カルシウム感知受容体の新しい展開

Bone and Nutrition. A prospect of calcium sensing receptor.

　1993年にカルシウム感知受容体（CaSR）が発見され，CaSRによるCa恒常性維持やCaSR変異によるCa代謝異常の病態が明らかとなっている。さらにCaSRはCa代謝と直接関連のない臓器にも広く発現していることが示され，その生理的意義や種々の病態との関連が指摘されている。本稿では，Ca代謝異常のみならず，乳癌や前立腺癌，大腸癌といった癌腫やアルツハイマー病，膵炎などの病態とCaSRの関連，さらにCaSRを治療ターゲットとした病態についての最新知見も述べたい。

　Following the discovery of the calcium-sensing receptor（CaSR）in 1993, its pivotal role in disorders of calcium homeostasis was demonstrated. Compelling evidence suggests that the CaSR plays multiple roles extending well beyond not only regulating the level of extracellular Ca2＋, but also controlling diverse and crucial roles in human physiology and pathophysiology. This review covers current knowledge of the role of the CaSR in disorders of calcium homeostasis（familial hypocalciuric hypercalcemia, neonatal severe hyperparathyroidism, autosomal dominant hypocalcemia, primary and secondary hyperparathyroidism, hypercalcemia of malignancy）as well as unrelated diseases such as breast and colorectal cancer, Alzheimer's disease and pancreatitis. In addition, it examines the use or potential use of CaSR agonists or antagonists in the management of disorders as diverse as hyperparathyroidism and Alzheimer's disease.