Synthetic Parathyroid Hormone-related Peptide Research Articles

Abaloparatide Treatment for Osteoporosis

Abstract Parathyroid hormone related peptide (PTHrP) is a paracrine factor produced by osteoblast lineage cells, which has a role in the regulation of bone remodeling and fracture repair. Early preclinical and clinical studies indicated that exogenous administration of PTHrP could have anabolic activity on the skeleton similar to that seen with exogenous PTH, but had potent vasodilatory effects which limited its clinical utility. Abaloparatide (Abalo) is a synthetic PTHrP(1-34) analog with 70% homology to PTHrP and 40% homology with Parathyroid hormone (PTH). Like PTH and PTHrP, Abalo interacts with the PTH1 receptor, however Abalo has higher affinity for the RG subtype of the Receptor and lower affinity for the R0 conformation (vs. PTH), resulting in relatively greater stimulation of bone formation and lesser bone resorption in preclinical models. Short-term clinical studies confirmed that Abalo had potent dose dependent anabolic activity with increases in BMD at the higher doses that were equal to or larger than that seen with PTH. In the Abalo Pivotal Trial, 2463 postmenopausal women with osteoporosis were randomized to blinded daily subcutaneous Abalo vs. placebo or open label PTH1-34. At 18 months, spine BMD had increased similarly with Abalo and TPTD, however, hip BMD increments were faster and significantly larger with Abalo. Consistent with the BMD effects, over 18 months, Abalo reduced vertebral fracture incidence by 86% and nonvertebral fracture incidence by 43%. The fracture risk reductions were sustained after both groups transitioned to antiresorptive medication. Abalo is a potent anabolic agent for treatment of osteoporosis and can be considered as initial therapy in patients at high risk for fracture.

Expression, Release, and Biological Activity of Parathyroid Hormone–Related Peptide From Coronary Endothelial Cells

Ventricular cardiomyocytes have previously been identified as potential target cells for parathyroid hormone-related peptide (PTHrP). Synthetic PTHrP peptides exert a positive contractile effect. Because systemic PTHrP levels are normally negligible, this suggests that PTHrP is expressed in the ventricle and acts as a paracrine mediator. We investigated the ventricular expression of PTHrP and its expression in cultured cells isolated from the ventricle, studied the release of PTHrP from hearts and cultures, and investigated whether this authentic PTHrP mimics the biological effects previously described for synthetic PTHrP on ventricular cardiomyocytes. We found PTHrP expressed in ventricles of neonatal and adult rat hearts. In cells isolated from adult hearts, we found PTHrP expression exclusively in coronary endothelial cells but not in cardiomyocytes. The latter, however, are target cells for PTHrP. PTHrP was released from isolated perfused hearts during hypoxic perfusion and from cultured coronary endothelial cells under energy-depleting conditions. This PTHrP was biologically active; ie, it exerted a positive contractile and lusitropic effect on cardiomyocytes. Authentic PTHrP was glycosylated and showed a slightly higher potency than synthetic PTHrP. These results suggest that PTHrP is an endothelium-derived modulator of ventricular function.

Effects of PTH-rP(107–111) and PTH-rP(7–34) on Adult Cardiomyocytes

We investigated whether parathyroid hormone-related peptide (PTH-rP), recently found expressed in the heart, exerts growth and contractile effects on adult cardiomyocytes from rat hearts. Synthetic PTH-rP peptides were used covering either a protein kinase C (PKC)-activating domain [PTH-rP(107–111)], or an adenylate cyclase activating domain [PTH-rP(1–34) and PTH-rP(7–34)]. PTH-rP(107–111) (1μm) increased creatine kinase BB activity (CK-BB), a CK isoform re-expressed during cardiac hypertrophy, within 24 h by 62±12%. This induction was abolished in the presence of the mitogen-activated-protein (MAP)-kinase-kinase inhibitor PD 98059. PTH-rP(107–111) activated p42-MAP-kinase within 15 min, increased protein synthesis (19± 4%), total protein mass (19±5%), cell volume (45±7%), and cross-sectional area (38±9%) of cardiomyocytes. Activation of p42-MAP-kinase and increase in protein synthesis were abolished in presence of bisindolylmaleimide, a PKC inhibitor. PTH- rP(107–111) did not directly influence contractile activity but reduced the contractile response to isoprenaline. In contrast, PTH-rP(1–34) and PTH-rP(7–34) induced spontaneous contractile activity in 3-day-old cultures. This induction was abolished in presence of Rp-cAMPS, a protein kinase A inhibitor, indicating an involvement of cAMP in this response. PTH-rP(1–34) also increased the cellular accumulation of cAMP. It is concluded that PTH-rP exert direct effects on adult cardiomyocytes by activating either PKC via a functional domain covered by amino acids 107–111 or by activation of cAMP-dependent protein kinase via a functional domain covered by amino acids 7–34. Since these parts of PTH-rP have either no homology [PTH-rP(107–111)] or only a limited structural similarity [PTH-rP(7–34)] to parathyroid hormone, these activities of PTH-rP have to be clearly distinguished from those described for parathyroid hormone.

Parathyroid Hormone-related Protein Antagonizes the Action of Parathyroid Hormone on Adult Cardiomyocytes

Ventricular cardiomyocytes have been identified as target cells for parathyroid hormone (PTH). A structurally related peptide hormone, parathyroid hormone-related peptide (PTH-rP), is expressed in the heart. In the present study, it was investigated whether PTH-rP can mimic or modify effects of PTH on cardiomyocytes. The investigated effect was induction of creatine kinase (CK) activity, which is associated with cardiac hypertrophy. PTH and PTH-rP have a similar secondary structure within the active domain 28 34, with exception of amino acid 29. At this position the hydrophilic glutamine in the PTH molecule corresponds to hydrophobic alanine in the PTH-rP molecule. Synthetic PTH or PTH-rP peptides covering domain 28 34 and recombinant full-length PTH(1 84) were used. PTH(28 48) (100 nm) induced CK activity within 24 h (123 +/- 3%; means +/- S.D., n = 4). PTH-rP(7-34) (1 nm to 1 microm) failed to induce CK activity in cardiomyocytes. Given simultaneously, PTH-rP (1 mum) reduced the stimulation of CK activity by PTH(1-84), PTH(1-34), and PTH(28-48) by 94 +/- 9, 79 +/- 8, and 69 +/- 14%, respectively (means +/- S.D., n = 4). In contrast, PTH-rP(7-34) was sufficient to stimulate proliferation of chicken chondrocytes. Thus, PTH-rP exerts different effects on cardiomyocytes and classical target cells for PTH. A synthetic hybrid peptide was synthesized, [Ala29]PTH(28-48), in which alanine replaced glutamine at position 29, as in the PTH-rP molecule. In contrast to PTH(28-48), this mutated peptide [Ala29]PTH(28-48) had no intrinsic activity but antagonized the effect of PTH(1-84) and PTH(28-48) on cardiomyocytes. The results demonstrate that on cardiomyocytes the effect of PTH can be antagonized by PTH-rP. This antagonism seems due to a hydrophobic replacement at position 29.

Parathyroid Hormone and Parathyroid Hormone-related Peptide Activate the Na+/H+ Exchanger NHE-1 Isoform in Osteoblastic Cells (UMR-106) via a cAMP-dependent Pathway

Parathyroid hormone (PTH) and parathyroid hormone-related peptide (PTHRP) regulate Na+/H+ exchanger activity in osteoblastic cells, although the signaling components involved are not precisely defined. Since these peptide hormones can stimulate production of diverse second messengers (i.e. cAMP and diacylglycerol) that activate protein kinase A (PKA) and protein kinase C (PKC) in target cells, it is conceivable that either one or both of these pathways can participate in modulating exchanger activity. To discriminate among these possibilities, a series of synthetic PTH and PTHRP fragments were used that stimulate adenylate cyclase and/or PKC. In the osteoblastic cell line UMR-106, human PTH(1-34) and PTHRP(1-34) augmented adenylate cyclase activity, whereas PTH(3-34), PTH(28-42), and PTH(28-48) had no effect. Nevertheless, all these peptide fragments were found to enhance PKC translocation from the cytosol to the membrane in a dose-dependent (10(-11) to 10(-7) M) manner. PTHRP(1-16), a biologically inert fragment, was incapable of influencing either the PKA or PKC pathway. PTH(1-34) and PTHRP(1-34), but not PTH(3-34), PTH(28-42), PTH(28-48), or PTHRP(1-16), elevated Na+/H+ exchanger activity, implicating cAMP as the transducing signal. In accordance with this observation, forskolin (10 microM), which directly stimulates adenylate cyclase, also activated Na+/H+ exchanger activity. The involvement of PKA was verified when the highly specific PKA inhibitor, H-89, completely abolished the stimulatory effect of PTH(1-34) and forskolin on Na+/H+ exchange. In addition, Northern blot analysis revealed the presence of only the NHE-1 isoform of the Na+/H+ exchanger in UMR-106 cells. In summary, these results indicated that PTH and PTHRP activate the Na+/H+ exchanger NHE-1 isoform in osteoblastic UMR-106 cells exclusively via a cAMP-dependent pathway.

Parathyroid Hormone and Parathyroid Hormone-related Peptide Inhibit the Apical Na+/H+ Exchanger NHE-3 Isoform in Renal Cells (OK) via a Dual Signaling Cascade Involving Protein Kinase A and C

Parathyroid hormone (PTH) and parathyroid hormone-related peptide (PTHRP) interact with a common G protein-coupled receptor and stimulate production of diverse second messengers (i.e. cAMP, diacylglycerol, and inositol 1,4,5-trisphosphate) that varies depending on the target cell. In renal proximal tubule OK cells, PTH inhibits the activity of the apical membrane Na+/H+ exchanger, although it is unclear whether the signal is transmitted through protein kinase A (PKA) and/or protein kinase C (PKC). To delineate the signaling circuitry, a series of synthetic PTH and PTHRP fragments were used that stimulate the adenylate cyclase-cAMP-PKA and/or phospholipase C-diacylglycerol-PKC pathways. Human PTH-(1-34) and PTHRP-(1-34) stimulated adenylate cyclase and PKC activity, whereas the PTH analogues, PTH-(3-34), PTH-(28-42), and PTH-(28-48), selectively enhanced only PKC activity. However, each peptide fragment inhibited Na+/H+ exchanger activity by 40-50%, suggesting that PKC and possibly PKA were capable of transducing the PTH/PTHRP signal to the transporter. This was corroborated when forskolin and phorbol 12-myristate 13-acetate (PMA), direct agonists of adenylate cyclase and PKC, respectively, both inhibited the Na+/H+ exchanger. The specific PKA antagonist, H-89, abolished the forskolin-mediated suppression of Na+/H+ exchanger activity, but did not prevent the inhibitory effects of PTH-(1-34) or PMA. In comparison, the potent PKC inhibitor, chelerythrine chloride, prevented the inhibition of Na+/H+ exchanger activity mediated by PTH-(28-48) and PMA but did not avert the negative regulation caused by PTH-(1-34) or forskolin. However, inhibition of both PKA and PKC prevented PTH-(1-34)-mediated suppression of Na+/H+ exchanger activity, indicating that PTH-(1-34) acted through both signaling pathways. In addition, Northern blot analysis revealed the presence of only the NHE-3 isoform of the Na+/H+ exchanger in OK cells. In summary, these results demonstrated that NHE-3 is expressed in OK cells and that activation of the PTH receptor can stimulate both the PKA and PKC pathways, each of which can independently lead to inhibition of NHE-3 activity.

Processing of pro-PTHRP by the prohormone convertase, furin: effect on biological activity.

We have examined the conversion of parathyroid hormone-related peptide (PTHRP) from its NH2-terminally extended precursor pro-PTHRP. Within pro-PTHRP, an amino acid sequence exists that can serve as a substrate for the prohormone convertase, furin. To evaluate the potential role of furin in processing of this entity, we expressed pro-PTHRP in COS-7 cells, which normally produce this enzyme. Transiently transfected COS-7 cells secreted high levels of PTHRP into conditioned culture medium. Cotransfection of these cells with antisense furin cDNA resulted in marked inhibition of furin mRNA expression and secretion of an NH2-terminal fragment of pro-PTHRP, which comigrated with synthetic pro-PTHRP-(-12-->+36) on gel-permeation high-pressure liquid chromatography. In an adenylate cyclase bioassay, condition medium containing this fragment and synthetic pro-PTHRP-(-12-->+36) both exhibited lower potency than synthetic PTHRP-(1-36) and conditioned medium containing PTHRP produced by COS-7 cells in the absence of antisense furin. These results demonstrate the capacity of furin to convert pro-PTHRP to a more active product and suggest a role for this enzyme in the normal intracellular processing of this hormone.

Parathyroid hormone-related peptide does not stimulate phosphate placental transport

It has been demonstrated that parathyroid hormone-related peptide (PTHrP) stimulates calcium (Ca) placental transport. Ca and inorganic phosphorous (P) metabolisms are intimately linked. Thus we have studied the influence of PTHrP on P placental transport in ewes. In our experimental paradigm, synthetic human PTHrP (1–86) fragment intravenously injected in six single chronically catheterized fetuses (3 × 1 μg/fetus/day, from day 129 to day 140 of gestation) had no significant effect upon P placental transport which was 131 ± 6 and 129 ± 9 mg/kg fetal weight/day in treated and control fetuses, respectively.

Parathyroid hormone-related peptide might stimulate calcium secretion into the milk of goats.

Parathyroid hormone-related peptide (PTHrP) has been shown to stimulate the placental calcium pump in pregnant ewes. Recent studies also suggest a physiological role for this peptide during lactation. In the present work, we have studied the possible role of synthetic human PTHrP(1-34), (1-86) and (140-173) fragments on calcium, inorganic phosphorus and magnesium secretion into milk of four adult goats in early lactation. This was done by measuring differences in calcium, inorganic phosphorus and magnesium concentrations in the carotid artery and superficial epigastric vein, the concentration of these minerals in milk and milk production. Both PTHrP(1-34) and (1-86) fragments stimulated calcium, inorganic phosphorus and magnesium uptake by the mammary gland and secretion into milk, without any significant effect on milk production. Therefore PTHrP might have important physiological roles in the pregnant and/or lactating female, by regulating calcium transport through the placenta and mammary gland.

Synthetic parathyroid hormone-related peptide(1–34) fragment stimulates placental calcium transfer in ewes

The influence of synthetic parathyroid hormone related peptide (PTHrp) fragments on placental transfer of Ca was studied in four groups of four single ovine fetuses fitted with catheters chronically implanted into their left jugular vein (for injections) and carotid artery (for blood sampling), and used between days 104 and 118 of gestation. The first group received PTHrp(1-34), the second PTHrp(107-138), the third bovine PTH(1-34), and the last (control) group was injected with solvent alone. Each peptide (6 nmol/fetus per day) was injected i.v. three times per day from day 105 until day 116 of gestation. Placental Ca transfer (mmol/24 h per kg fetal wt) from the dam to the fetus was not different in control fetuses (7.1 +/- 0.6) and those given PTHrp(107-138) (7.2 +/- 0.5), but it was significantly increased by bovine PTH(1-34) (8.6 +/- 0.4; P less than 0.05) and by PTHrp(1-34) (10.1 +/- 0.3; P less than 0.01). Both peptides also significantly increased plasma concentrations of 1,25 dihydroxy-vitamin D3 (1,25-(OH)2D). These results indicate that PTHrp(1-34) can stimulate placental Ca transfer by increasing 1,25-(OH)2D synthesis, but also possibly by acting directly upon the placenta.

Tumoral synthetic parathyroid hormone related peptide inhibits amiloride-sensitive sodium transport in cultured renal epithelia.

The amino-terminal fragment of a tumor parathyroid hormone-related peptide (PTHrP(1-34] produced by a human squamous cell carcinoma of the lung was recently synthesized. In the present work its effect on the amiloride-sensitive sodium transport, taken as an estimate of the Na+/H+ exchanger activity of cultured opossum kidney (OK) epithelia was compared to that of synthetic bovine parathyroid hormone (bPTH(1-34]. Both PTHrP(1-34) and bPTH(1-34) inhibited the initial rate of amiloride-sensitive 22Na transport. Half maximal inhibitory activity was obtained at about 10(-11)M for both PTHrP(1-34) and bPTH(1-34). In conclusion, tumoral PTHrP(1-34) appears to be as effective as bPTH(1-34) for inhibiting the amiloride-sensitive Na transport, and presumably for decreasing the activity of the Na+/H+ exchanger present in the apical membrane of kidney epithelial cells.