Simic Petra, Xie Han, Zhang Qian, Zhou Wen, Cherukuru Rohan, Adams Michael A, Turner Mandy E, Rhee Eugene P
Nephrology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States.
Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States.
Am J Physiol Renal Physiol. 2025 Feb 1;328(2):F165-F172. doi: 10.1152/ajprenal.00311.2024. Epub 2024 Dec 24.
Why fibroblast growth factor 23 (FGF23) levels increase markedly in chronic kidney disease (CKD) is unknown. Recently, we found that phosphate stimulates renal production of glycerol-3-phosphate (G-3-P), which circulates to the bone to trigger FGF23 production. To assess the impact of G-3-P on FGF23 production in CKD, we compared the effect of adenine-induced CKD in mice deficient in glycerol-3-phosphate dehydrogenase 1 (Gpd1), an enzyme that synthesizes G-3-P, along with wild-type littermates. We found that an adenine diet causes a similar degree of renal insufficiency across genotypes and that adenine-induced CKD increases blood G-3-P and FGF23 levels in wild-type mice. Furthermore, we found that the increases in both G-3-P and FGF23 are significantly attenuated, but not fully abrogated, in compared with mice with CKD. There is no difference in blood phosphate or parathyroid hormone between and mice on an adenine diet, but adenine-induced CKD causes greater cortical bone loss in mice. In a separate cohort of rats fed an adenine or control diet, we confirmed that CKD causes an increase in blood G-3-P levels. Importantly, an acute phosphate load increases G-3-P production in both CKD and non-CKD rats, with a significant correlation between measured kidney phosphate uptake and blood G-3-P levels. Together, these findings establish a key role for G-3-P in mineral metabolism in CKD, although more work is required to parse the factors that regulate both Gpd1-dependent and Gpd1-independent G-3-P production in this context. This study shows that glycerol-3-phosphate, a glycolytic by-product recently implicated in a kidney-to-bone signaling axis that regulates FGF23 production, increases in mice and rats with CKD. Furthermore, mice deficient in a key enzyme that synthesizes glycerol-3-phosphate have attenuated increases in both glycerol-3-phosphate and FGF23 in CKD, along with enhanced cortical bone loss. These studies identify glycerol-3-phosphate as a novel regulator of FGF23 and mineral metabolism in CKD.
成纤维细胞生长因子23(FGF23)水平在慢性肾脏病(CKD)中显著升高的原因尚不清楚。最近,我们发现磷酸盐刺激肾脏产生3-磷酸甘油(G-3-P),其循环至骨骼以触发FGF23的产生。为了评估G-3-P对CKD中FGF23产生的影响,我们比较了腺嘌呤诱导的CKD在甘油-3-磷酸脱氢酶1(Gpd1,一种合成G-3-P的酶)缺陷小鼠及其野生型同窝小鼠中的作用。我们发现腺嘌呤饮食在不同基因型中引起相似程度的肾功能不全,并且腺嘌呤诱导的CKD会增加野生型小鼠的血液G-3-P和FGF23水平。此外,我们发现与患有CKD的小鼠相比,G-3-P和FGF23的升高均显著减弱,但未完全消除。在腺嘌呤饮食的小鼠和小鼠之间,血磷或甲状旁腺激素没有差异,但腺嘌呤诱导的CKD在小鼠中导致更大的皮质骨丢失。在另一组喂食腺嘌呤或对照饮食的大鼠中,我们证实CKD会导致血液G-3-P水平升高。重要的是,急性磷酸盐负荷会增加CKD和非CKD大鼠的G-3-P产生,并且测得的肾脏磷酸盐摄取与血液G-3-P水平之间存在显著相关性。总之,这些发现确立了G-3-P在CKD矿物质代谢中的关键作用,尽管在此背景下还需要更多工作来解析调节Gpd1依赖性和Gpd1非依赖性G-3-P产生的因素。这项研究表明,3-磷酸甘油是一种糖酵解副产物,最近与调节FGF23产生的肾-骨信号轴有关,在患有CKD的小鼠和大鼠中会增加。此外,缺乏合成3-磷酸甘油关键酶的小鼠在CKD中3-磷酸甘油和FGF23的升高均减弱,同时皮质骨丢失增加。这些研究确定3-磷酸甘油是CKD中FGF23和矿物质代谢的新型调节剂。