Regulation of phosphate homeostasis by the phosphatonins and other novel mediators.

Regulation of phosphate homeostasis by the phosphatonins and other novel mediators.
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DOI:
10.1007/s00467-008-0751-z
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发表时间:
2008-08
影响因子:
3
通讯作者:
Kumar, Rajiv
Kumar, Rajiv
中科院分区:
医学3区
文献类型:
--
作者:
Shaikh, Aisha;Berndt, Theresa;Kumar, Rajiv

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多种因素调节磷酸盐在肠道的吸收效率和在肾脏的再吸收。除了众所周知的磷酸盐稳态调节剂,即甲状旁腺激素(PTH)和维生素D内分泌系统外,最近通过对与低磷血症相关的各种疾病的研究,发现了一些统称为磷脂素的多肽。成纤维细胞生长因子23(成纤维细胞生长因子23)、分泌卷曲相关蛋白4(SFRP-4)、成纤维细胞生长因子7(成纤维细胞生长因子7)和基质细胞外磷酸糖蛋白(MEPE)在多种低磷血症和高磷血症的发病机制中发挥作用,如肿瘤性骨软化症、X连锁低磷血症、常染色体显性遗传性低磷血症、常染色体隐性低磷血症和肿瘤钙化。这些因素是否真的是荷尔蒙,从某种意义上说,它们是由饮食中磷的摄入量和生物体对更高或更低磷的需要来调节的,还有待于在人类身上牢固地确立。此外,新的信息表明,肠道“感知”磷酸盐的腔内浓度,并通过阐述改变肾脏磷酸盐重吸收的新因素来调节肾脏中磷酸盐的排泄。
A variety of factors regulate the efficiency of phosphate absorption in the intestine and phosphate reabsorption in kidney. Apart from the well-known regulators of phosphate homeostasis, namely parathyroid hormone (PTH) and the vitamin D–endocrine system, a number of peptides collectively known as the “phosphatonins” have been recently identified as a result of the study of various diseases associated with hypophosphatemia. These factors, fibroblast growth factor 23 (FGF-23), secreted frizzled-related protein 4 (sFRP-4), fibroblast growth factor 7 (FGF-7) and matrix extracellular phosphoglycoprotein (MEPE), have been shown to play a role in the pathogenesis of various hypophosphatemic and hyperphosphatemic disorders, such as oncogenic osteomalacia, X-linked hypophosphatemic rickets, autosomal dominant hypophosphatemic rickets, autosomal recessive hypophosphatemia and tumoral calcinosis. Whether these factors are true hormones, in the sense that they are regulated by the intake of dietary phosphorus and the needs of the organism for higher or lower amounts of phosphorus, remains to be firmly established in humans. Additionally, new information demonstrates that the intestine “senses” luminal concentrations of phosphate and regulates the excretion of phosphate in the kidney by elaborating novel factors that alter renal phosphate reabsorption.
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