Regulation of FGF23: Beyond Bone.

Area of Science:

• Endocrinology
• Mineral Metabolism
• Bone Biology

Background:

• Fibroblast growth factor 23 (FGF23) is a key hormone derived from bone and bone marrow.
• It plays a critical role in maintaining phosphate homeostasis and regulating vitamin D synthesis.
• Dysregulation of FGF23 leads to conditions like hyperphosphatemia or hypophosphatemia, with significant health consequences.

Purpose of the Study:

• To review the current understanding of FGF23 regulation.
• To explore the intricate relationship between FGF23 and non-bone mineral factors.
• To highlight novel insights into FGF23's regulatory mechanisms and functional roles.

Main Methods:

• Review of existing scientific literature on FGF23.
• Analysis of studies investigating FGF23 interactions with various biological factors.
• Synthesis of findings on the bidirectional relationship between FGF23 and non-classical regulators.

Main Results:

• FGF23 levels are influenced by factors beyond bone mineral metabolism, including iron, erythropoietin, inflammation, energy, and metabolism.
• These factors impact both Fgf23 gene expression and FGF23 protein cleavage.
• FGF23 itself may play a role in regulating these non-bone mineral biological processes.

Conclusions:

• The regulation of FGF23 is complex and involves a bidirectional interplay with various systemic factors.
• Understanding these interactions provides new perspectives on FGF23's role in health and disease, particularly in kidney disease.
• Further research into these relationships could uncover new therapeutic targets for FGF23-related disorders.