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PTH, Intact // Intact Parathyroid Hormone

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PTH is produced in the parathyroid gland and is a key regulator in skeletal and mineral homeostasis. PTH is a 84 amino-acid peptide, with an helical conformation in the 1-34 portion of its binding domain to its receptor of type 1 (PTH1R) (Jin et al., 2000). PTH and PTH-related peptide (PTHrP) have highly conserved sequences and activates PTH1R. The C terminal fragments of the intact PTH, PTH(39-84) or PTH(53-84) bind another receptor CPTHR, expressed on bone cells (Divieti et al., 2001). The 1-34 portion of PTH (and the PTHrP) stimulate bone formation and increase bone mass in patients with osteoporosis (Brommage et al., 1999; Lindsay et al., 1997). On the opposite, the truncated PTH 7-34 is a low affinity agonist of the receptor PTHR1 with the C terminus part required for the high affinity binding to the receptor (Gardella et al., 1991; Jin et al., 2000). Since PTH circulates under different forms, biologically active or not, immunoassays for its measurement must be chosen with particular attention (Komaba et al., 2009; Souberbielle et al., 2006).

Several automated or manual sandwich immunoassays are employed in the laboratory for measurement in plasma and/or serum:

  • Second generation assays designed to measure the entire 1-84 amino-acid peptide in addition to the 7-84 amino-acid peptide (Intact PTH or Total PTH),
  • "Third" generation assays which measure only the 1-84 amino-acid peptide (Whole PTH or biologically active PTH) and the Amino-PTH (a post-translational form produced in parathyroid carcinomas).

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