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2017 ; 28
(4
): 1162-1174
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Chronic Hyperphosphatemia and Vascular Calcification Are Reduced by Stable
Delivery of Soluble Klotho
#MMPMID27837149
Hum JM
; O'Bryan LM
; Tatiparthi AK
; Cass TA
; Clinkenbeard EL
; Cramer MS
; Bhaskaran M
; Johnson RL
; Wilson JM
; Smith RC
; White KE
J Am Soc Nephrol
2017[Apr]; 28
(4
): 1162-1174
PMID27837149
show ga
?Klotho (?KL) regulates mineral metabolism, and diseases associated with ?KL
deficiency are characterized by hyperphosphatemia and vascular calcification
(VC). ?KL is expressed as a membrane-bound protein (mKL) and recognized as the
coreceptor for fibroblast growth factor-23 (FGF23) and a circulating soluble form
(cKL) created by endoproteolytic cleavage of mKL. The functions of cKL with
regard to phosphate metabolism are unclear. We tested the ability of cKL to
regulate pathways and phenotypes associated with hyperphosphatemia in a mouse
model of CKD-mineral bone disorder and ?KL-null mice. Stable delivery of
adeno-associated virus (AAV) expressing cKL to diabetic endothelial nitric oxide
synthase-deficient mice or ?KL-null mice reduced serum phosphate levels. Acute
injection of recombinant cKL downregulated the renal sodium-phosphate
cotransporter Npt2a in ?KL-null mice supporting direct actions of cKL in the
absence of mKL. ?KL-null mice with sustained AAV-cKL expression had a 74%-78%
reduction in aorta mineral content and a 72%-77% reduction in mineral volume
compared with control-treated counterparts (P<0.01). Treatment of UMR-106
osteoblastic cells with cKL + FGF23 increased the phosphorylation of
extracellular signal-regulated kinase 1/2 and induced Fgf23 expression.
CRISPR/Cas9-mediated deletion of fibroblast growth factor receptor 1 (FGFR1) or
pretreatment with inhibitors of mitogen-activated kinase kinase 1 or FGFR ablated
these responses. In summary, sustained cKL treatment reduced hyperphosphatemia in
a mouse model of CKD-mineral bone disorder, and it reduced hyperphosphatemia and
prevented VC in mice without endogenous ?KL. Furthermore, cKL stimulated Fgf23 in
an FGFR1-dependent manner in bone cells. Collectively, these findings indicate
that cKL has mKL-independent activity and suggest the potential for enhancing cKL
activity in diseases of hyperphosphatemia with associated VC.
|Animals
[MESH]
|Bone and Bones/metabolism
[MESH]
|Chronic Disease
[MESH]
|Diabetic Nephropathies/complications
[MESH]
|Disease Models, Animal
[MESH]
|Female
[MESH]
|Fibroblast Growth Factor-23
[MESH]
|Glucuronidase/administration & dosage/physiology/*therapeutic use
[MESH]