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Best Pract Res Clin Endocrinol Metab. 2013 Jun;27(3):333-43. doi: 10.1016/j.beem.2013.02.006. Epub 2013 Mar 13.

Role of the calcium-sensing receptor in extracellular calcium homeostasis.

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Division of Endocrinology, Diabetes and Hypertension, EBRC 223A, Brigham and Women's Hospital, 221 Longwood Ave., Boston, MA 02115, USA.


Maintaining a constant level of blood Ca(2+) is essential because of calcium's myriad intracellular and extracellular roles. The CaSR plays key roles in maintaining [Formula: see text] homeostasis by detecting small changes in blood Ca(2+) and modulating the production/secretion of the Ca(2+)-regulating hormones, PTH, CT, FGF23 and 1,25(OH)2D3, so as to appropriately regulate Ca(2+) transport into or out of blood via kidney, intestine, and/or bone. When Ca(2+) is high, the CaSR suppresses PTH synthesis and secretion, promotes its degradation, and inhibits parathyroid cellular proliferation. It has just the opposite effects on the C-cell, stimulating CT when [Formula: see text] is high. In bone, Ca(2+), acting via the CaSR, stimulates recruitment and proliferation of preosteoblasts, their differentiation to mature osteoblasts, and synthesis and mineralization of bone proteins. Conversely, [Formula: see text] inhibits the formation and activity and promotes apoptosis of osteoclasts, likely via the CaSR. These actions tend to mobilize skeletal Ca(2+) during [Formula: see text] deficiency and retain it when Ca(2+) is plentiful.


1,25(OH)(2)D(3); PTH; calcitonin; calcium; calcium-sensing receptor; extracellular; osteoblast; osteoclast

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