11Jan 2023
Regulation of FGF23 production and phosphate metabolism by bone–kidney interactions

Regulation of FGF23 production and phosphate metabolism by bone–kidney interactions

The bone-derived hormone fibroblast growth factor 23 (FGF23) functions in concert with parathyroid hormone (PTH) and the active vitamin D metabolite, 1,25(OH)2 vitamin D (1,25D), to control phosphate and calcium homeostasis. A rise in circulating levels of phosphate and 1,25D leads to FGF23 production in bone. Understanding the molecular mechanisms that control FGF23 synthesis in the bone and its bioactivity in the kidney has led to identifying potential targets for novel interventions. Emerging approaches to target aberrant phosphate metabolism include small molecule inhibitors that directly bind FGF23 and prevent its interactions with FGF receptors and α-Klotho. These FGF23 peptide fragments act as competitive inhibitors of intact FGF23 and small molecule inhibitors of kidney sodium-phosphate cotransporters.

  • #nephrology

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