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Developmental Toxicity Assay Based on Real-Time Monitoring of Fibroblast Growth Factor Signal Disruption in Human Induced Pluripotent Stem Cells
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Fibroblast growth factor 23.

Edward R Smith1, Lawrence P McMahon, Stephen G Holt

  • 1Department of Renal Medicine, Eastern Health Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Box Hill, Victoria, Australia.

Annals of Clinical Biochemistry
|November 26, 2013
PubMed
Summary
This summary is machine-generated.

Fibroblast growth factor 23 (FGF23) is important in mineral metabolism, but current measurement methods lack agreement. Standardizing FGF23 testing is needed before clinical use in chronic kidney disease patients.

Keywords:
Fibroblast growth factor 23chronic kidney diseaseenzyme-linked immunosorbent assaymethod comparisonparathyroid hormone

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Area of Science:

  • Endocrinology
  • Nephrology
  • Biochemistry

Background:

  • Fibroblast growth factor 23 (FGF23) plays a key role in mineral metabolism.
  • FGF23 is a potential early marker for chronic kidney disease (CKD)-related bone disease and cardiovascular risk.

Purpose of the Study:

  • To review preanalytical and analytical aspects of FGF23 measurement.
  • To discuss the suitability of FGF23 testing for routine clinical practice.

Main Methods:

  • Review of current FGF23 measurement techniques, focusing on enzyme-linked immunosorbent assays (ELISAs).
  • Analysis of factors contributing to assay variability, including fragment detection, antibody specificity, and calibration.

Main Results:

  • Current 'state-of-the-art' ELISAs for FGF23 show poor agreement, hindering direct comparison of results.
  • Analytical variability complicates the establishment of standardized reference intervals and clinical decision limits.
  • Assay-dependent biological variability of plasma FGF23 further complicates interpretation and testing protocols.

Conclusions:

  • Significant analytical variability currently limits the clinical utility of FGF23 measurements.
  • Standardization of FGF23 assays is required before widespread adoption in routine clinical practice.
  • It is premature to incorporate FGF23 measurements into standard testing repertoires.