Minerals Flashcards
Calbindin-D
Ca++ absorption in the intestine involves a viatmin D-induced intracellular Ca++ binding protein
Binds Ca++ once in the cytosol – keep inside the cell at rock bottom levels– Maintain steep gradient
Calmodulin
Most common Ca++ binding proteins in our cells
1. binds four calcium ions
2. Calmodulin changes conformation, resulting in an active complex
3. Two globular “hands” of the complex wrap around a binding site on a target protein
Essential allosteric activator of other proteins
Absorption of Ca++ occurs primarily in …
the duodenum
What two ion channels are involved in the absorption?
TRPV5 (transient receptor potential 5) & TRPV6
TRPV6»>TRPV5
TRPV5 mostly Ca++ DCT/PCT tubules of the kidney
TRPV5 expression
Highly induced by vitamin D (as calcitriol active hormone)
Lack of expression when vitamin D is low –>forces body to draw upon bone reserves —> low vitamin D – weak bones
PMCA1b
Basolateral Ca++-ATPase protein (active transport)
NCX1
Antiporter – 3Na+ for each outgoing Ca++
Not active, depend on Na+ gradient established by Na+/K+-ATPase – secondary active transport
Albumin
Binds calcium in serum, can not pass through the kidneys
Calcitriol
- Active form of vitamin D
- Role –> increase Ca++ levels in the blood
- stim bone resorption
- Intestinal Ca++ absorption
- Renal Ca++ reabsorption
PTH
- Role –> increase serum Ca++ and decrease serum Pi
- Increase bone resorption
- Increase renal Ca++ reabsorption
- Decrease renal Pi reabsorption
NO EFFECT on INTESTINAL Ca++ absorption
Calcitonin
- Role –> decrease blood Ca++
- Inhibit bone resorption
- Renal Ca++ reabsorption
Hypocalcemia causes?
Hypoparathyroidism (Wilson disease, thyroidectomy, Primary PTH deficiency, autoimmune destruction of parathyroid)
Low vitamin D (insufficient sunlight, low dietary intake, malabsorption, kidney disease)
Hypercalcemia causes?
Primary Hyperparathyroidism (excess PTH)
Cancer (bone mets)
Vitamin D toxicity
Hypocalcemia presentation?
- Bone density disorders (rickets, osteomalacia, osteoporosis)
- Neuromuscular tetany, spasms, cramping
- Bronchospasms, laryngospasms
- Cardiomyopathy, prolonged QT interval
Hypercalcemia presentation
- Soft tissue calcification
- EKG abnormalities, chronic Ca++ overload can lead to permanent damage
- N/V, anorexia
What stimulates 1alpha-Hydroxylase
Hormonal regulation of serum calcium levels
Low blood Ca++ stimulates –> PTH–>activates 1alpha-hydroxylase in kidney
1alpha-Hydroxylase function
Enzyme converts inactive form of Vitamin D (Cholecalciferol) into the active form (Calcitriol)
More potent than PTH in increasing serum Ca++
Acrodermatitis Enteropathica
Zn malabsorption disorder resulting in deficiency of SLC39A4 (encoding the ZIP4 protein)
Sx: skin rashes, slowed growth/development, immune deficiencies
Vision problems are also possible because Zn is involved in Vitamin A metabolism
ATP7A
Cu-ATPase –> actively transports Cu1+ across the basolateral membrane
ATP7B
Cu-ATPase protein
Affected by Wilson’s Disease–> impairs efflux of Cu from cells
Calcium Roles
Divalent cation (Ca++) with high charge density
Signaling molecule (second messenger)
Regulates activity of Calmodulin
Cofactor of blood clotting enzymes – THROMBIN