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Toxins 2019, 11(3), 175; https://doi.org/10.3390/toxins11030175

FGF23, Biomarker or Target?

1
Nephrology Service, University Hospital Reina Sofia, 14005 Cordoba, Spain
2
Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/University of Cordoba, 14005 Cordoba, Spain
3
Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
Received: 25 February 2019 / Revised: 14 March 2019 / Accepted: 19 March 2019 / Published: 22 March 2019
(This article belongs to the Special Issue Disposition of Uremic Toxins: The Challenges in Uremia)
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Abstract

Fibroblast growth factor 23 (FGF23) plays a key role in the complex network between the bones and other organs. Initially, it was thought that FGF23 exclusively regulated phosphate and vitamin D metabolism; however, recent research has demonstrated that an excess of FGF23 has other effects that may be detrimental in some cases. The understanding of the signaling pathways through which FGF23 acts in different organs is crucial to develop strategies aiming to prevent the negative effects associated with high FGF23 levels. FGF23 has been described to have effects on the heart, promoting left ventricular hypertrophy (LVH); the liver, leading to production of inflammatory cytokines; the bones, inhibiting mineralization; and the bone marrow, by reducing the production of erythropoietin (EPO). The identification of FGF23 receptors will play a remarkable role in future research since its selective blockade might reduce the adverse effects of FGF23. Patients with chronic kidney disease (CKD) have very high levels of FGF23 and may be the population suffering from the most adverse FGF23-related effects. The general population, as well as kidney transplant recipients, may also be affected by high FGF23. Whether the association between FGF23 and clinical events is causal or casual remains controversial. The hypothesis that FGF23 could be considered a therapeutic target is gaining relevance and may become a promising field of investigation in the future. View Full-Text
Keywords: calcium; phosphate; chronic kidney disease; dialysis; fibroblast growth factor 23 (FGF23); fibroblast growth factor receptor (FGFR); Klotho; parathyroid hormone calcium; phosphate; chronic kidney disease; dialysis; fibroblast growth factor 23 (FGF23); fibroblast growth factor receptor (FGFR); Klotho; parathyroid hormone
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Rodelo-Haad, C.; Santamaria, R.; Muñoz-Castañeda, J.R.; Pendón-Ruiz de Mier, M.V.; Martin-Malo, A.; Rodriguez, M. FGF23, Biomarker or Target? Toxins 2019, 11, 175.

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