Fibroblast Growth Factor 23 as a Therapeutic Target

Authors

  • Fan Li, MD, MS Division of Nephrology, Department of Medicine, the University of Tennessee Health Science Center, Memphis,TN, 38165, USA
  • Zhousheng Xiao, MD, PhD Division of Nephrology, Department of Medicine, the University of Tennessee Health Science Center, Memphis,TN, 38165, USA

DOI:

https://doi.org/10.17140/NPOJ-4-118

Keywords:

antagonist, fibroblast

Abstract

This fibroblast growth factor-23 (FGF-23) has been found as a circulating hormone and pathogenic factor in many disease
conditions. This review focuses on recent advances in FGF-23 as a therapeutic target, including fibroblast growth factor receptors
(FGFR) tyrosine kinase inhibitor, FGF-23 antibody, FGF-23 C-terminal peptide, CYP24A1 inhibitor, and FGF-23 antagonist. We
also update the advantages and disadvantages of targeting upstream and downstream molecules in FGF-23 signaling pathways.

References

Weber TJ, Liu S, Indridason OS, Quarles LD. Serum FGF23 levels in normal and disordered phosphorus homeostasis. J Bone Miner Res. 2003; 18:1227-1234. doi: 10.1359/jbmr.2003.18.7.1227

Yamashita T, Yoshioka M, Itoh N. Identification of a novel fibroblast growth factor, FGF-23, preferentially expressed in the ventrolateral thalamic nucleus of the brain. Biochem Biophys Res Commun. 2000; 277: 494-498. doi: 10.1006/bbrc.2000.3696

Liu S, Gupta A, Quarles LD. Emerging role of fibroblast growth factor-23 in a bone-kidney axis regulating systemic phosphate homeostasis and extracellular matrix mineralization. Curr Opin Nephrol Hypertens. 2007; 16: 329-335. doi: 10.1097/ MNH.0b013e3281ca6ffd

Quarles LD. The bone and beyond: ‘Dem bones’ are made for more than walking. Nat Med. 2011; 17: 428-430. doi: 10.1038/ nm0411-428

Faul C, Amaral AP, Oskouei B, et al. FGF-23 induces left ventricular hypertrophy, J Clin Invest. 2011; 121: 393-408. doi: 10.1172/JCI46122

Gutierrez OM, Mannstadt M, Isakova T, et al. Fibroblast growth factor-23 and mortality among patients undergoing hemodialysis. N Engl J Med. 2008; 359: 584-592. doi: 10.1056/NEJMoa0706130

Olauson H, Larsson TE. FGF23 and Klotho in chronic kidney disease. Curr Opin Nephrol Hypertens. 2013; 22: 397-404. doi: 10.1097/MNH.0b013e32836213ee

Quarles LD. FGF23, PHEX, and MEPE regulation of phosphate homeostasis and skeletal mineralization. Am J Physiol Endocrinol Metab. 2003; 285: e1-e9. doi: 10.1152/ajpendo.00016.2003

Mackenzie NC, Zhu D, Milne EM, et al. Altered bone development and an increase in FGF-23 expression in Enpp1(-/-) mice. PLoS One. 2012; 7: e32177. doi: 10.1371/journal. pone.0032177

Han X, Li L, Yang J, King G, Xiao Z, Quarles LD. Counter-regulatory paracrine actions of FGF-23 and 1,25(OH)2 D in macrophages. FEBS Lett. 2016; 590: 53-67. doi: 10.1002/1873- 3468.12040

Han X, Xiao Z, Quarles LD. Membrane and integrative nuclear fibroblastic growth factor receptor (FGFR) regulation of FGF-23. J Biol Chem. 2015; 290: 10447-10459. doi: 10.1074/jbc. M114.609230

Liu S, Guo R, Simpson LG, Xiao ZS, Burnham CE, Quarles LD. Regulation of fibroblastic growth factor-23 expression but not degradation by PHEX. J Biol Chem. 2003; 278: 37419-37426. doi: 10.1074/jbc.M304544200

Liu S, Zhou J, Tang W, Jiang X, Rowe DW, Quarles LD. Pathogenic role of Fgf-23 in Hyp mice. Am J Physiol Endocrinol Metab. 2006; 291: E38-E49. doi: 10.1152/ajpendo.00008.2006

Liu S, Zhou J, Tang W, Menard R, Feng JQ, Quarles LD. Pathogenic role of Fgf-23 in Dmp1-null mice. Am J Physiol Endocrinol Metab. 2008; 295: E254-E261. doi: 10.1152/ajpendo.90201.2008

Wang X, Wang S, Li C, et al. Inactivation of a novel FGF23 regulator, FAM20C, leads to hypophosphatemic rickets in mice. PLoS genet. 2012; 8: e1002708. doi: 10.1371/journal.pgen.1002708

Martin A, Liu S, David V, et al. Bone proteins PHEX and DMP1 regulate fibroblastic growth factor Fgf-23 expression in osteocytes through a common pathway involving FGF receptor (FGFR) signaling. FASEB J. 2011; 25: 2551-2562. doi: 10.1096/ fj.10-177816

Xiao Z, Huang J, Cao L, Liang Y, Han X, Quarles LD. Osteocyte-specific deletion of Fgfr1 suppresses FGF-23. PLoS One. 2014; 9: e104154. doi: 10.1371/journal.pone.0104154

Zhang Q, Doucet M, Tomlinson RE, et al. The hypoxia-inducible factor-1alpha activates ectopic production of fibroblast growth factor-23 in tumor-induced osteomalacia. Bone Res. 2016; 4: 16011. doi: 10.1038/boneres.2016.11

Feng JQ, Ward LM, Liu S, et al. Loss of DMP1 causes rickets and osteomalacia and identifies a role for osteocytes in mineral metabolism. Nat Genet. 2006; 38: 1310-1315. doi: 10.1038/ng1905

Wang X., Wang S, Li C, et al. Inactivation of a novel FGF23 regulator, FAM20C, leads to hypophosphatemic rickets in mice. PLoS Genet. 2012; 8: e1002708. doi: 10.1371/journal.pgen.1002708

Whyte MP, McAlister WH, Fallon MD, et al. Raine syndrome (OMIM #259775), caused by FAM20C mutation, is congenital sclerosing osteomalacia with cerebral calcification (OMIM 259660). J Bone Miner Res. 2016; 32: 757-769. doi: 10.1002/jbmr.3034

Oya K, Ishida K, Nishida T, et al. Immunohistochemical analysis of dentin matrix protein 1 (DMP1) phosphorylation by Fam20C in bone: Implications for the induction of biomineralization. Histochem Cell Biol. 2016; 147: 341-351. doi: 10.1007/s00418-016- 1490-z

Shimada T, Mizutani S, Muto T, et al. Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia. Proc Natl Acad Sci U S A. 2001; 98: 6500-6505. doi: 10.1073/pnas.101545198

Fukumoto S. Yamashita T. Fibroblast growth factor-23 is the phosphaturic factor in tumor-induced osteomalacia and may be phosphatonin. Curr Opin Nephrol Hypertens. 2002; 11: 385-389. doi: 10.1097/00041552-200207000-00003

White KE, Jonsson KB, Carn G, et al. The autosomal dominant hypophosphatemic rickets (ADHR) gene is a secreted polypeptide overexpressed by tumors that cause phosphate wasting. J Clin Endocrinol Metab. 2001; 86: 497-500. doi: 10.1210/jcem.86.2.7408

Komaba H, Fukagawa M. The role of FGF23 in CKD--with or without Klotho. Nat Rev Nephrol. 2012; 8: 484-490. doi: 10.1038/ nrneph.2012.116 Systematic Review | Volume 4 | issue 1|

Quarles LD. Evidence for a bone-kidney axis regulating phosphate homeostasis. J Clin Invest. 2003; 112: 642-646. doi: 10.1172/JCI200319687

Gutierrez OM, Januzzi JL, Isakova T, et al. Fibroblast growth factor-23 and left ventricular hypertrophy in chronic kidney disease. Circulation. 2009; 119: 2545-2552. doi: 10.1161/ CIRCULATIONAHA.108.844506

Isakova T, Xie H, Yang W, et al. Fibroblast growth factor-23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA. 2011; 305: 2432-2439. doi: 10.1001/jama.2011.826

Hsu HJ, Wu MS. Fibroblast growth factor-23: A possible cause of left ventricular hypertrophy in hemodialysis patients. Am J Med Sci. 2009; 337: 116-122. doi: 10.1097/MAJ.0b013e3181815498

Jean G, Bresson E, Terrat JC, et al. Peripheral vascular calcification in long-haemodialysis patients: Associated factors and survival consequences. Nephrol Dial Transplant. 2009; 24: 948-955. doi: 10.1093/ndt/gfn571

Munoz Mendoza J, Isakova T, Ricardo AC, et al. Fibroblast growth factor-23 and Inflammation in CKD. Clin J Am Soc Nephrol. 2012; 7: 1155-1162. doi: 10.2215/CJN.13281211

Hanks LJ, Casazza K, Judd SE, Jenny NS, Gutierrez OM. Associations of fibroblast growth factor-23 with markers of inflammation, insulin resistance and obesity in adults. PLoS One. 2015; 10: e0122885. doi: 10.1371/journal.pone.0122885

Wöhrle S, Henninger C, Bonny O, et al. Pharmacological inhibition of fibroblast growth factor (FGF) receptor signaling ameliorates FGF23-mediated hypophosphatemic rickets. J Bone Miner Res. 2013; 28: 899-911. doi: 10.1002/jbmr.1810

Wöhrle S, Bonny O, Beluch N, et al. FGF receptors control vitamin D and phosphate homeostasis by mediating renal FGF-23 signaling and regulating FGF-23 expression in bone. J Bone Miner Res. 2011; 26: 2486-2497. doi: 10.1002/jbmr.478

Bai X, Miao D, Xiao S, et al. CYP24 inhibition as a therapeutic target in FGF23-mediated renal phosphate wasting disorders. J Clin Invest. 2016; 126: 667-680. doi: 10.1172/JCI81928

Carpenter TO, Imel EA, Ruppe MD, et al. Randomized trial of the anti-FGF23 antibody KRN23 in X-linked hypophosphatemia, J Clin Invest. 2014; 124: 1587-1597. doi: 10.1172/JCI72829

Shalhoub V, Shatzen EM, Ward SC, et al. FGF23 neutralization improves chronic kidney disease-associated hyperparathyroidism yet increases mortality. J Clin Invest. 2012; 122: 2543-2553. doi: 10.1172/JCI61405

Goetz R, Nakada Y, Hu MC, et al. Isolated C-terminal tail of FGF23 alleviates hypophosphatemia by inhibiting FGF23-FGFR-Klotho complex formation. Proc Natl Acad Sci U S A. 2010; 107: Systematic Review | Volume 4 | Number 1| Xiao Z et al 407-412. doi: 10.1073/pnas.090200610

Johnson K, Levine K, Sergi J, et al. Therapeutic effects of FGF23 c-tail Fc in a murine preclinical model of X-linked hypophosphatemia via the selective modulation of phosphate reabsorption. J Bone Miner Res. 2017; 32: 2062-2073. doi: 10.1002/ jbmr.3197

Xiao Z, Riccardi D, Velazquez HA, et al. A computationally identified compound antagonizes excess FGF-23 signaling in renal tubules and a mouse model of hypophosphatemia. Sci Signal. 2016; 9: ra113. doi: 10.1126/scisignal.aaf5034

Urakawa I, Yamazaki Y, Shimada T, et al. Klotho converts canonical FGF receptor into a specific receptor for FGF23. Nature. 2006; 444: 770-774. doi: 10.1038/nature05315

White KE, Cabral JM, Davis SI, et al. Mutations that cause osteoglophonic dysplasia define novel roles for FGFR1 in bone elongation. Am J Hum Genet. 2005; 76: 361-367. doi: 10.1086/427956

Herbert C, Schieborr U, Saxena K, et al. Molecular mechanism of SSR128129E, an extracellularly acting, small-molecule, allosteric inhibitor of FGF receptor signaling. Cancer Cell. 2013; 23: 489-501. doi: 10.1016/j.ccr.2013.02.018

Herbert C, Schieborr U, Saxena K, et al. Molecular mechanism of SSR128129E, an extracellularly acting, small-molecule, allosteric inhibitor of FGF receptor signaling. Cancer Cell. 2016; 30: 176-178. doi: 10.1016/j.ccell.2016.06.015

Aono Y, Yamazaki Y, Yasutake J, et al. Therapeutic effects of anti-FGF23 antibodies in hypophosphatemic rickets/osteomalacia. J Bone Miner Res. 2009; 24: 1879-1888. doi: 10.1359/jbmr.090509

Moe SM, Chertow GM, Parfrey PS, et al. Cinacalcet, fibroblast growth factor-23, and cardiovascular disease in hemodialysis: The evaluation of cinacalcet HCl therapy to lower cardiovascular events (EVOLVE) trial. Circulation. 2015; 132: 27-39. doi: 10.1161/ CIRCULATIONAHA.114.013876

Murphy D, McCulloch CE, Lin F, et al. Trends in prevalence of chronic kidney disease in the United States. Ann Intern Med. 2016; 165: 473-481. doi: 10.7326/M16-0273

Bai XY, Miao D, Goltzman D, Karaplis AC. The autosomal dominant hypophosphatemic rickets R176Q mutation in fibroblast growth factor 23 resists proteolytic cleavage and enhances in vivo biological potency. J Biol Chem. 2003; 278: 9843-9849. doi: 10.1074/ jbc.M210490200

Bai X, Miao D, Li J, Goltzman D, Karaplis AC. Transgenic mice overexpressing human fibroblast growth factor 23 (R176Q) delineate a putative role for parathyroid hormone in renal phosphate wasting disorders. Endocrinology. 2004; 145: 5269-5279. doi: 10.1210/en.2004-0233

Beck L, Soumounou Y, Martel J, et al. Pex/PEX tissue distribution and evidence for a deletion in the 3’ region of the Pex gene in X-linked hypophosphatemic mice. J Clin Invest. 1997; 99: 1200-1209. doi: 10.1172/JCI119276

Otvos L, Wade JD. Current challenges in peptide-based drug discovery. Front Chem. 2014; 2: 62 doi: 10.3389/fchem.2014.00062

Florenzano P, Gafni RI, Collins MT. Tumor-induced osteomalacia. Bone Rep. 2017; 7: 90-97. doi: 10.1016/j. bonr.2017.09.002

Fukumoto S. Targeting fibroblast growth factor-23 signaling with antibodies and inhibitors, is there a rationale?. Front Endocrinol (Lausanne). 2018; 9: 48. doi: 10.3389/fendo.2018.00048

Ichikawa S, Imel EA, Kreiter ML, et al. A homozygous missense mutation in human KLOTHO causes severe tumoral calcinosis. J Clin Invest. 2007; 117: 2684-2691. doi: 10.1172/JCI31330

Topaz O, Shurman DL, Bergman R, et al. Mutations in GALNT3, encoding a protein involved in O-linked glycosylation, cause familial tumoral calcinosis. Nat Genet. 2004; 36: 579-581. doi: 10.1038/ng1358

Downloads

Published

2018-10-29

How to Cite

Fan Li, MD, MS, & Zhousheng Xiao, MD, PhD. (2018). Fibroblast Growth Factor 23 as a Therapeutic Target. Nephrology, 16–21. https://doi.org/10.17140/NPOJ-4-118

Issue

Section

Articles

Most read articles by the same author(s)