“…We also showed a significant increase in renal excretion of calcium (290 ± 70.9 vs. 146.8 ± 82.8 mg/24 h; P = 0.05), and reduction in both total (9.0 ± 0.4 vs. 9.8 ± 0.4 mg/dl) and ionized serum calcium levels (1.18 ± 0.05 vs. 1.26 ± 0.04 mmol/l) and increased circulating levels of PTH (55 ± 18.3 vs. 32.3 ± 15.3 pg/ml), leading to typical Bone alterations in NF1 patients are probably due to involvement of bone remodeling, by osteoclasts and osteoblasts, in which neurofibromin plays an important role in the differentiation and functional activity, with higher bone resorption and lower bone formation, induced by altered production of mineralized matrix and incomplete maturation of osteoblast precursors [19,21,23,33,37] and increased resorption, migration and survival of osteoclasts [14,29,31,32,45,46]. Other cellular elements can be involved into altered bone growth, such as chondrocytes, fibroblasts and endothelial cells, all expressing physiologically neurofibromin [12,30,40].…”