It is then cleaved a second time, again at the amino-terminal portion, to form active parathyroid hormone comprised of 84 amino acids. The initial structure formed is a pre-pro-PTH, a 115 amino acid polypeptide that is cleaved to form pro-PTH comprised of 90 amino acids. Parathyroid hormone is a polypeptide that is synthesized and cleaved into an active form within the parathyroid gland. The understanding of PTH is of paramount relevance and importance. The mechanism of PTH in the body is intricate, and the clinical ramifications of irregularities are significant. Increased calcium levels in the serum serve as a negative-feedback loop signaling the parathyroid glands to stop the release of PTH. As serum calcium levels drop, the secretion of PTH by the parathyroid gland increases. PTH effects are present in the bones, kidneys, and small intestines. In conjunction with calcitriol, PTH regulates calcium and phosphate. PTH facilitates the synthesis of active vitamin D and calcitriol (1,25-dihydroxycholecalciferol) in the kidneys. The parathyroid gland secretes parathyroid hormone (PTH), a polypeptide, in response to low calcium levels detected in the blood. The parathyroid gland is comprised of 4 small glands located posteriorly to the thyroid in the middle aspect of the anterior neck. In the blood, the sensitive process of calcium and phosphate homeostasis is maintained primarily by an appropriately functioning parathyroid gland.
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