The concentration of free calcium in plasma is set by the extracellular action of noncollagenous proteins and hydroxyapatite

The late Wm. F. Neuman frequently included the following statement in his speeches: "Plasma calcium is undersaturated in respect to itself, but supersaturated in respect to bone". As a physical chemist he knew that if plasma or extracellular fluid came in direct contact with bone surfaces plasma calcium level should fall to the saturated solubility of hydroxyapatite. How could the condition given in the quote exist? He answered this question by laboratory experiments but unfortunately died before he could explain it scientifically. In the current perspective article we feel that we cannot only explain Neuman's riddle but also use the answer to describe a revised premise for extracellular control of calcium concentrations in body fluids. The answer lies in the solubility of hydroxyapatite. A simple contact of bone mineral surface with body fluids should lead to a calcium concentration in plasma too low to support life. The evolutionary process prevented this by adding one or more noncollagenous proteins at the surface of hydroxyapatite. These proteins elevated the saturated solubility of the crystal latticework sufficiently to provide a calcium concentration that would sustain life. This report explains the solubility process in as much detail as our scientific information will permit and also includes the role of parathyroid hormone in the process. We hope that serious study of our article will permit acceptance of our premise for calcium control and induce further study that should demonstrate its importance in all aspects of bone metabolism.

Calcium homeostasis: reassessment of the actions of parathyroid hormone

The purpose of this report is to adjust our interpretation of the actions of parathyroid hormone (PTH) to include its action on the bone mineral-noncollagenous protein interactions at all bone surfaces. The three primary areas that respond to PTH are: (1) all bone surface areas in contact with the extracellular fluid (ECF), (2) the kidney, and indirectly the intestinal tract, and (3) the bone remodeling sequence. The primary rapid action of the hormone is to set and maintain the free calcium concentration of the ECF. This it does by raising the equilibrium level at bone mineral surfaces. It affects the noncollagenous protein bone mineral process to raise the free calcium level in the ECF from the base level of 3.5mg/100ml to the physiological level of 5.0mg/100ml. Maintaining the higher level requires continuous secretion of parathyroid hormone. The action of PTH at bone surfaces tends to be catabolic in nature in regard to bone loss. The hormone also acts on the kidney to raise the threshold for calcium reabsorption and by stimulation of renal hydroxylation of vitamin D to increase intestinal absorption of calcium. Its action here is to supply the ECF with calcium derived from food intake. This is the extent of PTH action on renal processes. PTH acts on all three steps in the bone remodeling process. While its total function here is not clear, the result is a net increase in the synthesis of collagen. The report concludes by comparing the actions of PTH as proposed here to the functions of PTH that have been proposed in the past.

Calcium homeostasis and bone surface proteins, a postulated vital process for plasma calcium control

This report is a more in-depth explanation of a recently reported hypothesis for controlling the ionic calcium content of plasma and extracellular fluids (ECF). The hypothesis proposes a two-step process for returning calcium to the ECF against the established gradient continuously moving calcium from plasma to bone surfaces. The first step in this process is the predicted transfer of calcium directly from bone surfaces to the non-collagenous proteins, which are in contact with bone mineral. This calcium would be complexed to existing proteins and a portion would automatically become available for equilibration with ionic calcium in the ECF. The basis of the hypothesis is that the equilibration level helps to set the ionic calcium concentration of plasma. The gradient toward bone and the proposed two-step return occur in the ECF of bone and would be considered normal physiochemical processes. Thus, these processes are critical for mineral ion homeostasis in mammals. In this hypothesis, parathyroid hormone (PTH) is not required for the basic process. However, PTH works within the process to raise and set a precise plasma calcium concentration. The report to follow describes the process and discusses its relationship to normal and pathological conditions affecting human health.