Expression and Regulation of FGF23 in Osseous and Extra-Skeletal Tissues During Normal and Altered Metabolic States

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Medicine and Health Sciences


Phosphorus equilibrium in the body is regulated through uptake and release via the intestine, kidney and bone. These processes are coordinated through the activity and regulation of Fibroblast Growth Factor 23 (FGF23). FGF23 is primarily produced in osseous structures by osteocytes and osteoblasts. Under normal physiological conditions, elevations in serum phosphorus or active 1,25dihydroxyvitamin D stimulate tran-scriptional upregulation of FGF23 and promote the release of the full-length intact FGF23 protein which targets it to downstream tissues. Studies in rare heritable forms of phosphate dysregulation revealed novel pathways of FG23 regulation including iron deficiency and inflammation. Notably, FGF23 expression under these conditions were not confined to the skeletal tissues. Thus, this review will examine the regulation of FGF23 in normal and altered metabolic states as well as how they affect expression within extra-skeletal tissue.


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