Skip to main content
SpringerLink
Log in

Adrenal effects of teriparatide in the treatment of severe postmenopausal osteoporosis

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

The aim of our study was to investigate the effects of teriparatide on the hypophysis–adrenal axis in postmenopausal women. Treatment with teriparatide increased plasmatic and urinary levels of cortisol after 6 and 12 months. Our paper demonstrates a possible direct secretagogue effect of teriparatide on adrenals in osteoporotic postmenopausal women.

Introduction

Teriparatide, recombinant human parathyroid hormone (1-34) (rhPTH [1-34]), is approved for the treatment of osteoporosis in men and postmenopausal women at high risk for fracture. In literature, data regarding the secretagogue effect of PTH on adrenocortical cells are present on in vitro, but not on in vivo, studies. The aim of our study was to investigate the effects of teriparatide on the hypophysis–adrenal axis in postmenopausal women.

Methods

Twenty postmenopausal women with severe osteoporosis were treated with teriparatide in a regimen of 20 μg daily, self-administered injections at bedtime for 12 months and a calcium and vitamin D supplementation. At the same time, 20 osteopenic women matched for age and body mass index with the patients were enrolled and treated only with calcium and vitamin D. In all subjects, calcium, adrenocorticotropic hormone (ACTH), and plasmatic and urinary cortisol were evaluated at baseline and after 6 and 12 months.

Results

Treatment with teriparatide increased plasmatic and urinary levels of cortisol after 6 and 12 months, reaching statistical significance only after 1 year. Plasmatic levels of ACTH did not change significantly.

Conclusions

Our paper, for the first time, demonstrates a possible direct secretagogue effect of teriparatide on adrenals in osteoporotic postmenopausal women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cosman F, Lindsay R (2004) Therapeutic potential of parathyroid hormone. Curr Osteoporos Rep 2:5–11

    Article  PubMed  Google Scholar 

  2. Turner RT (1997) The effects of programmed administration of human parathyroid hormone fragment (1-34) on bone histomorphometry and serum chemistry in rats. Endocrinology 138:4607–4612

    Article  PubMed  Google Scholar 

  3. Dempster DW, Cosman F, Kurland ES, Zhou H, Nieves J, Woelfert L, Shane E, Plavetić K, Müller R, Bilezikian J, Lindsay R (2001) Effects of daily treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: a paired biopsy study. J Bone Miner Res 16:1846–1853

    Article  CAS  PubMed  Google Scholar 

  4. Jiang Y, Zhao JJ, Mitlak BH, Wang O, Genant HK, Eriksen EF (2003) Recombinant human parathyroid hormone (1-34) (teriparatide) improves both cortical and cancellaneous bone structure. J Bone Miner Res 18:1932–1941

    Article  CAS  PubMed  Google Scholar 

  5. Rehman Q, Lang TF, Arnaud CD, Modin GW, Lane NE (2003) Daily treatment with parathyroid hormone is associated with an increase in vertebral cross-sectional area in postmenopausal women with glucocorticoid-induced osteoporosis. Osteoporos Int 14:77–81

    Article  CAS  PubMed  Google Scholar 

  6. Zanchetta JR, Bogado CE, Ferretti JL, Wang O, Wilson MG, Sato M, Gaich GA, Dalsky GP, Myers SL (2003) Effects of teriparatide (recombinant human parathyroid hormone (1-34)) on cortical bone in postmenopausal women with osteoporosis. J Bone Miner Res 18:539–543

    Article  CAS  PubMed  Google Scholar 

  7. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH (2001) Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441

    Article  CAS  PubMed  Google Scholar 

  8. Rafferty B, Zanelli JM, Rosenblatt M, Schulster D (1983) Corticosteroidogenesis and adenosine 39, 59-monophosphate production by the amino-terminal (1-34) fragment of human parathyroid hormone in rat adrenocortical cells. Endocrinology 113:1036–1042

    Article  CAS  PubMed  Google Scholar 

  9. Rosenberg J, Pines M, Hurwitz S (1987) Response of adrenal cells to parathyroid hormone stimulation. J Endocrinol 112:431–437

    Article  CAS  PubMed  Google Scholar 

  10. Hinson J, Birmingham MK (1987) ACTH and adrenal aerobic glycolysis. Effects of O-nitrophenylsulphonyl and other ACTH analogs, vasoactive intestinal peptide and human parathyroid hormone (1-34) on lactic acid, steroid and cyclic-AMP production by mouse adrenocortical cells. J Endocrinol 115:61–68

    Article  CAS  PubMed  Google Scholar 

  11. Isales CM, Barrett PQ, Brines M, Bollag W, Rasmussen H (1991) Parathyroid hormone modulates angiotensin II-induced aldosterone secretion from the adrenal glomerulosa cells. Endocrinology 129:489–495

    Article  CAS  PubMed  Google Scholar 

  12. Mazzocchi G, Aragona F, Malendowicz LK, Nussdorfer GG (2001) PTH and PTH-related peptide enhance steroid secretion from human adrenocortical cells. Am J Physiol Endocrinol Metab 280:209–213

    Google Scholar 

  13. Parsons JA (1976) Parathyroid physiology and the skeleton. In: Bourne GH (ed) The biochemistry and physiology of bone, vol 4. Academic, New York, pp 159–183

    Google Scholar 

  14. Clemens TL, Cormier S, Eichinger A, Endlich K, Fiaschi-Taesch N, Fischer E, Friedman PA, Karaplis AC, Massfelder T, Rossert J, Schlüter KD, Silve C, Stewart AF, Takane K, Helwig JJ (2001) Parathyroid hormone-related protein and its receptors: nuclear functions and roles in the renal and cardiovascular systems, the placental trophoblasts and the pancreatic islets. Br J Pharmacol 134:1113–1136

    Article  CAS  PubMed  Google Scholar 

  15. Philbrick WM, Wysolmerski JJ, Galbraith S, Holt E, Orloff JJ, Yang KH, Vasavada RC, Weir EC, Broadus AE, Stewart AF (1996) Defining the roles of parathyroid hormone-related protein in normal physiology. Physiol Rev 76:127–173

    CAS  PubMed  Google Scholar 

  16. Wysolmerski JJ, Stewart AF (1998) The physiology of parathyroid hormone-related protein: an emerging role as a developmental factor. Annu Rev Physiol 60:431–460

    Article  CAS  PubMed  Google Scholar 

  17. Rotllant J, Guerreiro PM, Anjos L, Redruello B, Canario AV, Power DM (2005) Stimulation of cortisol release by the N terminus of teleost parathyroid hormone-related protein in interrenal cells in vitro. Endocrinology 146:71–76

    Article  CAS  PubMed  Google Scholar 

  18. Smith DP, Zhang XY, Frolik CA, Harvey A, Chandrasekhar S, Black EC, Hsiung HM (1996) Structure and functional expression of a complementary DNA for porcine parathyroid hormone/parathyroid hormone-related peptide receptor. Biochim Biophys Acta 1307:339–347

    PubMed  Google Scholar 

  19. Gensure RC, Gardella TJ, Jüppner H (2005) Parathyroid hormone and parathyroid hormone-related peptide and their receptors. Biochem Biophys Res Commun 328:666–678

    Article  CAS  PubMed  Google Scholar 

  20. Murray TM, Rao LG, Divieti P, Bringhurst FR (2006) Parathyroid hormone secretion and action: evidence for discrete receptors for the carboxyl-terminal region and related biological actions of carboxyl-terminal ligands. Endocr Rev 26:78–113

    Article  Google Scholar 

  21. Schwidinger WF, Frederiks J, Watkins L, Robinson H, Bathon JM, Pines M, Suva LJ, Levine MA (1998) Coupling of the PTH/PTHrP receptor to multiple G proteins. Endocr 8:201–209

    Article  Google Scholar 

  22. Guerreiro PM, Rotllant J, Fuentes J, Power DM, Canario AV (2006) Cortisol and parathyroid hormone-related peptide are reciprocally modulated by negative feedback. Gen Comp Endocrinol 148:227–235

    Article  CAS  PubMed  Google Scholar 

  23. Schilling T, Pecherstorfer M, Blind E, Kohl B, Wagner H, Ziegler R, Raue F (1996) Glucocorticoids decrease the production of parathyroid hormone-related protein in vitro but not in vivo in the Walker carcinosarcoma 256 rat model. Bone 18:315–319

    Article  CAS  PubMed  Google Scholar 

  24. Cohen-Solal ME, Bouizar Z, Denne MA, Graulet AM, Gueris J, Bracq S, Jullienne A, de Vernejoul MC (1995) 1, 25 dihydroxyvitamin D and dexamethasone decrease in vivo Walker carcinoma growth, but not parathyroid hormone related protein secretion. Horm Metab Res 27:403–407

    Article  CAS  PubMed  Google Scholar 

  25. Habener J, Arnold A, Potts JT Jr (1995) Hyperparathyroidism. In: De Groote LJ (ed) Endocrinology. Saunders, Philadelphia, pp 1044–1060

    Google Scholar 

  26. Fairhurst BJ, Shettar SP (1981) Hypercalcemia and pheochromocytoma. Postgrad Med J 57:459–460

    Article  CAS  PubMed  Google Scholar 

  27. Nussdorfer GG (1996) Paracrine control of adrenal cortical function by medullary chromaffin cells. Pharmacol Rev 48:495–530

    CAS  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Messina, A.O.U. Policlinico “G. Martino” Via C. Valeria, 98125, Messina, Italy

    A. Lasco, A. Catalano, N. Morabito, A. Gaudio, G. Basile, A. Trifiletti & M. Atteritano

Authors
  1. A. Lasco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Catalano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Morabito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Gaudio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Basile
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Trifiletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Atteritano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Atteritano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lasco, A., Catalano, A., Morabito, N. et al. Adrenal effects of teriparatide in the treatment of severe postmenopausal osteoporosis. Osteoporos Int 22, 299–303 (2011). https://doi.org/10.1007/s00198-010-1222-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-010-1222-5

Keywords

Search

Navigation