Clin Nephrol. 2024 Sep;102(3):117-124. doi: 10.5414/CN111435.
It was in the philosopher's stone quest that the alchemist Hennig Brand isolated chemiluminescent white phosphorus (P), Greek for "light bearer", from urine in 1669. By 1771 phosphorus was isolated from bone, and in 1777 it was identified by Antoine Lavoisier as a highly reactive element that exists predominantly in nature as ionic phosphate (PO) and in solution as phosphoric acid (HPO). Early 20 century studies revealed phosphorylated biomolecules as essential components of replicative nuclear material (RNA, DNA), a metabolic source of energy (ATP), and structural components of cellular membrane (phospholipid bilayer). Life on earth began as organophosphates of a self-replicating RNA that evolved into DNA and acquired a membrane to form the original eukaryotes, which eventually joined to form multicellular organisms of the deep sea. Tissue mineralization during transition from the ocean to land generated the endoskeleton, the largest phosphorus stores of evolving vertebrates. Subsequent studies of phosphate homeostasis elucidated its complex regulatory system based on the interaction of the kidney, small intestine, bone, and parathyroid glands, orchestrated by hormones (PTH, calcitriol, FGF23, Klotho), and carried out by phosphate-specific transporters (SLC34 and SLC20 families) all to ensure adequate phosphate for survival and health. Paradoxically, kidney replacement therapy in the 1970s, by prolonging the lives of millions of individuals with kidney failure, revealed the hazards of phosphorus excess. "Phosphorus the light bearer" has become in the eyes of many nephrologists "Phosphorus the cardiovascular toxin".
1669 年,哲学家布兰登(Hennig Brand)在寻找点金石的过程中,从尿液中分离出了具有化学发光性的白磷(phosphorus),希腊语意为“light bearer”。1771 年,磷从骨骼中被分离出来,1777 年,安托万·拉瓦锡(Antoine Lavoisier)将其鉴定为一种高度反应性的元素,主要以离子磷酸盐(PO)形式存在于自然界中,在溶液中则以磷酸(HPO)形式存在。20 世纪初的研究揭示了磷酸化生物分子是复制核物质(RNA、DNA)、代谢能量来源(ATP)和细胞膜结构成分(磷脂双层)的重要组成部分。地球上的生命起源于自我复制的 RNA 中的有机磷,它演变成 DNA,并获得了细胞膜,形成了原始的真核生物,最终形成了深海中的多细胞生物。从海洋到陆地的过渡过程中的组织矿化产生了内骨骼,这是进化脊椎动物储存磷的最大器官。随后对磷酸盐稳态的研究阐明了其复杂的调节系统,该系统基于肾脏、小肠、骨骼和甲状旁腺的相互作用,由激素(PTH、骨化三醇、FGF23、Klotho)协调,并由磷酸盐特异性转运蛋白(SLC34 和 SLC20 家族)执行,所有这些都是为了确保有足够的磷酸盐来维持生存和健康。具有讽刺意味的是,20 世纪 70 年代,肾脏替代疗法通过延长数百万肾衰竭患者的生命,揭示了磷过量的危害。在许多肾病学家眼中,“light bearer”的磷变成了“心血管毒素”。