The Atlanta Department of Veterans Affairs Medical Center, Decatur, Georgia, USA.
Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA.
JCI Insight. 2023 May 22;8(10):e154729. doi: 10.1172/jci.insight.154729.
The intake of dietary phosphate far exceeds recommended levels; however, the long-term health consequences remain relatively unknown. Here, the chronic physiological response to sustained elevated and reduced dietary phosphate consumption was investigated in mice. Although serum phosphate levels were brought into homeostatic balance, the prolonged intake of a high-phosphate diet dramatically and negatively impacted bone volume; generated a sustained increase in the phosphate responsive circulating factors FGF23, PTH, osteopontin and osteocalcin; and produced a chronic low-grade inflammatory state in the BM, marked by increased numbers of T cells expressing IL-17a, RANKL, and TNF-α. In contrast, a low-phosphate diet preserved trabecular bone while increasing cortical bone volume over time, and it reduced inflammatory T cell populations. Cell-based studies identified a direct response of T cells to elevated extracellular phosphate. Neutralizing antibodies against proosteoclastic cytokines RANKL, TNF-α, and IL-17a blunted the high-phosphate diet-induced bone loss identifying bone resorption as a regulatory mechanism. Collectively, this study illuminates that habitual consumption of a high-phosphate diet in mice induces chronic inflammation in bone, even in the absence of elevated serum phosphate. Furthermore, the study supports the concept that a reduced phosphate diet may be a simple yet effective strategy to reduce inflammation and improve bone health during aging.
饮食磷酸盐的摄入量远远超过推荐水平;然而,其长期的健康后果仍然相对未知。在这里,研究人员研究了慢性生理对持续摄入高磷和低磷饮食的反应。尽管血清磷酸盐水平达到了体内平衡,但长期摄入高磷饮食会极大地、负面地影响骨量;持续增加磷酸盐反应性循环因子 FGF23、PTH、骨桥蛋白和骨钙素;并在 BM 中产生慢性低度炎症状态,其特征是表达 IL-17a、RANKL 和 TNF-α 的 T 细胞数量增加。相比之下,低磷饮食随着时间的推移保持了小梁骨,同时增加了皮质骨量,减少了炎症性 T 细胞群。基于细胞的研究确定了 T 细胞对升高的细胞外磷酸盐的直接反应。针对破骨细胞生成细胞因子 RANKL、TNF-α 和 IL-17a 的中和抗体减弱了高磷饮食引起的骨丢失,确定了骨吸收是一种调节机制。总的来说,这项研究表明,习惯性摄入高磷饮食会在小鼠的骨骼中引起慢性炎症,即使在血清磷酸盐没有升高的情况下也是如此。此外,该研究支持这样一种概念,即低磷饮食可能是一种简单而有效的策略,可以减少炎症并改善衰老过程中的骨骼健康。