Skip to main content
Erschienen in: Osteoporosis International 1/2009

01.01.2009 | Original Article

Activation of the calcium sensing receptor stimulates gastrin and gastric acid secretion in healthy participants

verfasst von: L. Ceglia, S. S. Harris, H. M. Rasmussen, B. Dawson-Hughes

Erschienen in: Osteoporosis International | Ausgabe 1/2009

Einloggen, um Zugang zu erhalten

Abstract

Summary

In 17 adults on a fixed metabolic diet, an 11-day course of cinacalcet increased serum gastrin and basal gastric acid output, but not maximal gastric acid output, compared with a placebo. These findings indicate that the calcium sensor receptor plays a role in the regulation of gastric acid.

Introduction

Gastric acid secretion is a complex process regulated by neuronal and hormonal pathways. Ex vivo studies in human gastric tissues indicate that the calcium sensing receptor (CaR), expressed on the surface of G and parietal cells, may be involved in this regulation. We sought to determine whether cinacalcet, a CaR allosteric agonist, increases serum gastrin and gastric acid secretion.

Methods

Seventeen healthy adults with normal gastric acid output were placed on an 18-day metabolic diet. On day 8 (baseline), participants were given cinacalcet (15 then 30 mg/day) or placebo for 11 days. Changes in gastric acid output, serum gastrin, and other measures were compared in the two groups.

Results

Changes in serum gastrin and basal acid output (adjusted for baseline body weight) were significantly more positive in the cinacalcet group compared with placebo (P = 0.004 and P = 0.039 respectively). Change in maximal acid output was similar in the two groups (P = 0.995). As expected, cinacalcet produced significant decreases in serum PTH (P < 0.001) and ionized calcium levels (P = 0.032), and increases in serum phosphorus levels (P = 0.001) and urinary calcium (P = 0.023).

Conclusions

This study provides in vivo evidence that activation of the CaR increases serum gastrin levels and basal gastric acid secretion in healthy adults.
Literatur
1.
Zurück zum Zitat Reeder DD, Conlee JL, Thompson JC (1971) Calcium carbonate antacid and serum gastrin concentration in duodenal ulcer. Surg Forum 22:308–310PubMed Reeder DD, Conlee JL, Thompson JC (1971) Calcium carbonate antacid and serum gastrin concentration in duodenal ulcer. Surg Forum 22:308–310PubMed
2.
Zurück zum Zitat Levant JA, Walsh JH, Isenberg JI (1973) Stimulation of gastric secretion and gastrin release by single oral doses of calcium carbonate in man. N Engl J Med 289:555–558PubMed Levant JA, Walsh JH, Isenberg JI (1973) Stimulation of gastric secretion and gastrin release by single oral doses of calcium carbonate in man. N Engl J Med 289:555–558PubMed
3.
Zurück zum Zitat Barreras RF, Donaldson RM Jr (1967) Effects of induced hypercalcemia on human gastric secretion. Gastroenterology 52:670–675PubMed Barreras RF, Donaldson RM Jr (1967) Effects of induced hypercalcemia on human gastric secretion. Gastroenterology 52:670–675PubMed
4.
5.
Zurück zum Zitat Barreras RF (1970) Acid secretion after calcium carbonate in patients with duodenal ulcer. N Engl J Med 282:1402–1405PubMed Barreras RF (1970) Acid secretion after calcium carbonate in patients with duodenal ulcer. N Engl J Med 282:1402–1405PubMed
6.
Zurück zum Zitat Behar J, Hitchings M, Smyth RD (1977) Calcium stimulation of gastrin and gastric acid secretion: effect of small doses of calcium carbonate. Gut 18:442–448PubMedCrossRef Behar J, Hitchings M, Smyth RD (1977) Calcium stimulation of gastrin and gastric acid secretion: effect of small doses of calcium carbonate. Gut 18:442–448PubMedCrossRef
7.
Zurück zum Zitat Brown EM, Gamba G, Riccardi D et al (1993) Cloning and characterization of an extracellular Ca(2+)-sensing receptor from bovine parathyroid. Nature 366:575–580PubMedCrossRef Brown EM, Gamba G, Riccardi D et al (1993) Cloning and characterization of an extracellular Ca(2+)-sensing receptor from bovine parathyroid. Nature 366:575–580PubMedCrossRef
8.
Zurück zum Zitat Ray JM, Squires PE, Curtis SB, Meloche MR, Buchan AM (1997) Expression of the calcium-sensing receptor on human antral gastrin cells in culture. J Clin Invest 99:2328–2333PubMedCrossRef Ray JM, Squires PE, Curtis SB, Meloche MR, Buchan AM (1997) Expression of the calcium-sensing receptor on human antral gastrin cells in culture. J Clin Invest 99:2328–2333PubMedCrossRef
9.
Zurück zum Zitat Buchan AM, Squires PE, Ring M, Meloche RM (2001) Mechanism of action of the calcium-sensing receptor in human antral gastrin cells [see comment]. Gastroenterology 120:1128–1139PubMedCrossRef Buchan AM, Squires PE, Ring M, Meloche RM (2001) Mechanism of action of the calcium-sensing receptor in human antral gastrin cells [see comment]. Gastroenterology 120:1128–1139PubMedCrossRef
10.
Zurück zum Zitat Dufner MM, Kirchhoff P, Remy C et al (2005) The calcium-sensing receptor acts as a modulator of gastric acid secretion in freshly isolated human gastric glands. Am J Physiol 289:G1084–G1090 Dufner MM, Kirchhoff P, Remy C et al (2005) The calcium-sensing receptor acts as a modulator of gastric acid secretion in freshly isolated human gastric glands. Am J Physiol 289:G1084–G1090
11.
Zurück zum Zitat Nemeth EF (2004) Calcimimetic and calcilytic drugs: just for parathyroid cells? Cell Calcium 35:283–289PubMedCrossRef Nemeth EF (2004) Calcimimetic and calcilytic drugs: just for parathyroid cells? Cell Calcium 35:283–289PubMedCrossRef
12.
Zurück zum Zitat Igarashi T, Ogata E, Maruyama K, Fukuda T (2000) Effect of calcimimetic agent, KRN568, on gastrin secretion in healthy subjects. Endocr J 47:517–523PubMedCrossRef Igarashi T, Ogata E, Maruyama K, Fukuda T (2000) Effect of calcimimetic agent, KRN568, on gastrin secretion in healthy subjects. Endocr J 47:517–523PubMedCrossRef
13.
Zurück zum Zitat Brown EM, Hebert SC (1997) Calcium-receptor-regulated parathyroid and renal function. Bone 20:303–309PubMedCrossRef Brown EM, Hebert SC (1997) Calcium-receptor-regulated parathyroid and renal function. Bone 20:303–309PubMedCrossRef
14.
Zurück zum Zitat Chernecky CC, Berger BJ (eds) (1997) Laboratory tests and diagnostic procedures. Saunders, Philadelphia Chernecky CC, Berger BJ (eds) (1997) Laboratory tests and diagnostic procedures. Saunders, Philadelphia
15.
Zurück zum Zitat Wolfe MM, Soll AH (1988) The physiology of gastric acid secretion. N Engl J Med 319:1707–1715PubMed Wolfe MM, Soll AH (1988) The physiology of gastric acid secretion. N Engl J Med 319:1707–1715PubMed
16.
Zurück zum Zitat Hersey SJ, Sachs G (1995) Gastric acid secretion. Physiol Rev 75:155–189PubMed Hersey SJ, Sachs G (1995) Gastric acid secretion. Physiol Rev 75:155–189PubMed
17.
Zurück zum Zitat Geibel JP, Wagner CA, Caroppo R et al (2001) The stomach divalent ion-sensing receptor scar is a modulator of gastric acid secretion. J Biol Chem 276:39549–39552PubMedCrossRef Geibel JP, Wagner CA, Caroppo R et al (2001) The stomach divalent ion-sensing receptor scar is a modulator of gastric acid secretion. J Biol Chem 276:39549–39552PubMedCrossRef
18.
Zurück zum Zitat Waldum HL, Brenna E, Sandvik AK (1998) Relationship of ECL cells and gastric neoplasia. Yale J Biol Med 71:325–335PubMed Waldum HL, Brenna E, Sandvik AK (1998) Relationship of ECL cells and gastric neoplasia. Yale J Biol Med 71:325–335PubMed
19.
Zurück zum Zitat Waldum HL, Arnestad JS, Brenna E, Eide I, Syversen U, Sandvik AK (1996) Marked increase in gastric acid secretory capacity after omeprazole treatment. Gut 39:649–653PubMedCrossRef Waldum HL, Arnestad JS, Brenna E, Eide I, Syversen U, Sandvik AK (1996) Marked increase in gastric acid secretory capacity after omeprazole treatment. Gut 39:649–653PubMedCrossRef
20.
Zurück zum Zitat Recker RR (1985) Calcium absorption and achlorhydria. N Engl J Med 313:70–73PubMed Recker RR (1985) Calcium absorption and achlorhydria. N Engl J Med 313:70–73PubMed
21.
Zurück zum Zitat Wood RJ, Serfaty-Lacrosniere C (1992) Gastric acidity, atrophic gastritis, and calcium absorption. Nutr Rev 50:33–40PubMedCrossRef Wood RJ, Serfaty-Lacrosniere C (1992) Gastric acidity, atrophic gastritis, and calcium absorption. Nutr Rev 50:33–40PubMedCrossRef
22.
Zurück zum Zitat O’Connell MB, Madden DM, Murray AM, Heaney RP, Kerzner LJ (2005) Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 118:778–781PubMedCrossRef O’Connell MB, Madden DM, Murray AM, Heaney RP, Kerzner LJ (2005) Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 118:778–781PubMedCrossRef
23.
Zurück zum Zitat Goodman WG, Hladik GA, Turner SA et al (2002) The calcimimetic agent AMG 073 lowers plasma parathyroid hormone levels in hemodialysis patients with secondary hyperparathyroidism. J Am Soc Nephrol 13:1017–1024PubMed Goodman WG, Hladik GA, Turner SA et al (2002) The calcimimetic agent AMG 073 lowers plasma parathyroid hormone levels in hemodialysis patients with secondary hyperparathyroidism. J Am Soc Nephrol 13:1017–1024PubMed
24.
Zurück zum Zitat Shoback DM, Bilezikian JP, Turner SA, McCary LC, Guo MD, Peacock M (2003) The calcimimetic cinacalcet normalizes serum calcium in subjects with primary hyperparathyroidism. J Clin Endocrinol Metab 88:5644–5649PubMedCrossRef Shoback DM, Bilezikian JP, Turner SA, McCary LC, Guo MD, Peacock M (2003) The calcimimetic cinacalcet normalizes serum calcium in subjects with primary hyperparathyroidism. J Clin Endocrinol Metab 88:5644–5649PubMedCrossRef
25.
Zurück zum Zitat Favus MJ (ed) (2006) Primer on the metabolic bone diseases and disorders of mineral metabolism. American Society for Bone and Mineral Research, Washington, DC Favus MJ (ed) (2006) Primer on the metabolic bone diseases and disorders of mineral metabolism. American Society for Bone and Mineral Research, Washington, DC
26.
Zurück zum Zitat Conigrave AD, Lok HC (2004) Activation of renal calcium and water excretion by novel physiological and pharmacological activators of the calcium-sensing receptor. Clin Exp Pharmacol Phys 31:368–371CrossRef Conigrave AD, Lok HC (2004) Activation of renal calcium and water excretion by novel physiological and pharmacological activators of the calcium-sensing receptor. Clin Exp Pharmacol Phys 31:368–371CrossRef
27.
Zurück zum Zitat Peacock M, Bilezikian JP, Klassen PS, Guo MD, Turner SA, Shoback D (2005) Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 90:135–141PubMedCrossRef Peacock M, Bilezikian JP, Klassen PS, Guo MD, Turner SA, Shoback D (2005) Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 90:135–141PubMedCrossRef
28.
Zurück zum Zitat Silverberg SJ, Bone HG III, Marriott TB et al (1997) Short-term inhibition of parathyroid hormone secretion by a calcium-receptor agonist in patients with primary hyperparathyroidism. N Engl J Med 337:1506–1510PubMedCrossRef Silverberg SJ, Bone HG III, Marriott TB et al (1997) Short-term inhibition of parathyroid hormone secretion by a calcium-receptor agonist in patients with primary hyperparathyroidism. N Engl J Med 337:1506–1510PubMedCrossRef
29.
Zurück zum Zitat Rude RK (1998) Magnesium deficiency: a cause of heterogeneous disease in humans. J Bone Miner Res 13:749–758PubMedCrossRef Rude RK (1998) Magnesium deficiency: a cause of heterogeneous disease in humans. J Bone Miner Res 13:749–758PubMedCrossRef
30.
Zurück zum Zitat Djurhuus MS, Gram J, Petersen PH, Klitgaard NAH, Bollerslev J, Becknielsen H (1995) Biological variation of serum and urinary magnesium in apparently healthy males. Scand J Clin Lab Invest 55:549–558PubMedCrossRef Djurhuus MS, Gram J, Petersen PH, Klitgaard NAH, Bollerslev J, Becknielsen H (1995) Biological variation of serum and urinary magnesium in apparently healthy males. Scand J Clin Lab Invest 55:549–558PubMedCrossRef
31.
Zurück zum Zitat Martini LA, Wood RJ (2001) Assessing magnesium status: a persisting problem. Nutr Clin Care 4:332–337CrossRef Martini LA, Wood RJ (2001) Assessing magnesium status: a persisting problem. Nutr Clin Care 4:332–337CrossRef
32.
Zurück zum Zitat Gaginella TS (ed) (1996) Handbook of methods in gastrointestinal pharmacology. CRC, Boca Raton Gaginella TS (ed) (1996) Handbook of methods in gastrointestinal pharmacology. CRC, Boca Raton
33.
Zurück zum Zitat Block GA, Martin KJ, de Francisco AL et al (2004) Cinacalcet for secondary hyperparathyroidism in patients receiving hemodialysis. N Engl J Med 350:1516–1525PubMedCrossRef Block GA, Martin KJ, de Francisco AL et al (2004) Cinacalcet for secondary hyperparathyroidism in patients receiving hemodialysis. N Engl J Med 350:1516–1525PubMedCrossRef
34.
Zurück zum Zitat Dong BJ (2005) Cinacalcet: an oral calcimimetic agent for the management of hyperparathyroidism. Clin Ther 27:1725–1751PubMedCrossRef Dong BJ (2005) Cinacalcet: an oral calcimimetic agent for the management of hyperparathyroidism. Clin Ther 27:1725–1751PubMedCrossRef
Metadaten
Titel
Activation of the calcium sensing receptor stimulates gastrin and gastric acid secretion in healthy participants
verfasst von
L. Ceglia
S. S. Harris
H. M. Rasmussen
B. Dawson-Hughes
Publikationsdatum
01.01.2009
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 1/2009
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0637-8

Weitere Artikel der Ausgabe 1/2009

Osteoporosis International 1/2009 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.