude of PTH (teriparatide) cycling affect the balance of osteo-catabolic and -anabolic effects. Understanding the underlying mechanism of differential osteo-anabolic and -catabolic responses induced by intermittent and continuous levels of PTH, respectively, may provide new therapeutic options for patients and minimize unintended consequences of intervention protocols.

Hyperparathyroidism in Pregnancy Leading to Pancreatitis and Preeclampsia with Severe Features

Background. Hyperparathyroidism is underdiagnosed in pregnancy, yet early diagnosis is necessary for the potentially severe sequelae of hypercalcemia for both the woman and fetus.Case. A 31-year-old, gravida 3, para 0-0-2-0 at 32 weeks and 3 days of gestation, presented with preeclampsia with severe features concomitant with acute pancreatitis and known diabetes mellitus type 2. She was stabilized and delivered. In the postpartum period, her total calcium level remained elevated. Ionized calcium levels and parathyroid hormone levels were also elevated, and she was diagnosed with hyperparathyroidism.Conclusion. Hyperparathyroidism and hypercalcemia are risk factors for pancreatitis. Women who develop pancreatitis during pregnancy are at increased risk of developing preeclampsia. If elevated serum calcium is noted, it should be confirmed with ionized calcium level and parathyroid hormones as ionized calcium levels are unaffected by pregnancy.