Calcium Homeostasis COPY COPY Flashcards
What are the roles of calcium in the body?
- Signalling
- Blood clotting
- Apoptosis
- Skeletal support
- Membrane excitatability
What is the role of calcium in signalling?
Exocytosis of synaptic vessels
- Sarcoplasmic reticulum = contraction of muscle fibres
How does calcium mediate membrane excitatability?
Calcium decreases sodium permeability of the membrane
What happens to membrane excitatability during hypocalcaemia?
- Neuronal Na+ permeability is increased
- Hyperexcitation of neurones occurs
- In extreme cases, hypocalcaemia causes tetany and asphyxiation
What happens to membrane excitatability during hypercalcaemia?
- High calcium decreases neuronal Na+ permeability
- Reduces excitatability
- Depresses neuromuscular activity
- Hypercalcaemia can cause cardiac arrhythmias
How is calcium distributed in the body?
99% in bones
0.9% ICF
0.1% ECF - only physiologically active
How is calcium stored in bone?
Stored as hydroxyapatite (contains phosphates so phosphate homeostasis is important in calcium storage)
Where is calcium stored in the ICF?
Mitochondria/sarcoplasmic reticulum
How is calcium found in the ECF?
40% is bound to proteins
50% free
10% complexed
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What are normal values of [Ca2+]plasma
2.2 - 2.6mM
What is the effect of alkalosis on calcium protein binding?
Increased
- Therefore hyperventilation (alkalosis) can lead to hypocalcaemic tetany
What is the effect of acidosis on calcium binding?
Reduced
- H+ ions displace protein bound calcium
- Can lead to arrhythmia
What is the primary and secondary role of bone stored calcium?
Primary = maintaining plasma calcium levels
Secondary = structural support
What is the role of osteoblasts and how do they achieve it?
Build up bone
- Lay down collagen matrix that they then calcify
- They then differentiate into osteocytes
What is the role of osteoclasts and how do they do it?
Break down bone and release calcium
- Secrete H+ ions into the bone to dissolve calcium and release it
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What two hormones increase [Ca2+]plasma?
- Parathyroid hormone
- Calcitriol
What type of hormone is parathyroid hormone (PTH)?
Peptide
When and by what is parathyroid secreted?
- Low [Ca2+]plasma
- Secreted by parathyroid glands
In what ways does PTH increase [Ca2+]plasma?
- Stimulates osteoclasts
- Inhibits osteoblasts
- Increases reabsorption of Ca2+ in kidney tubules
- Increase renal excretion of phosphates (inhibitis formation of hydroxyapatite)
- Stimulates kidneys to synthesise calcitriol
What type of hormone is calcitriol?
Steroid
What is calcitriol made from?
It is the activated form of vitamin D3
What is the 2 step production of calcitriol?
- Dietary and sunlight Vit D used
- Converted to 25 hydroxycholecalciferol in the liver
- Then converted to calcitriol in the kidney by the action of PTH
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How does calcitriol increase [Ca2+]plasma?
- Stimulates osteoclasts
- Increases renal absorption of calcium
- Increases calcium uptake in the gut
How is calcium absorbed in the gut?
Requires active transport
- This requires calcitriol to occur
What are rickets and osteomalacia?
Rickets = bone bending during growing in children from Vit D def.
Osteomalacia = same but in adults
What type of hormone is calcitonin?
Peptide hormone
Where is calcitonin released from and when is it released?
C cells in the thyroid gland
- Released in response to high [Ca2+]plasma
What is the function of calcitonin and how does it achieve this?
Decreases [Ca2+]plasma
- Binds to osteoclasts to prevent bone reabsorption
Is calcitonin very important in humans?
No
Full thyroidectomies don’t usually have any effect on [Ca2+]plasma
What effect does cortisol have on [Ca2+]plasma?
- Mixed effect
- Inhibits osteoblasts so may increase
- BUT
- Increases renal excretion and
- Reduces intestinal reabsorption
What effect do Insulin and Oestrogen have on [Ca2+]plasma?
- Both increase bone formation therefore lower
- Insulin at high levels during growth spurts to increase this bone formation
What effects does prolactin have on body calcium stores?
- Promotes calcium absorption by stimulating the secretion of calcitriol