FGF-23 REGULATION OF PHOSPHATE HOMEOSTASIS

描述（由申请方提供）：由于磷酸盐稳态受损导致的代谢性骨病的病理生理机制尚未完全了解。研究由矿物质代谢紊乱引起的疾病的分子病因学有助于鉴定磷酸盐稳态的新循环调节剂，统称为“磷酸化酶”。“我们在定位克隆方法中鉴定了磷酸化成纤维细胞生长因子-23（FGF 23），以分离常染色体显性低磷酸盐血症性佝偻病（ADHR）的基因，其特征在于继发于肾磷酸盐消耗、佝偻病/骨软化和骨折的低磷酸盐血症。在当前资助周期的这项工作的基础上，我们的研究小组发现了一种与FGF 23升高相关的新型隐性磷酸盐消耗性疾病的分子基础，并确定了ADHR的镜像疾病，家族性肿瘤钙质沉着症（TC），是由隐性FGF 23功能缺失突变引起的。TC表型也存在于Klotho（KL）-null小鼠中，我们的数据表明FGF 23通过这种受体样分子发挥其生物学作用。然而，介导FGF 23依赖性生物活性的KL同种型是未知的。我们使用携带人ADHR Fgf 23突变的小鼠中的新型敲除的初步发现证明了独特骨骼改变的存在，为体内FGF 23功能提供了新的见解。尽管在确定FGF 23在正常情况和疾病中的作用方面已经取得了重大进展，但FGF 23控制磷酸盐处理的机制仍不清楚。因此，在该提议中要测试的中心假设是：FGF 23以受调节的方式从骨细胞分泌，并通过特定的靶分子起作用以控制肾脏中的磷酸盐稳态。我们将通过以下具体目的来解决这一假设：使用小鼠敲入模型来测试ADHR的分子机制;确定KL在FGF 23的肾近端小管和远端小管作用中的作用;以及测试KL同种型在体内指导FGF 23生物活性的能力。 这些研究将从长期来看，为与FGF 23表达改变相关的综合征的发病机制、更常见的磷酸盐稳态紊乱疾病以及磷酸盐稳态的基础生物学提供重要的见解。

DESCRIPTION (provided by applicant): The pathophysiological mechanisms that underlie metabolic bone diseases due to impaired phosphate homeostasis are incompletely understood. Investigating the molecular etiology of disorders caused by disturbed mineral metabolism has been instrumental in identifying new circulating regulators of phosphate homeostasis, collectively referred to as `phosphatonins.' We identified the phosphatonin Fibroblast growth factor-23 (FGF23) in a positional cloning approach to isolate the gene for autosomal dominant hypophosphatemic rickets (ADHR), characterized by hypophosphatemia secondary to renal phosphate wasting, rickets/osteomalacia and fracture. Building upon this work during the current grant cycle, our group discovered the molecular basis for a novel recessive phosphate wasting disorder associated with elevated FGF23, as well as determined that the mirror-image disorder to ADHR, familial tumoral calcinosis (TC), is caused by recessive FGF23 loss of function mutations. A TC phenotype is also present in the Klotho (KL)-null mouse, and our data demonstrate that FGF23 elicits its biological actions through this receptor-like molecule. However, the KL isoform that mediates FGF23-dependent bioactivity is unknown. Our preliminary findings using a novel knock in mouse carrying a human ADHR Fgf23 mutation demonstrate the presence of unique skeletal alterations, providing new insight into FGF23 function in vivo. Although significant progress has been made determining the roles of FGF23 in normal circumstances and in disease, the mechanisms whereby FGF23 controls phosphate handling remain unclear. Thus, the central hypothesis to be tested within this proposal is: FGF23 is secreted from bone cells in a regulated manner and acts through specific target molecules to control phosphate homeostasis in the kidney. We will address this hypothesis by undertaking the following specific aims: To test the molecular mechanisms underlying ADHR using a murine knock in model; to determine the role of KL in the renal proximal tubule and distal tubule actions of FGF23; and to test the KL isoforms for the ability to direct FGF23 bioactivity in vivo. These investigations will, over the long term, provide critical insight into the pathogenesis of syndromes associated with altered FGF23 expression, into more common disorders of disturbed phosphate homeostasis, as well as into the basic biology of phosphate homeostasis.