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Secondary hyperparathyroidism (SHP) is a common complication of chronic kidney disease (CKD) that correlates with morbidity and mortality. In experimental SHP, the increased PTH gene expression is due to increased PTH mRNA stability and is mediated by protein\u2013PTH mRNA interactions. Adenosine\u2013uridine\u2010rich binding factor 1 (AUF1) stabilizes and K\u2010homology splicing regulatory protein (KSRP) destabilizes PTH mRNA. The peptidyl\u2010prolyl <jats:italic>cis\/trans<\/jats:italic> isomerase Pin1 acts on target proteins, including mRNA\u2010binding proteins. Pin1 leads to KSRP dephosphorylation, but in SHP, parathyroid Pin1 activity is decreased and phosphorylated KSRP fails to bind PTH mRNA, leading to increased PTH mRNA stability and levels. A further level of post\u2010transcriptional regulation occurs through microRNA (miRNA). Dicer mediates the final step of miRNA maturation. Parathyroid\u2010specific <jats:italic>Dicer<\/jats:italic> knockout mice that lack miRNAs in the parathyroid develop normally. Surprisingly, these mice fail to increase serum PTH in response to both hypocalcemia and CKD, indicating that parathyroid Dicer and miRNAs are essential for stimulation of the parathyroid. Human and rodent parathyroids share similar miRNA profiles that are altered in hyperparathyroidism. The evolutionary conservation of abundant miRNAs and their regulation in hyperparathyroidism indicate their significance in parathyroid physiology and pathophysiology. let\u20107 and miR\u2010148 antagonism modifies PTH secretion <jats:italic>in\u00a0vivo<\/jats:italic> and <jats:italic>in\u00a0vitro<\/jats:italic>, suggesting roles for specific miRNAs in parathyroid function.\u00a0This review summarizes the current knowledge on the post\u2010transcriptional mechanisms of PTH gene expression in SHP and the central contribution of miRNAs to the high serum PTH levels of both primary hyperparathyroidism and SHP.<\/jats:p>","DOI":"10.1111\/febs.15300","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T14:16:33Z","timestamp":1584627393000},"page":"2903-2913","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Post\u2010transcriptional mechanisms regulating parathyroid hormone gene 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