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In vitro, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) induces differentiation of HL-60 cells and inhibits their proliferation as well as the proliferation of leukemic cells from patients. In vivo, the survival of mice challenged with syngeneic leukemic cells is enhanced by treatment with 1,25(OH)2D3. Patients treated with 1,25(OH)2D3 develop hypercalcemia at a serum level of 2 x 10(-10) mol/l which is a concentration too low to achieve an antileukemic effect in vitro. Several interesting vitamin D3 analogs have recently been developed. We initially examined the effect of 1,25(OH)2-16ene-23yne-19-nor-26,27-F6-D3 and 24a,26a,27a-tri-homo-22,24-diene-1-alpha,25-(OH)2-D3 on clonal growth and differentiation of HL-60 cells. Each of the analogs had comparable effects on clonal growth with 50% inhibition (ED50) at concentrations of 0.2-0.5 x 10(-9) M; 1,25(OH)2D3 was about 20- to 50-fold less active in inhibiting growth. Differentiation was determined by induction of superoxide production, as measured by nitroblue tetrazolium (NBT) reduction and by expression of a macrophage-specific enzyme (alpha napthyl acetate esterase (ANAE)). The 24a,26a,27a-tri-homo-22,24-diene-1-alpha,25-(OH)2-D3 and 1,25(OH)2-16ene-23yne-19-nor-26,27-F6-D3 were about 5- to 14-fold more potent than 1,25(OH)2D3. The hypercalcemia inducing side-effects of these analogs and three other previously identified, extremely potent vitamin D3 compounds, as well as 1,25(OH)2D3, were studied. The analogs were administered intraperitoneally every other day (qod) for 5 weeks; serum was collected weekly and Ca2+ measured by atomic absorption spectrophotometry. The highest tolerated dose of each analog leaving all mice alive was for 1,25(OH)2D3: 0.25 micrograms; 1,25(OH)2-24a,26a,27a-tri-homo-22,24-diene-D3: 0.25 micrograms; and 1,25(OH)2-16ene-23yne-19-nor-26,27-F6-D3: 0.0625 micrograms. Another hexafluoro compound with potent abilities to induce differentiation (1,25(OH)2-16ene-23yne-26,27-F6-D3) was very toxic, all mice died in the second week while receiving 0.0625 micrograms qod. Prior studies showed that the most potent compound in inducing differentiation of HL-60 was 1,25(OH)2-20-epi-D3; but it is very toxic as only one mouse survived a dose of > or = 0.0125 micrograms qod for 5 weeks. 1,25(OH)2-16ene-23yne-D3 is an extremely active inducer of differentiation but, on the other hand, it has low potential to produce hypercalcemia; mice maintained normal serum calcium levels even while receiving 2 micrograms qod for 5 weeks.(ABSTRACT TRUNCATED AT 400 WORDS)

Both estrogen and androgen have been reported to attenuate cyclic AMP responses to parathyroid hormone stimulation in cultured bone cells. The present study examines the effect of in vivo estrogen deficiency on skeletal adenylate cyclase (AC) activity. The AC activity was compared in bone membranes prepared from normal female guinea pigs and from age-matched guinea pigs 3 weeks after ovariectomy. Histomorphometric analysis of femoral specimens from the ovariectomized guinea pigs demonstrated significant decreases in percentage bone volume, the percentage eroded surfaces and osteoclast numbers, and increased osteoid thickness, compared with the normal controls. No differences were found in basal AC activity, the ability of bone AC to be stimulated by parathyroid hormone (bPTH(1-34)) or isoproterenol, or in the regulation of AC activity by calcium and magnesium. We conclude that bone AC is not a direct target for estrogen effects on bone cells and that the reported effects of sex steroids on cAMP levels in bone cells probably act via an indirect mechanism.

Hypercalcemia of malignancy is a commonly encountered serious clinical problem that often requires aggressive therapy. In order to combine the rapid hypocalcemic effects of calcitonin with the more delayed effect of a bisphosphonate, we administered etidronate, 7.5 mg/kg/day intravenously and salmon calcitonin, 100 IU subcutaneously, every 12 hours for 3 days in 9 patients with hypercalcemia associated with malignancy. The mean serum calcium concentration fell from 3.33 +/- 0.1 mmol/liter (mean +/- SEM) to 2.88 +/- 0.1 mmol/liter within 24 hours (P less than 0.001). All patients had a fall in the serum calcium concentration of greater than 0.5 mmol/liter and it returned to normal in 7 of the 9 patients. We conclude that the combination of salmon calcitonin with etidronate more effectively lowers the serum calcium concentration in patients with hypercalcemia of malignancy then the use of either agent alone.

cAMP has been shown to mediate the response of the parathyroid gland to a number of agonists and appears to take part in the regulation of this gland by divalent cations as well. We have studied the effects of the concentrations of free magnesium (Mg+2) and ionic calcium (Ca+2) on the kinetic properties of normal porcine parathyroid adenylate cyclase. In a previous study we obtained evidence for two calcium inhibition sites in this enzyme complex. In the present study we observed that the Mg+2 concentration influences the relative contribution of these sites to the overall calcium inhibition. At a high Mg+2 concentration (10 mM), the high affinity site contributes less than 50% of the total calcium inhibitable activity, whereas at a Mg+2 concentration in the low physiological range (0.5 mM), the high affinity site accounts for all the calcium inhibitable activity. Mg+2 was found to be a potent activator of porcine parathyroid adenylate cyclase, with a Ka of Mg of 0.8-2 mM. Ionic calcium at low concentrations (0.2-5 microM) acts as a competitive inhibitor with respect to Mg+2 activation. The calcium inhibition constant was estimated to be 2-3 microM. The Km for ATPMg-2 was 0.3 mM, which is similar to that found in other studies of adenylate cyclase activity in parathyroid tissue. The effects of Ca+2 on enzymatic activity with respect to the ATPMg-2 concentration showed noncompetitive inhibition. The calcium inhibition constant with respect to its effect on Vmax (KIv) was 3 microM; the calcium inhibition constant with respect to its effect on the binding of ATPMg-2 (KIs) was 10 microM. It is concluded from these results that the concentrations of intracellular Ca+2 reported to be present in parathyroid cells could inhibit adenylate cyclase activity. The mode of calcium inhibition that involves competition with magnesium would be particularly significant at low intracellular Mg+2 concentrations, and this phenomenon may account for the parathyroid secretory defect which is a characteristic feature of the magnesium-deficient state.

Plasma membranes were prepared from mineralized guinea pig bone in order to study Mg2+ and Ca2+ modulation of skeletal adenylate cyclase. Plasma membrane preparation was accomplished by crushing the bone in liquid N2 and subsequent multiple washings in buffer containing EGTA to remove all Ca2+ prior to adenylate cyclase assay. Skeletal adenylate cyclase was found to be dependent on GTP and Mg2+ and responsive to bovine 1-34 PTH. Ca2+ caused a competitive inhibition of Mg2+ -activated skeletal adenylate cyclase. The apparent KaMg was 1.9 +/- 0.3 in the presence of 0.2 microM Ca2+ but increased to a mean of 7.2 +/- 1.3 in the presence of 5.0 microM Ca2+. Analysis of the Ca2+ inhibition curves at concentrations from .05 microM-1.0 mM were consistent with the presence of two Ca2+ inhibition sites, one with an apparent Ki of 1-2 microM and the other with an apparent Ki of approximately 500 microM. Lowering the Mg2+ concentration increased the contribution of the high affinity Ca2+ binding site to the overall Ca2+ inhibition, and raising the Mg2+ concentration had the opposite effect. While bPTH 1-34 enhanced adenylate cyclase activity, it did not increase the affinity of Mg2+ for skeletal adenylate cyclase nor did it alter the KiCa or the pattern of Ca2+ inhibition. These data may explain the skeletal resistance to PTH during Mg deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

A 1-min calcium injection was compared with a pentagastrin injection as provocative measures in stimulating calcitonin secretion in 4 patients with medullary thyroid carcinoma. In all cases the calcium injection resulted in a greater rise in serum calcitonin concentration. The patients tolerated the calcium injection well. However, two patients experienced substernal pressure and dyspnea following the pentagastrin injection. It is concluded that a 1-min calcium injection is a safe, rapid and effective procedure in the diagnosis of medullary thyroid carcinoma.

Seventeen surgically-induced postmenopausal (PM) women were randomized to receive either 0.625 mg of conjugated estrogens (CE) daily or 150 mg of intramuscular depomedroxyprogesterone acetate (DMPA) every 3 months. Urinary calcium/creatinine ratios were significantly higher than ratios of premenopausal controls before treatment, but were lower in all patients 2 months after both types of treatment. Compared to controls, all PM patients had similar levels of serum PTH and 25 hydroxy vitamin D before and after treatment. As a group, PM patients had lower levels of 1.25-dihydroxyvitamin D. In 5 patients who had levels which were below the normal range, 3 were treated with CE and 2 received DMPA. These patients all had significant increases in 1,25-dihydroxyvitamin D after treatment. Serum calcitonin did not change with either CE or DMPA treatment. These data suggest that, while both CE and DMPA lower calcium excretion in PM women, the mechanism(s) for the effects of hormonal treatment on bone resorption remain unsettled.