Cinacalcet in hyperfunctioning parathyroid diseases

Abstract

The calcium-sensing receptor (CaR) on the parathyroid cell surface senses ionized calcium concentration in the extracellular fluid and regulates minute-to-minute parathyroid hormone (PTH) secretion. Synthetic allosteric modulators of CaR have been developed, and one of the positive modulators (calcimimetics) is cinacalcet HCl or cinacalcet. Cinacalcet increases the sensitivity of CaR to be activated by extracellular calcium, and thus suppresses PTH release. Cinacalcet is an effective treatment for secondary hyperparathyroidism (SHPT) in patients with uremia on hemodialysis. In this review, based on basic experiments using cinacalcet, we postulate the beneficial effects of cinacalcet on hyperfunctioning parathyroid diseases.