Endocrine - Parathyroid Development

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Embryonic origins of the endocrine organs of the neck

The parathyroid gland appears in the adult as a pair of inferior and a pair of superior "bumps" on the beside the (dorsal) thyroid (hence the name, "para"). The embryonic origin of this gland is from the third and fourth pharyngeal pouches endoderm, and could also have ectoderm and neural crest contributions. This developmental process also generates multiple small parathyroid clusters in addition to the main parathyroid glands.[1]

At 6 weeks a diverticulum elongates from the pouch, initially hollow and then solidifynig with cell proliferation.

Interestingly, the inferior parathyroid originates from the third pharyngeal pouch and the superior arises from the fourth pharyngeal pouch, the adult anatomical position is the opposite of the pharyngeal rostro-caudal order. This occurs due to the third pharyngeal pouch also giving rise to the thymus, the superior pair descend along with the thymus.

The fetal parathyroids appear functional as they respond to calcium levels. The fetal calcium levels also higher than maternal levels.

Endocrine Links: Introduction | BGD Lecture | Science Lecture | Pineal | Hypothalamus‎ | Pituitary | Thyroid | Parathyroid | Thymus‎ | Pancreas‎ | Adrenal‎ | Gonad‎ | Placenta‎ | Other Tissues | Stage 22 | Abnormalities | Hormones | Category:Endocrine
Historic Embryology - Endocrine  
1904 interstitial Cells | 1908 Pancreas Different Species | 1912 Suprarenal Bodies | 1914 Suprarenal Organs | 1918 Rabbit Hypophysis | 1926 Human Hypophysis | 1937 Pineal
| Lecture - Head Development |

Some Recent Findings

Human Embryo (week 6 - 8)[1]
  • Multiple roles for HOXA3 in regulating thymus and parathyroid differentiation and morphogenesis in mouse[2] "Previous studies have shown that the Hoxa3 null mutant lacks third pharyngeal pouch derivatives, the thymus and parathyroids by E18.5, and organ-specific markers are absent or downregulated during initial organogenesis. Our current analysis of the Hoxa3 null mutant shows that organ-specific domains did undergo initial patterning, but the location and timing of key regional markers within the pouch, including Tbx1, Bmp4 and Fgf8, were altered. Expression of the parathyroid marker Gcm2 was initiated but was quickly downregulated and differentiation failed; by contrast, thymus markers were delayed but achieved normal levels, concurrent with complete loss through apoptosis. To determine the cell type-specific roles of Hoxa3 in third pharyngeal pouch development, we analyzed tissue-specific mutants using endoderm and/or neural crest cell (NCC)-specific Cre drivers. Simultaneous deletion with both drivers resulted in athymia at E18.5, similar to the null. By contrast, the individual tissue-specific Hoxa3 deletions resulted in small, ectopic thymi, although each had a unique phenotype. Hoxa3 was primarily required in NCCs for morphogenesis. In endoderm, Hoxa3 temporally regulated initiation of the thymus program and was required in a cell-autonomous manner for parathyroid differentiation. Furthermore, Hoxa3 was required for survival of third pharyngeal pouch-derived organs, but expression in either tissue was sufficient for this function." Developmental Signals - Homeobox
  • Thymus-associated parathyroid hormone has two cellular origins with distinct endocrine and immunological functions[1] "In mammals, parathyroid hormone (PTH) is a key regulator of extracellular calcium and inorganic phosphorus homeostasis. Although the parathyroid glands were thought to be the only source of PTH, extra-parathyroid PTH production in the thymus, which shares a common origin with parathyroids during organogenesis, has been proposed to provide an auxiliary source of PTH, resulting in a higher than expected survival rate for aparathyroid Gcm2⁻/⁻ mutants. However, the developmental ontogeny and cellular identity of these "thymic" PTH-expressing cells is unknown. ...Our data show conclusively that the thymus does not serve as an auxiliary source of either serum PTH or parathyroid function. We further show that the normal process of parathyroid organogenesis in both mice and humans leads to the generation of multiple small parathyroid clusters in addition to the main parathyroid glands, that are the likely source of physiologically relevant "thymic PTH."" Endocrine - Thymus Development
More recent papers
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Search term: Parathyroid Embryology

Oliwia Anna Segiet, Mariusz Deska, Łukasz Mielańczyk, Marlena Brzozowa-Zasada, Grzegorz Buła, Jacek Gawrychowski, Romuald Wojnicz Expression of TRAIL and Fas in Primary Hyperparathyroidism. J Invest Surg: 2016;1-5 PubMed 27763797

P Libánský, P Broulík, M Fialová, J Kubinyi, R Lischke, D Táborská, J Tvrdoň, J Šedý, S Adámek [Videothoracoscopic excision of mediastinal parathyroid adenoma in primary hyperparathyroidism]. [Videothorakoskopické odstranění mediastinálně uloženého adenomu příštítného tělíska při primární hyperparathyreóze.] Rozhl Chir: 2016, 95(6);245-8 PubMed 27410759

Arthur Varoquaux, Electron Kebebew, Frederic Sebag, Katherine Wolf, Jean-François Henry, Karel Pacak, David Taieb Endocrine tumors associated with the vagus nerve. Endocr. Relat. Cancer: 2016; PubMed 27406876

M A D Silva, D F P Vasconcelos, M R Marques, S P Barros Parathyroid hormone intermittent administration promotes delay on rat incisor eruption. Arch. Oral Biol.: 2016, 69;102-108 PubMed 27285944

Vincenzo De Sanctis, Ashraf T Soliman, Salvatore Di Maio, Heba Elsedfy, Nada A Soliman, Rania Elalaily Thyroid Hemiagenesis from Childhood to Adulthood: Review of Literature and Personal Experience. Pediatr Endocrinol Rev: 2016, 13(3);612-9 PubMed 27116848

Development Overview

Parathyroid primordia (week 6 GA)[1]
Adult parathyroid anatomy
  • Endoderm - third and fourth pharyngeal pouches, could also have ectoderm and neural crest
  • 3rd Pharyngeal Pouch - inferior parathyroid, initially descends with thymus
  • 4th Pharyngeal Pouch - superior parathyroid
  • Week 6 - diverticulum elongate, hollow then solid, dorsal cell proliferation
  • Fetal parathyroids - respond to calcium levels, fetal calcium levels higher than maternal

Parathyroid Hormone

(PTH, parathormone or parathyrin) A polypeptide (84 amino acids) hormone which increases the concentration of calcium ions in the blood. Its actions oppose the hormone calcitonin from the thyroid gland parafollicular cells (C cells), which decrease calcium. Acts through the parathyroid hormone receptor in bone, kidney and gastrointestinal tract.

  • stimulate osteoclasts - degrade bone matrix, releasing calcium
  • increase calcium gastrointestinal tract absorption

Parathyroid Hormone-related Protein

(PTHrP) Originally identified in the clinical syndrome humoral hypercalcemia of malignancy. It's developmental role is that of a regulatory protein expressed during the formation of many organs.

  • mammary gland development - epithelial-mesenchymal interactions[3]
  • chondrocyte differentiation[4]




  • Postnatal adult ageing increased parathyroid hormone plasma levels are associated with cognitive decline and dementia.
  • Parathyroid carcinoma (cancer) is a rare malignancy, occurring with an incidence of 0.5 to 4% of all cases of primary hyperparathyroidism.

Adult Histology


  1. 1.0 1.1 1.2 1.3 Zhijie Liu, Alison Farley, Lizhen Chen, Beth J Kirby, Christopher S Kovacs, C Clare Blackburn, Nancy R Manley Thymus-associated parathyroid hormone has two cellular origins with distinct endocrine and immunological functions. PLoS Genet.: 2010, 6(12);e1001251 PubMed 21203493
  2. Jena L Chojnowski, Kyoko Masuda, Heidi A Trau, Kirk Thomas, Mario Capecchi, Nancy R Manley Multiple roles for HOXA3 in regulating thymus and parathyroid differentiation and morphogenesis in mouse. Development: 2014, 141(19);3697-708 PubMed 25249461
  3. M E Dunbar, J J Wysolmerski Parathyroid hormone-related protein: a developmental regulatory molecule necessary for mammary gland development. J Mammary Gland Biol Neoplasia: 1999, 4(1);21-34 PubMed 10219904
  4. Benjamin A Alman, Jay S Wunder Parathyroid hormone-related protein regulates glioma-associated oncogene transcriptional activation: lessons learned from bone development and cartilage neoplasia. Ann. N. Y. Acad. Sci.: 2008, 1144;36-41 PubMed 19076361


  • The development of the parathyroid gland: from fish to human. Zajac JD, Danks JA. Curr Opin Nephrol Hypertens. 2008 Jul;17(4):353-6. Review. PMID: 18660669
  • Parathyroid development and the role of tubulin chaperone E. Parvari R, Diaz GA, Hershkovitz E. Horm Res. 2007;67(1):12-21. Epub 2006 Sep 27. Review. PMID: 17008776
  • Role of parathyroid hormone-related peptide and Indian hedgehog in skeletal development. Jüppner H. Pediatr Nephrol. 2000 Jul;14(7):606-11. Review. PMID: 10912527


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  • parathyroid hormone - (PTH, parathormone or parathyrin) A polypeptide (84 amino acids) hormone secreted by the parathyroid gland, which increases the concentration of calcium ions in the blood. Its actions oppose the hormone calcitonin from the thyroid gland parafollicular cells (C cells), which decrease calcium. Acts through the parathyroid hormone receptor located mainly in bone, kidney and gastrointestinal tract. Hormone dual role is to: stimulate osteoclasts in bone to degrade bone matrix releasing calcium; increase gastrointestinal tract absorption of calcium.

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Cite this page: Hill, M.A. 2017 Embryology Endocrine - Parathyroid Development. Retrieved February 22, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Endocrine_-_Parathyroid_Development

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