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The PTH-Vitamin D-FGF23 axis.

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Fibroblast growth factor 23 (FGF23) regulates phosphate and vitamin D. This review details FGF23 regulation, its interactions with parathyroid hormone (PTH) and vitamin D, and emerging therapies for FGF23-related disorders.

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Area of Science:

  • Endocrinology
  • Mineral Metabolism
  • Molecular Biology

Background:

  • Fibroblast growth factor 23 (FGF23) is a key hormone regulating phosphate and vitamin D.
  • Understanding the FGF23-Vitamin D-Parathyroid Hormone (PTH) axis is crucial for mineral homeostasis.
  • Disruptions in FGF23 signaling are linked to various metabolic disorders.

Purpose of the Study:

  • To review the multifaceted regulation of FGF23, including its genomic structure and posttranslational modifications.
  • To elucidate the intricate interactions between FGF23, vitamin D, and PTH in maintaining mineral balance.
  • To discuss disorders associated with altered FGF23 levels and explore emerging therapeutic strategies.

Main Methods:

  • Comprehensive literature review of FGF23 regulation and function.
  • Analysis of FGF23 interactions within the bone-kidney-parathyroid axis.
  • Synthesis of current knowledge on FGF23-related diseases and treatments.

Main Results:

  • Detailed overview of FGF23's genomic, transcriptional, translational, and posttranslational regulation.
  • Elucidation of FGF23's role in the complex interplay with vitamin D and PTH.
  • Identification of various disorders stemming from dysregulated FGF23 and potential therapeutic targets.

Conclusions:

  • FGF23 is a central player in mineral homeostasis, interacting with vitamin D and PTH.
  • This review redefines the roles of PTH and vitamin D within a broader bone-kidney-parathyroid feedback loop.
  • Further research is needed to clarify complex aspects of FGF23 regulation and its clinical implications.