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Indian Journal of Medical and Paediatric Oncology
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Year : 2019  |  Volume : 40  |  Issue : 2  |  Page : 294  

MEN1-related hyperparathyroidism: Response to cinacalcet and calcium-sensing receptor gene variant Arg990Gly

1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Haikou, China; Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Web Publication17-Oct-2019

Correspondence Address:
Sora Yasri
KMT Primary Care Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmpo.ijmpo_191_17

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How to cite this article:
Yasri S, Wiwanitkit V. MEN1-related hyperparathyroidism: Response to cinacalcet and calcium-sensing receptor gene variant Arg990Gly. Indian J Med Paediatr Oncol 2019;40:294

How to cite this URL:
Yasri S, Wiwanitkit V. MEN1-related hyperparathyroidism: Response to cinacalcet and calcium-sensing receptor gene variant Arg990Gly. Indian J Med Paediatr Oncol [serial online] 2019 [cited 2020 Apr 9];40:294. Available from: http://www.ijmpo.org/text.asp?2019/40/2/294/269454


Calcium biometabolism is usually an aberrant in abnormal parathyroid neoplasm. How blood calcium level is controlled in such cases is very interesting. The calcium-sensing receptor (CASR) plays an important role in this regard, and its polymorphism is widely studied.[1] The interrelationship between parathyroid malignancy, blood calcium, and underlying CASR polymorphism is very interesting. Whether different CASR polymorphisms have an effect on the drug treatment of the neoplasm is an important question that needs to be addressed.

An important parathyroid neoplasm with aberration of blood calcium is type 1 multiple endocrine neoplasia (MEN1). MEN1 on is usually related to primary hyperparathyroidism and has a high postsurgery recurrence rate.[2] In a recent study, Filopanti et al. reported the response to cinacalcet and its relationship with the CASR gene variant Arg990Gly.[3] Filopanti et al. mentioned no significant effect of such a polymorphism.[3] Here, the authors perform reappraisal on the effect of CASR Arg990Gly based on the quantum medicine assessment on molecular change in the polymorphism using the same technique as presented in previous publications.[4],[5],[6] It can be seen that Arg990Gly has a lower protein molecular weight than naïve type (the magnitude of decrease molecular mass per molecule is equal to 56.9%). The lower molecular mass means lower final bioaction product. This implies that MEN1 with CASR Arg990Gly should have a lower blood calcium level. If MEN1 with CASR Arg990Gly is responsive to the same dose of cinacalcet, it is likely to result in a less minimizing of blood calcium level. Of interest, this finding is concordant with the report by Filopanti et al.[3]

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There are no conflicts of interest.

  References Top

Kinoshita Y. The functions of calcium-sensing receptor in regulating mineral metabolism. Clin Calcium 2017;27:491-7.  Back to cited text no. 1
Giusti F, Marini F, Brandi ML. Multiple endocrine neoplasia type 1. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJ, et al., editors. Gene Reviews ®. Seattle (WA): University of Washington, Seattle; 1993.  Back to cited text no. 2
Filopanti M, Verga U, Ermetici F, Olgiati L, Eller-Vainicher C, Corbetta S, et al. MEN1-related hyperparathyroidism: Response to cinacalcet and its relationship with the calcium-sensing receptor gene variant arg990Gly. Eur J Endocrinol 2012;167:157-64.  Back to cited text no. 3
Joob B, Wiwanitkit V. HSD11B1 rs846908 polymorphisms and tacrolimus concentrations: Quantum chemical analysis and implication in patients with renal transplantation. J Nephropharmacol 2017;6:19-20.  Back to cited text no. 4
Joob B, Wiwanitkit V. ATP-binding cassette, sub-family B (MDR/TAP), member 1 (ABCB1) polymorphism and clopidogrel concentration in acute coronary syndrome: Molecular change can explain the observed therapeutic concentration. Anatol J Cardiol 2016;16:303-4.  Back to cited text no. 5
Wiwanitkit S, Wiwanitkit V. Change in molecular weight due to important pfatp6 and pfmdr1 polymorphisms and susceptibility to antimalarial drug: Possible role of epigenetic phenomenon. Asian Pac J Trop Biomed 2017;7:181-2.  Back to cited text no. 6


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