Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA.
J Endocrinol Invest. 2011 Jul;34(7 Suppl):3-7.
Calcium and phosphate are essential to many vital physiological processes, making the maintenance of their homeostasis crucial for survival. A tightly controlled balance of calcium and phosphorus is maintained by hormonal control of transport in the intestine, bone, and kidney. The kidneys participate by modulating calcium and phosphate reabsorption from the glomerular filtrate according to the body needs. This process is mediated by ion transporters. Besides the classical endocrine factors (i.e., PTH and vitamin D metabolites), new factors have been identified that are involved in maintaining calcium and primarily phosphate balance. Fibroblast growth factor-23 (FGF23) regulates urinary phosphate excretion by interacting with FGF receptors. Klotho, a transmembrane protein, facilitates this interaction, with the result of reducing phosphate reabsorption by the kidney leading to hypophosphatemia. More recently, dental matrix protein-1, an osteocyte product, has been shown to participate in FGF23-mediated regulation of phosphorus homeostasis. Transgenic mouse models have been of great value in the elucidation of Klotho and FGF23 function. This review highlights current knowledge into calcium and phosphate homeostasis in health and disease.
钙和磷对许多重要的生理过程至关重要，因此维持其体内平衡对于生存至关重要。通过激素控制肠道、骨骼和肾脏中的运输来维持钙和磷的严格平衡。肾脏通过根据身体需要调节从肾小球滤过物中重吸收钙和磷来参与这一过程。这个过程由离子转运体介导。除了经典的内分泌因素（即 PTH 和维生素 D 代谢物）外，还发现了新的因子参与维持钙和主要的磷平衡。成纤维细胞生长因子 23（FGF23）通过与 FGF 受体相互作用调节尿磷排泄。Klotho 是一种跨膜蛋白，促进这种相互作用，结果导致肾脏对磷的重吸收减少，从而导致低磷血症。最近，牙基质蛋白 1（一种骨细胞产物）被证明参与了 FGF23 介导的磷稳态调节。转基因小鼠模型在阐明 Klotho 和 FGF23 功能方面具有重要价值。这篇综述强调了钙和磷在健康和疾病中的体内平衡的最新知识。
