Sun Meiheng, Wu Xiaoqiu, Yu Yuanyuan, Wang Luyao, Xie Duoli, Zhang Zhenlin, Chen Lin, Lu Aiping, Zhang Ge, Li Fangfei
Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tsai, Hong Kong.
Institute of Integrated Bioinfomedicine and Translational Science, School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tsai, Hong Kong.
Front Cell Dev Biol. 2020 Sep 10;8:576110. doi: 10.3389/fcell.2020.576110. eCollection 2020.
Since calcium and phosphorus play vital roles in a multitude of physiologic systems, disorders of calcium and phosphorus metabolism always lead to severe consequences such as skeletal-related and cardiovascular morbidity, or even life-threatening. Physiologically, the maintenance of calcium and phosphorus homeostasis is achieved via a variety of concerted actions of hormones such as parathyroid hormone (PTH), vitamin D, and fibroblast growth factor (FGF23), which could be regulated mainly at three organs, the intestine, kidney, and bone. Disruption of any organ or factor might lead to disorders of calcium and phosphorus metabolism. Currently, lacking of accurate diagnostic approaches and unknown molecular basis of pathophysiology will result in patients being unable to receive a precise diagnosis and personalized treatment timely. Therefore, it is urgent to identify early diagnostic biomarkers and develop therapeutic strategies. Fortunately, proteomics and metabolomics offer promising tools to discover novel indicators and further understanding of pathological mechanisms. Therefore, in this review, we will give a systematic introduction on PTH-1,25(OH)D-FGF23 axis in the disorders of calcium and phosphorus metabolism, diagnostic biomarkers identified, and potential altered metabolic pathways involved.
由于钙和磷在众多生理系统中发挥着至关重要的作用，钙磷代谢紊乱总是会导致严重后果，如骨骼相关疾病和心血管疾病，甚至危及生命。在生理状态下，钙磷稳态的维持是通过甲状旁腺激素（PTH）、维生素D和成纤维细胞生长因子（FGF23）等多种激素的协同作用实现的，这些激素的调节主要涉及三个器官，即肠道、肾脏和骨骼。任何一个器官或因素的失调都可能导致钙磷代谢紊乱。目前，缺乏准确的诊断方法以及病理生理学分子基础不明，将导致患者无法及时获得精确诊断和个性化治疗。因此，迫切需要鉴定早期诊断生物标志物并制定治疗策略。幸运的是，蛋白质组学和代谢组学为发现新指标和进一步了解病理机制提供了有前景的工具。因此，在本综述中，我们将系统介绍钙磷代谢紊乱中的PTH-1,25(OH)D-FGF23轴、已鉴定的诊断生物标志物以及潜在的代谢途径改变。
