title: Fibroblast growth factor 23 and Klotho: physiology and pathophysiology of an endocrine network of mineral metabolism.
abstract: The metabolically active and perpetually remodeling calcium phosphate-based endoskeleton in terrestrial vertebrates sets the demands on whole-organism calcium and phosphate homeostasis that involves multiple organs in terms of mineral flux and endocrine cross talk. The fibroblast growth factor (FGF)-Klotho endocrine networks epitomize the complexity of systems biology, and specifically, the FGF23-αKlotho axis highlights the concept of the skeleton holding the master switch of homeostasis rather than a passive target organ as hitherto conceived. Other than serving as a coreceptor for FGF23, αKlotho circulates as an endocrine substance with a multitude of effects. This review covers recent data on the physiological regulation and function of the complex FGF23-αKlotho network. Chronic kidney disease is a common pathophysiological state in which FGF23-αKlotho, a multiorgan endocrine network, is deranged in a self-amplifying vortex resulting in organ dysfunction of the utmost severity that contributes to its morbidity and mortality.
authors: Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA.
authors: Ming Chang
authors: MC
authors: Hu
authors: Kazuhiro
authors: K
authors: Shiizaki
authors: Makoto
authors: M
authors: Kuro-o
authors: Orson W
authors: OW
authors: Moe
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000502:physiology; D004703:Endocrine System / Q000502:physiology*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000502:physiology*; D005966:Glucuronidase / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007422:Intestines / Q000502:physiology; D007668:Kidney / Q000502:physiology; D000090265:Klotho Proteins; D008903:Minerals / Q000378:metabolism*
chemical_list: C000717427:FGF23 protein, human; D008903:Minerals; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005966:Glucuronidase; D000090265:Klotho Proteins
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