Physiological and pathological roles of parathyroid hormone-related peptide.

Parathyroid hormone-related peptide was originally identified as a tumor-produced factor that mediated malignancy-associated hypercalcemia by binding to the common parathyroid hormone/parathyroid hormone-related peptide receptor to stimulate osteoclastic bone resorption and renal tubular resorption of calcium. Its role as a humoral factor in hypercalcemia of malignancy is well established, and recent work has demonstrated its importance as a tumor-produced factor in the pathogenesis of bone metastasis. Besides these cancer-related functions, work in the past decade has clearly established that parathyroid hormone-related peptide has many important functions in normal physiology related to growth and development, reproductive function and smooth muscle relaxation. Many other physiological functions are also being attributed to this versatile peptide. An understanding of these functions in malignancy and normal physiology should lead to innovative therapy for malignancy as well as other disorders not previously related to calcium homeostasis.