title: FGF23 is a putative marker for bone healing and regeneration.
abstract: Besides numerous other factors, fibroblast growth factor receptor (FGFR) signaling is involved in fracture healing and bone remodeling. FGF23 is a phosphatonin produced by osteoblastic cells, which signals via FGFR1, thereby exerting effects in bone and kidney. We analyzed if serum FGF23 levels might be an indicator to predict fracture healing and union. FGF23 (C-Term) was elevated on day 3 postoperatively in 55 patients sustaining an exchange of total hip implants due to aseptic loosening. A prospective study of 40 patients undergoing primary hip arthroplasty also showed elevated FGF23 (C-Term) but no change in FGF23 (intact) levels on days 1, 4, and 10 postoperatively. Serum phosphate and phosphate clearance stayed within normal ranges. FGF23 mRNA expression in ovine callus was compared between a standard and delayed course of osteotomy healing. In the standard model, a marked increase in FGF23 mRNA expression compared to the delayed healing situation was observed. Immunohistochemical analysis showed FGF23 production of osteoblasts and granulation tissue in the fracture callus during bone healing. In conclusion, FGF23 is involved in bone healing, can be measured by a sensitive assay in peripheral blood, and is a promising candidate as an indicator for healing processes prone to reunion versus nonunion.
authors.affiliation: Orthopedic Center for Musculoskeletal Research, University of Wuerzburg, Wuerzburg, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Goebel
authors.forename: Jasmin
authors.initials: J
authors.lastname: Lienau
authors.forename: Ulrich
authors.initials: U
authors.lastname: Rammoser
authors.forename: Lothar
authors.initials: L
authors.lastname: Seefried
authors.forename: Karl Florian
authors.initials: KF
authors.lastname: Wintgens
authors.forename: Jochen
authors.initials: J
authors.lastname: Seufert
authors.forename: Georg
authors.initials: G
authors.lastname: Duda
authors.forename: Franz
authors.initials: F
authors.lastname: Jakob
authors.forename: Regina
authors.initials: R
authors.lastname: Ebert
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood*; D002146:Bony Callus / Q000502:physiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood* / Q000235:genetics*; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010006:Osteoblasts / Q000502:physiology; D010027:Osteotomy; D010710:Phosphates / Q000097:blood; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011475:Prosthesis Failure; D012333:RNA, Messenger / Q000378:metabolism; D012038:Regeneration / Q000502:physiology*; D012756:Sheep
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D010710:Phosphates; D012333:RNA, Messenger; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D000469:Alkaline Phosphatase