Na2EDTA Infusion Research Articles

Induction of hypocalcaemia and evaluation of reticuloruminal motility using a three-axis accelerometer

Context Reticuloruminal motility, which is continuous and regular, is essential for digestive activity, but some functional abnormalities can appear in cattle with several metabolic disorders. Particularly in periparturient dairy cows, decreased blood calcium concentrations induce deterioration of rumen motility as well as the risk of reproductive disorders. Aims This study aimed to evaluate reticuloruminal motility using a bolus-type biosensor incorporated with a three-axis accelerometer (3XA) following induction of hypocalcaemia by infusion of ethylenediamine–tetraacetic acid disodium salt dihydrate (Na2EDTA) solution. Methods In the 2 × 2 crossover experiment, six non-pregnant and non-lactating cows were assigned to each of the treatment (TRE) and control (CON) groups and infused for 1 h with 13% Na2EDTA solution and physiological saline respectively. The cylindrical biosensor was fed and placed in the reticulum before the experiment, and the three acceleration values of each cow were recorded and transmitted wirelessly. Considering the device shape, the reticuloruminal motility was represented as the vector value (V2) calculated with each change in X- and Z-axis acceleration over time. Key results Plasma calcium concentrations were measured to confirm hypocalcaemia, and the average was significantly decreased to 1.23 mmol/L at 1 h in TRE. The mean V2 value was significantly decreased in TRE compared with CON, from 1 to 2 h after Na2EDTA infusion. Conclusion 3XA was able to detect a change in reticuloruminal motility caused by hypocalcaemia. The use of 3XA in cattle will allow for rapid treatment of hypocalcaemia or other metabolic disorders that reduce productivity. Implications The 3XA inserted into the reticulum of a dairy cow detected a decrease in reticuloruminal motility wirelessly caused by induced hypocalcaemia.

Validation of the bovine blood calcium checker as a rapid and simple measuring tool for the ionized calcium concentration in cattle

Point-of-care (POC) devices that veterinary practitioners can use to easily and rapidly measure blood ionized calcium (iCa) levels in cows immediately after withdrawing a blood sample on the dairy farm are needed. Aims of present studies was to compare the commercially available ion-selective electrode handheld iCa meter (bovine blood iCa checker) with the benchtop blood gas analyzer GEM premier 3500 and handheld analyzer i-STAT 1. Sixty-two paired-point whole blood samples were obtained from three cows with hypocalcemia experimentally induced by Na2-EDTA infusion. Whole blood samples were also obtained from the 36 cows kept on a farm in field conditions. The results using the bovine blood iCa checker correlated with those using the GEM premier 3500 and i-STAT 1. Bovine blood iCa checker was “compatible” with the GEM premier 3500 and i-STAT 1 because the frequency of differences between the measurements within ± 20% of the mean were 100% (65/65, >75%) and 90.8% (59/65, >75%), respectively. In the field trial, the blood iCa concentration measured by the bovine blood Ca checker was significantly positively correlated with that measured by the i-STAT 1 portable analyzer. Bovine blood iCa checker was “compatible” with the i-STAT 1 because the frequency of differences between the measurements within ± 20% of the mean was 100% (36/36, >75%). Results from these findings, the bovine blood iCa checker may be applied as a simplified system to measure the iCa concentration in bovine whole blood.

Changes in plasma pH and blood and urinary macromineral concentrations in experimentally induced hypocalcemic cows with Na2EDTA.

This study was performed to confirm the alterations of blood and urine parameters in artificially induced hypocalcemic cows. For a 2 × 2 cross-over design, four non-pregnant, non-lactating Holstein Friesian cows (623 ± 63 kg) were utilized. Cows in the treatment and control group were infused with ethylenediaminetetraacetic acid (Na2EDTA) solution and normal saline through an intravenous catheter for 3 hr, respectively. Laboratory analyses included complete blood cell count, plasma chemistry, blood gas analysis and urine chemistry. During the hypocalcemic period, abnormal signs were not observed clinically, hematologically nor biochemically either in groups. But, plasma calcium and magnesium concentrations continued to decrease throughout Na2EDTA infusion, and significant group differences (P<0.05 or P<0.001) were detected until 5 hr after the initiation of infusion. Urinary excretions of these minerals were significantly reduced compared to the control group by 6 hr (Ca, P<0.05; Mg, P<0.001). Moreover, there is a significant group difference in the change in plasma pH at 1 hr after Na2EDTA infusion (P<0.05) and maintained a decreased level until 6 hr. Consequently, the blood pH was diminished simultaneously with hypocalcemia and hypomagnesemia induction in cows infused with Na2EDTA. This phenomenon may be one of the mechanisms to recover normocalcemia including maximizing the effect of parathyroid hormone, however, further studies are needed to elucidate the mechanism to alter the blood pH in hypocalcemia.

Acute Hypocalcemia Enhances Prolactin Levels : A Study before and after Oophorectomy

The effect of acute hypocalcemia on serum prolactin values was investigated in 13 female subjects before and after oophorectomy. An infusion of disodium-EDTA (50 mg/kg b.w., for 120 min) was administered to each patient. Ionized calcium, immunoreactive parathyroid hormone and prolactin serum levels were determined 15 min prior to the infusion, at the beginning of each infusion and thereafter at every 30 min interval. The decrease in serum ionized calcium induced by Na2-EDTA infusion was not influenced by surgery. Serum prolactin and parathyroid hormone values before and after oophorectomy showed a significant (p less than 0.01) increase at 90 and 120 min. The maximum serum prolactin increase was achieved at 120 min and was not influenced by oophorectomy. The results demonstrate that acute hypocalcemia increases serum prolactin levels in female subjects and suggest a possible role for parathyroid hormone and dopaminergic system, even if their interaction remains speculative.

Hypocalcemia Reduces Endogenous Glucose Production in Hyperketonemic Sheep

In previous experiments it has been shown that hyperketonemia lowered plasma glucose concentration in sheep and depressed endogenous glucose production by approximately 30%. This facilitates the onset of pregnancy toxemia. In the last trimester of gestation, hyperketonemia in sheep is often associated with hypocalcemia. There is an indication that hypocalcemia exerts an additional depressive effect on endogenous glucose production. The present study was undertaken to examine the effect in sheep of hypocalcemia on endogenous glucose production in the presence of normo- and hyperketonemia. The experiments were carried out with seven multiparous sheep during three different reproductive states, i.e., during pregnancy (10±8 d prepartum), during lactation (21±8 d postpartum), and 4wk after weaning of the lambs. Concentration of glucose in plasma, turnover of glucose and the rate constant of glucose turnover were measured by isotope dilution during normo- and hypocalcemia and in the presence of normal and elevated β-hydroxybutyrate (BHB) concentrations. Hypocalcemia was induced by i.v. infusions of Na2EDTA. Hyperketonemia was maintained by i.v. infusion of DL-β-hydroxybutyrate. The experiments showed that induction of hypocalcemia: 1) induced a decline in plasma glucose concentration in all reproductive states during normo- and hyperketonemia and 2) significantly lowered endogenous production of glucose in nonpregnant hyperketonemic and in lactating normoketonemic ewes. Pregnant normoketonemic ewes were able to compensate for the hypoglycemic effect of hypocalcemia and to keep endogenous production at the normocalcemic level. We concluded that hypocalcemia does not promote the onset of pregnancy toxemia per se but will facilitate the development of the disease when it is present in combination with hyperketonemia.

Plasma Calcium, Inorganic Phosphate and Magnesium During Hypocalcaemia Induced by a Standardized EDTA Infusion in Cows

The intravenous Na2EDTA infusion technique allows effective specific chelation of circulating Ca2+ leading to a progressive hypocalcaemia. Methods previously used were not described in detail and results obtained by monitoring total and free ionic calcium were not comparable due to differences in sampling and analysis. This paper describes a standardized EDTA infusion technique that allowed comparison of the response of calcium, phosphorus and magnesium between 2 groups of experimental cows. The concentration of the Na2EDTA solution was 0.134 mol/l and the flow rate was standardized at 1.2 ml/kg per hour. Involuntary recumbency occurred when ionised calcium dropped to 0.39 – 0.52 mmol/l due to chelation. An initial fast drop of ionized calcium was observed during the first 20 min of infusion followed by a fluctuation leading to a further drop until recumbency. Pre-infusion [Ca2+] between tests does not correlate with the amount of EDTA required to induce involuntary recumbence. Total calcium concentration measured by atomic absorption remained almost constant during the first 100 min of infusion but declined gradually when the infusion was prolonged. The concentration of inorganic phosphate declined gradually in a fluctuating manner until recumbency. Magnesium concentration remained constant during infusion. Such electrolyte responses during infusion were comparable to those in spontaneous milk fever. The standardized infusion technique might be useful in future experimental studies.

The course of selected bone resorption marker concentrations in response to short-term hypocalcemia experimentally induced with disodium EDTA infusions in dairy cows.

The collagen metabolites hydroxyproline (HYP), deoxypyridinoline (DPD), and the carboxyterminal telopeptide of type I collagen (ICTP) are suitable markers for bone resorption in humans and several animal species. The purpose of this study was to describe the course of bone resorption markers during short-term hypocalcemia induced with disodium ethylenediaminetetraacetic acid (Na2EDTA) and to investigate whether bone resorption is increased in dairy cows under these conditions. EDTA infusions have been used as a model for periparturient paresis in dairy cows and to estimate the calcium mobilization rate from body reserves in ruminants. In this study, hypocalcemia was induced by means of a 5% Na2EDTA infusion (0.55 mg/kg/min Na2EDTA for 5 h = total dose of 100.6 g). Two experiments were conducted: (1) Six 4-11 years-old Brown Swiss cows were infused intravenously with EDTA for 5 h. Blood and urine samples were taken repeatedly from 1 day before until 10 days after infusion. (2) Towards the end of the lactation, the experiment was repeated with the same animals after a 14-day-period of feeding a low calcium diet (26 g/animal per day). The EDTA-infusion induced hypocalcemia and hypophosphatemia. The HYP-, DPD- and ICTP-concentration remained mainly unaffected during both infusions. Only DPD showed an increase during infusion and HYP an increase 2 days after the infusion. In conclusion, the EDTA infusion had little effect on the concentrations of the measured bone markers, which may be due to the fact that the serum calcium pool was refilled by increased absorption of Ca via the gastrointestinal tract. From these results, it can be concluded that bone resorption was not influenced by EDTA infusion.

Induced hypocalcaemia by Na2EDTA infusion. A review.

Disodium ethylenediaminetetraacetate (Na2EDTA) has been used in infusion studies in cows and other species for more than 35 years, primarily for the induction of hypocalcemia as a model for milk fever. This paper reviews such studies and discusses blood calcium kinetics, toxicology, changes in various blood parameters and the effect on blood circulation, cardiac function and smooth muscle motility in the gastro-intestinal tract and in the pregnant uterus. It is concluded that Na2EDTA infusion may serve as a valid model for spontaneous hypocalcemia. However, experimental results may vary with factors such as the choice of method for blood total calcium analysis, and the rate of EDTA infusion. Standardization of these and certain other experimental conditions may greatly improve the comparability of results obtained in EDTA infusion studies. For cows, an infusion rate of 1.2 ml/kg/h of a 5% (w/v) solution, corresponding to 0.25 mmol/kg/min, has been suggested as a standard infusion.

Effect of Hypocalcaemia on Glucose Metabolism in Hyperketonaemic Piglets

In nine 2- to 3-month-old hyperketonaemic piglets the kinetics of glucose and D-beta-hydroxybutyrate (D-BHB) metabolism were studied during hypo- and normocalcaemia in paired experiments. Hyperketonaemia (1.3 and 2.5 mmol D-BHB (l plasma)-1) was generated by a stepwise increase of DL-BHB infusion. Hypocalcaemia spontaneously developed in five piglets due to an inherited calcitriol deficiency and was induced in four control piglets by a continuous infusion of Na2-EDTA. The method of single isotopic marker injections of glucose and D-BHB was used to calculate replacement rates, rate constants and half-lives of glucose and D-BHB in plasma. When DL-BHB was infused at the same rate into normo- and hypocalcaemic piglets, hypocalcaemia reduced the rate constant of glucose by 20-30% and the replacement rate of glucose by 34%. In the presence of hyperketonaemia, hypocalcaemia increased the rate of replacement of D-BHB by 6-40%. The replacement rate represents the sum of endogenous production and the rate of DL-BHB infusion. This observation shows that the endogenous production of D-BHB was higher during hypocalcaemia than during normocalcaemia.

Hypocalcemia induced by intravenous administration of disodium ethylenediaminotetraacetate and its effects on excretion of calcium in urine of cows fed a high chloride diet.

Evidence supports the theory that a diet that is rich in nonmetabolizable anions fed to dairy cows during the dry period reduces the risk of hypocalcemic paresis puerperalis. When cows are fed a diet that is rich in anions instead of cations, more Ca is absorbed in the intestine and excreted in urine. We hypothesized that, in cows fed a diet that was rich in anions, the increased flow of Ca through the body could be drained to support the maintenance of plasma Ca concentration around parturition. The hypothesis was tested by binding plasma Ca through intravenous administration of Na2-EDTA and measuring excretion of Ca in urine. In a 2-period x 14-d crossover study, six, nonpregnant, nonlactating, multiparous cows were fed either a diet that was rich in cations (dietary cation-anion difference = +332 meq/kg of dry matter) or rich in anions (dietary cation-anion difference = -230 meq/kg of dry matter). On the last day of each feeding period, Na2-EDTA was infused intravenously until the amount of plasma Ca that was not bound to EDTA reached approximately 1 mmol/L. The amount of EDTA that could be infused was significantly greater when the cows were fed the diet that was rich in anions. During the infusion of Na2-EDTA the rate of Ca excretion in urine dropped to almost 0 when the diet that was rich in anions was fed. After feeding the diet that was rich in cations, excretion of Ca in urine was negligible and was not reduced further by Na2-EDTA infusion. Thus, in cows fed a diet that was rich in anions, the Ca intended for excretion with urine can be used when plasma Ca is under stress as would occur at the onset of lactation. However, the amount of Ca derived from plasma, interstitial fluid, and the skeleton during Na2-EDTA infusion was quantitatively much more important to the supply of Ca than was the reduction in excretion of Ca in urine. Most likely, this relationship would also be true when the production of colostrum begins.

Unexpected outcome after two consecutive infusions of disodium EDTA in dairy cows.

Disodium ethylenediaminetetraacetic acid (Na2EDTA) is a cation chelator which is used as an anticoagulant in blood samples and as a therapeutic agent in lead poisoning. Several experiments have been carried out with EDTA to induce hypocalcemia in cows and other animals, and toxic effects have rarely been reported. In this study, hypocalcemia was induced by means of a 5% Na2EDTA infusion (0.55 mg/kg/min Na2EDTA for 5 h = total dose of 100.6 g). Accidental acute toxicity and fatalities occurred after a consecutive second infusion in several cows. Researchers designing new experiments should be aware of a potential EDTA toxicity at a routinely used dose and rate of administration.

Rumen Motility During Induced Hyper- and Hypocalcaemia

Rumen motility was recorded on an experimental cow by means of telemetric signal transfer from strain gauge force transducers fixed surgically on the peritoneal surface of the rumen wall in the left flank. The normocalcaemic cow was given a standard milk fever treatment with calcium borogluconate (400 ml with 14 mg Ca/ml) intravenously. Transient clinical signs were: decreased rumination, muscle ticks, salivation and a heart rate reduction of 20%. Rectal temperature remained unaltered. Frequency of rumen contractions was reduced up to 40% whereas amplitude of contractions did not deviate from baseline values. Hypocalcaemia was induced in a second experiment by iv infusion of Na2EDTA. At 0.60 mmol/l ionized blood calcium periods of no motility were recorded whereas inactivity of rumen activity was persistent at 0.55 mmol/l ionized blood calcium. The cow went down at 0.45-0.48 mmol/l ionized blood calcium at which point the heart rate was increased by 40%. The high sensitivity of the method employed allowed the conclusion that already at a concentration of ionized blood calcium at 1.0 mmol/l both frequency and amplitude of rumen contractions decreased rapidly although eating behaviour and rumination appeared unaffected during the short term observation periods. Implications of this finding towards health and production in transition cows are discussed.

Functional evidence for two types of parathyroid adenoma.

The carboxyterminal parathyroid hormone (C-PTH)/intact (I-) PTH ratio is influenced by serum calcium concentrations in man, increasing to a maximum value in hypercalcaemia and decreasing to a minimum value in hypocalcaemia. We decided to use this ratio to screen for parathyroid tumour with a normal sensitivity to calcium, symptomatic mainly through a mass effect. Nineteen patients with hypercalcaemia and elevated or inappropriate PTH, were studied in the basal state and during CaCl2 and Na2EDTA infusion and compared with 26 normal individuals. They all had one parathyroid adenoma removed surgically, and two remained hypercalcaemic. In the basal state, the patients were hypercalcaemic (ionized calcium 1.44 +/- 0.12 vs. 1.23 +/- 0.03 mmol/l, P < 0.001) and had elevated PTH levels (I-PTH: 10.8 +/- 8.0 vs. 2.3 +/- 0.6 pmol/l, P < 0.001; C-PTH: 31.6 +/- 38.9 vs. 5.25 +/- 1.11 pmol/l, P < 0.001) when compared with normals. Their mean C-PTH/I-PTH ratio was similar to normals (2.7 +/- 1.3 vs. 2.4 +/- 0.6, NS) but, when individual values were considered, three patients had elevated values at 4.9, 5.3 and 5.8 (normal = 1.2-3.6). The regression line between basal C- and I-PTH revealed a significantly higher slope in these patients (P < 0.0001). The 16 patients with a normal basal C-PTH/I-PTH ratio had, as a group, an increased set point of I- or C-PTH stimulation by calcium and increased values of stimulated and non-suppressible I- and C-PTH, but these abnormalities were not all present in the smaller tumours (< or = 200 mg). Only three tumours in that group were larger than 1000 mg. Serum calcium concentration was related to the increased set point and non-suppressible fraction of I-PTH in these patients (r2 = 0.797). The three patients with a high basal C-PTH/I-PTH ratio had large tumours (2346, 4364 and 17,300 mg) and were more difficult to study, requiring a larger decrease in calcium concentration to achieve maximal stimulation. In the basal state, they were already expressing a non-suppressible level of I- or C-PTH and already had a maximal C-PTH/I-PTH ratio. Our data further suggest a normal set point of I- and C-PTH stimulation in the two patients who achieved sufficient hypocalcaemia and a normal set point of C-PTH/I-PTH ratio modulation in these three patients. Their hypercalcaemia was essentially related to the non-suppressible fraction of PTH. Furthermore, larger tumours were less active than smaller ones and produced less stimulated I-PTH/100 mg of tissue. These data indicate two types of parathyroid tumours when calcium sensitivity is considered: (1) a majority of small tumours with abnormal sensitivity to calcium, symptomatic through an abnormal set point and an increased non-suppressible fraction and (2) a smaller number of larger tumours, with normal sensitivity to calcium and an increased non-suppressible fraction, of PTH.

Adaptation of parathyroid function to intravenous 1,25-dihydroxyvitamin D3 or partial parathyroidectomy in normal dogs.

Parathyroid function was studied in 14 normal dogs 1 month before and after daily i.v. administration of 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) (eight dogs), or about 50% parathyroidectomy (six dogs), to test the hypothesis that degradation of newly synthesized intact parathyroid hormone (I-PTH) is involved in parathyroid gland adjustment to a modified demand for I-PTH. Parathyroid function was studied through i.v. infusions of Na2EDTA and CaCl2 and measurement of ionized calcium (Ca2+), I-PTH and carboxyl-terminal PTH (C-PTH) at various time points. The C-PTH/I-PTH ratio was used as an index for change in the relative proportion of circulating C-PTH vs I-PTH, 1 month prior to and following each intervention. This ratio was further validated by looking at the HPLC profile of I- and C-PTH in hypo- and hypercalcemia under experimental conditions. Basal Ca2+ was unaltered 1 month after surgery, and was maintained constant in the 1,25-(OH)2D3-treated group by gradually decreasing 1,25-(OH)2D3 doses over time from 0.25 to 0.13 microgram twice daily during the last week of the experimental protocol. In this same group, basal 1,25-(OH)2D3 was increased by 65% (P < 0.0001) and basal I-PTH was decreased by 40% (P < 0.05), while basal C-PTH and the C-PTH/I-PTH ratio remained unchanged. Stimulated and non-suppressible I- and C-PTH followed the same pattern with, this time, an increase of stimulated and non-suppressible C-PTH/I-PTH ratio of 60% (P < 0.05) and 85% (P < 0.05) respectively. There was no change in basal I-PTH, C-PTH, or C-PTH/I-PTH ratio after surgery. However, stimulated I- and C-PTH were decreased by 45% (P < 0.005) and 65% (P < 0.005) respectively, with a 30% (P < 0.005) decrease of stimulated C-PTH/I-PTH ratio. There was no change in non-suppressible I-PTH, while non-suppressible C-PTH decreased by 55% (P < 0.005), with a 55% (P < 0.05) decrease in non-suppressible C-PTH/I-PTH ratio. The HPLC profiles of I- and C-PTH obtained in hypo- and hypercalcemia disclosed a similar distribution of the immuno-reactivity into peaks before and after i.v. administration of 1,25-(OH)2D3 as well as partial parathyroidectomy. This indicated that C-PTH/I-PTH ratio changes were related to different circulating levels of I- and C-PTH rather than to a different composition of I- and C-PTH. These data indicate a shift in the circulating PTH profile toward more PTH carboxyl-terminal fragments after 1 month of i.v. 1,25-(OH)2D3, but toward more intact PTH 1 month after about 50% parathyroidectomy, possibly reflecting adjustments in PTH degradation induced by a modified demand for I-PTH. Although these changes are most likely modulated at the parathyroid gland level, we cannot formally eliminate participation of the hormone's peripheral metabolism.

Effects of hypocalcaemia on blood flow to the ovaries of the sheep.

The objectives of the study were to use sheep as a model to determine whether a reduction in plasma calcium concentration similar to that observed during periods of postpartum subclinical hypocalcaemia in lactating dairy cattle might affect the blood flow to the ovaries. Different levels of hypocalcaemia were induced in each of six, non-pregnant sheep by the slow intravenous infusion of Na2-EDTA. Measurements of blood flow to the ovaries were made before and after the induction of hypocalcaemia, using 113Sn and 46Sc radiolabelled microspheres. As plasma ionized calcium was reduced, there was a significant decline in ovarian blood flow. Ovarian blood flow (percentage of resting) = 0.54 Ca++ (percentage of resting) + 58.4. This model was significant at P < 0.01, with R2 = 0.92. Accordingly, a reduction in plasma ionized calcium of 50% would yield a reduction in ovarian blood flow of 16%.

Influence of Ca2+ concentration on the clearance and circulating levels of intact and carboxy-terminal iPTH in pentobarbital-anesthetized dogs.

The role of hormone secretion and hormone clearance in the differential control of circulating levels of intact (I-) and carboxy-terminal (C-) immunoreactive parathyroid hormone (iPTH) was evaluated in 18 pentobarbital-anesthetized dogs. Catheters were installed in the aorta, left renal, and hepatic veins for sampling. Hepatic and renal blood flows were calculated from sulfobromophtalein (BSP) and p-aminohippuric acid (PAH) extraction and clearance. I- and C-iPTH were measured during a 1 h of infusion of CaCl2 or Na2EDTA. High-performance liquid chromatography (HPLC) profiles of I- and C-iPTH in and out of the liver and kidney were also obtained. Data on two dogs (one CaCl2 and one Na2EDTA infusion) were pooled for the analysis of one parathyroid function using a four-parameter mathematical model. Results obtained in the basal state and during analysis of the parathyroid function were also compared with those of 24 awakened dogs. Results are means +/- SD. Anesthetized dogs had lower levels of Ca2+ (1.29 +/- 0.03 vs. 1.34 +/- 0.04 mmol/l; p < 0.001) and higher levels of I- (11.5 +/- 5.7 vs. 3.0 +/- 1.9 pmol/l, p < 0.001) and C-iPTH (52 +/- 20.9 vs. 22.8 +/- 10.5 pmol/l; p < 0.001) than awakened dogs. Their stimulated (S) and nonsuppressible (NS) I-iPTH levels were increased 2- and 4-fold, respectively, while similar C-iPTH levels rose only 1.35- and 1.75-fold; this caused their S (4.4 +/- 0.7 vs. 6.8 +/- 1.9; p < 0.001) and NS (24.6 +/- 11.8 vs. 49.8 +/- 27.5; p < 0.05) C-iPTH/I-iPTH ratios to decrease. This was not explained by different renal clearance rates of I- and C-iPTH since both were similar at approximately 10 ml/kg/minute and unaffected by Ca2+ concentration. Clearance of all I- and C-iPTH HPLC molecular forms by the kidney appeared equal. A 50% decrease in the hepatic clearance of I-iPTH to approximately 12 ml/kg/minute in pentobarbital-anesthetized dogs, related to a lower hepatic blood flow, explained the higher levels of S and NS I-iPTH in these animals. I-iPTH hepatic clearance was unaffected by Ca2+ concentration. C-iPTH hepatic clearance was much lower at approximately 5 ml/kg/minute, abolished by hypercalcemia, and reduced by the influence of anesthesia on hepatic blood flow. This also explained the higher S C-iPTH levels in anesthetized animals. I-PTH(1-84) detected by the C-iPTH assay explained only 37.6% of the hepatic C-iPTH clearance in hypocalcemia and 73.3% in hypercalcemia. Overall, our results indicate that total C-iPTH clearance is about 40.2% that of I-iPTH in hypocalcemia and 41.3% in hypercalcemia. This would only explain a 2.4- to 2.5-fold difference in circulating levels of I- and C-iPTH if secretion rates were equal; the larger difference observed in S and NS C-iPTH/I-iPTH ratio values is thus mainly explained by different production rates.

Experimental production of hypocalcemia by EDTA infusion in calves: a critical appraisal assessed from the profile of blood chemicals and enzymes.

Physiological studies of the effects of Ca2+ withdrawal using Na2EDTA have been conducted with the prior basic assumption that Na2EDTA-specific direct or indirect effects on the functions under study were negligible. The present study aimed at providing unequivocal confirmation of such assumption by establishing the pattern of response of blood constituents to intravenous infusions of Na2EDTA in calves. Na2EDTA infusion in calves allowed effective chelation of blood Ca2+, leading to a progressive hypocalcemia. Magnesium levels remained constant and concentrations of other ions (Na+, K+, Pi, H+, HCO3-), although significantly altered (P < or = 0.0001), remained within the normal range. Comparison of enzymes, urea, and creatinine changes precluded renal, hepatic, or muscular parenchymatous damages as being the cause of dysfunctions in the context of Na2EDTA-induced hypocalcemia. It was not possible, however, to standardize the Na2EDTA infusion characteristics (flow, volume) to obtain previsible Ca2+ decay in different animals. Conversely, monitoring of systemic arterial pressure (SAP) offered a precious tool to estimate the degree of hypocalcemia reached. Infusion rate must, therefore, be manipulated using careful on-line monitoring of SAP to obtain an experimental range of Ca2+ as large as possible. It was concluded that physiological data collected during Na2EDTA perfusions can be reliably discussed in terms of Ca2+ dependence rather than in terms of either Na2EDTA toxicity, electrolytes maladjustment, acid-base imbalance, impaired blood oxygenation, or hepatic, renal, myocardic, or skeletal muscle damages.

Phosphorus and protein restriction and parathyroid function in chronic renal failure

Phosphorus retention as a result of chronic renal failure (CRF) induces secondary hyperparathyroidism (HPT II) while supplemented low-phosphorus low-protein diets (LPD) prevent it. The aim of this study was to assess in seven patients with advanced CRF and biological HPT II the effects of a LPD providing daily 5 to 7 mg/kg phosphorus, 0.4 g/kg protein, 300 mg calcium (Ca) and supplemented with amino acids, ketoacids, CaCO3 and vitamin D2, on the relationship between ionized Ca (iCa) and PTH concentrations. Hyper- and hypocalcemia were induced by CaCl2 and Na2-EDTA infusion. After three months of LPD, serum phosphorus decreased from 1.59 +/- 0.15 to 1.26 +/- 0.24 mmol/liter (mean +/- SEM, P < 0.02), basal PTH levels from 251 +/- 25 to 127 +/- 16 pg/ml (P < 0.03), while basal iCa and GFR did not vary. The sigmoidal PTH-calcium curve shifted downward with maximal PTH decreased from 482 +/- 86 to 319 +/- 60 pg/ml (P < 0.02) and minimal PTH from 35 +/- 4 to 21 +/- 4 pg/ml (P < 0.05). On the other hand, the slope of the % maximal PTH-iCa curve, which is an indicator of the sensitivity of the parathyroid cell to changes in iCa concentrations, did not vary significantly. The set point of Ca and calcitriol levels were not modified. These results demonstrate a direct inhibition of PTH secretion over a wide range of iCa concentration by LPD in patients with advanced CRF and mild HPT II over a three months period. This effect is independent of changes in plasma calcitriol levels.

Lack of involution of hyperplastic parathyroid glands in dogs: adaptation via a decrease in the calcium stimulation set point and a change in secretion profile.

This study analyzes the parathyroid function in four dogs before and after 2 years of a low-calcium, high-sodium, vitamin D-deficient diet and the involution of the same function following (1) correction of dietary calcium deficiency and administration of i.v. 1,25-(OH)2D (0.25 micrograms twice per day) during 1 month, (2) after an additional month of normal dog chow supplemented with oral vitamin D (25 micrograms per day), and, finally, (3) after 5 and 17 months of a diet with normal levels of calcium and vitamin D. The parathyroid function was evaluated through i.v. infusion of CaCl2 and Na2 EDTA with measurement of intact (I) and carboxyl-terminal (C) immunoreactive parathyroid hormone (iPTH). The C-iPTH/I-iPTH ratio was calculated to assess the modulation of molecular forms of iPTH induced by the various treatments. The 2 years of calcium and vitamin D deprivation lowered ionized calcium (1.23 +/- 0.04, p < 0.05) and 25-OHD (4.02 +/- 2.06 nM, p < 0.005) and tended to decrease 1,25-(OH)2D (80.8 +/- 8.6 pM); it increased basal I- and C-iPTH levels approximately eightfold (I-iPTH, 40.2 +/- 20.7, p < 0.05; C-iPTH, 185.4 +/- 94.9, p < 0.05) and stimulated I-iPTH (60.2 +/- 23.0 pM, p < 0.05) and C-iPTH (239.6 +/- 80.7 pM, p < 0.05) fivefold. A greater rise in nonsuppressible I-iPTH levels than in C-iPTH levels led to a decreased C-iPTH/I-iPTH ratio in hypercalcemia (12.5 +/- 2.8 versus 27.8 +/- 6.05 pM, p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Immunological evidences for post-translational control of the parathyroid function by ionized calcium in dogs

To outline the role of post-translational events in the control of the parathyroid function in vivo, we have studied the parathyroid function of normal dogs receiving i.v. infusions of CaCl2 and Na2EDTA with intact (I), carboxylterminal (C) and midcarboxylterminal (M) iPTH assays and evaluated the influence of ionized calcium on circulating molecular forms of iPTH via alterations in C/I, M/I and M/C iPTH ratios. Furthermore, the use of the mathematical model fitting the sigmoidal relationship between ionized calcium and iPTH ratios was improved through the generation of more iPTH ratio points in the ascending part of the sigmoid function. Quantitatively, the response to hypocalcemia was highest with M (98.7 +/- 36.8 pmol/l; P < 0.0167 vs. L and P < 0.0001 vs. I) and higher with L (83.1 +/- 26.1 pmol/l; P < 0.0001 vs. I) than with I (12.1 +/- 3.2 pmol/l). Similar results were observed for the non-suppressible fraction of iPTH measured by the three iPTH assays in hypercalcemia. The slope of the sigmoid function was more acute for I than for C or M, while all three secretion set-points were similar at 1.30 mmol/l. Qualitatively, all iPTH ratios increased from hypo- to hypercalcemia, results being more pronounced for the M/I and C/I iPTH ratios (7.66 +/- 2.57 to 73.9 +/- 41.4 and 6.76 +/- 1.93 to 49.8 +/- 27.5) than for the M/C iPTH ratio (1.24 +/- 0.48 to 1.82 +/- 1.16). The slopes of the three ratios were similar as were the set-points, but in this last case, values were higher (1.40 mmol/l) than for secretion set-points. These results indicate that dog parathyroid function is similar to that of man. The lower set-points for secretion and higher ones for regulating M/I and C/I iPTH ratios favor an optimal amount of I in face of decreasing ionized calcium and permit to control the non-suppressible fraction of iPTH secretion via M and C fragments production in face of increasing ionized calcium. These events are important to understand the implication and signification of post-translational events in the parathyroid glands and in peripheral blood in the phenomenon of PTH immunoheterogeneity. They further outline that the tools used here will be useful to study similar phenomenons in individuals in face of diseased parathyroid glands.