The Role of Fibroblast Growth Factor 23 in Inflammation and Anemia

Czaya, Brian; Faul, Christian

doi:10.3390/ijms20174195

Cited by 77 publications

(59 citation statements)

References 317 publications

(462 reference statements)

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“…In the early stages of CKD, serum FGF23 levels can rise 1000-fold above normal values. This condition is determined by the need to maintain acceptable phosphate levels [89]. The overexpression of FGF23 is linked to hypophosphatemic rickets/osteomalacia, in contrast, a decrease in the action of FGF23 results in hyperphosphatemic calcinosis with high 1,25(OH)2D3 levels [90].…”

Section: Fgf23-klotho and Vitamin D Axis In Endocrine-paracrine Renalmentioning

confidence: 99%

Protective Role of Vitamin D in Renal Tubulopathies

et al. 2020

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Vitamin D is tightly linked with renal tubular homeostasis: the mitochondria of proximal convoluted tubule cells are the production site of 1α,25-dihydroxyvitamin D3. Patients with renal impairment or tubular injury often suffer from chronic inflammation. This alteration comes from oxidative stress, acidosis, decreased clearance of inflammatory cytokines and stimulation of inflammatory factors. The challenge is to find the right formula for each patient to correctly modulate the landscape of treatment and preserve the essential functions of the organism without perturbating its homeostasis. The complexity of the counter-regulation mechanisms and the different axis involved in the Vitamin D equilibrium pose a major issue on Vitamin D as a potential effective anti-inflammatory drug. The therapeutic use of this compound should be able to inhibit the development of inflammation without interfering with normal homeostasis. Megalin-Cubilin-Amnionless and the FGF23-Klotho axis represent two Vitamin D-linked mechanisms that could modulate and ameliorate the damage response at the renal tubular level, balancing Vitamin D therapy with an effect potent enough to contrast the inflammatory cascades, but which avoids potential severe side effects.

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Section: Fgf23-klotho and Vitamin D Axis In Endocrine-paracrine Renalmentioning

confidence: 99%

Protective Role of Vitamin D in Renal Tubulopathies

et al. 2020

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“…It seemed that the effect of decreased FGF23 in CharXgen group cannot be fully explained by lowering serum phosphate. In addition, experimental study indicated that inflammation was novel regulator of systemic FGF23 synthesis and secretion [43,44]. Previous report demonstrated IS was able to induce oxidative stress and inflammation [11].…”

Section: Discussionmentioning

confidence: 96%

CharXgen-Activated Bamboo Charcoal Encapsulated in Sodium Alginate Microsphere as the Absorbent of Uremic Toxins to Retard Kidney Function Deterioration

Lin

Sun

et al. 2020

IJMS

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Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are two protein bound uraemic toxins accumulated in chronic kidney disease (CKD) and associated with adverse outcomes. The purpose of this study isto evaluate the effect of the new activated charcoal, CharXgen, on renal function protection and lowering serum uraemic toxins in CKD animal model. The physical character of CharXgen was analyzed before and after activation procedure by Scanning Electron Microscope (SEM) and X-ray diffractometer (XRD). The effect of CharXgen on biochemistry and lowering uremic toxins was evaluated by in vitro binding assay and CKD animal model. CharXgen have high interior surface area analyzed by SEM and XRD and have been produced from local bamboo after an activation process. CharXgen was able to effectively absorb IS, p-cresol and phosphate in an in vitro gastrointestinal tract simulation study. The animal study showed that CharXgen did not cause intestine blackening. Serum albuminand liver function did not change after feeding with CharXgen. Moreover, renal function was improved in CKD rats fed with CharXgen as compared to the CKD group, and there were no significant differences in the CKD and the CKD + AST-120 groups. Serum IS and PCS were higher in the CKD group and lower in rats treated with CharXgen and AST-120. In rats treated with CharXgen, Fibroblast growth factor 23 was significantly decreased as compared to the CKD group. This change cannot be found in rats fed with AST-120.It indicates that CharXgen is a new safe and non-toxic activated charcoal having potential in attenuating renal function deterioration and lowering protein-bound uraemic toxins. Whether the introduction of this new charcoal could further have renal protection in CKD patients will need to be investigated further.

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“…Iron citrate complexes have been shown to capture and reduce phosphate and FGF23 levels in both dialyzed and non-dialyzed CKD patients [53]. As phosphates [56] and FGF23 [57] A significant reduction in the requirement for therapy with erythropoiesis stimulating agents was also reported [60]. Further studies in dialyzed patients are ongoing (ClinicalTrials.gov: NCT04042324).…”

Section: Sucrosomial Ironmentioning

confidence: 99%

Iron deficiency anemia – new possibilities of iron supplementation in various clinical conditions

Michalak

2020

Acta Haematologica Polonica

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Iron deficiency anemia (IDA) treatment is done to eliminate the causes of iron deficiency, iron supplementation, and rarely red blood cell transfusion. Divalent iron salts are the first line of oral treatment, but their use lead to frequent gastrointestinal adverse reactions. Iron is administered intravenously in the event of contraindications, intolerance, or inefficiency of oral therapy, but the parenteral route of drug delivery is not easily accepted by the patients. Intravenous preparations for single administration of a large dose of iron have a good therapy safety profile, but are more expensive than oral and are usually administered in a hospital setting. The availability of new iron compounds: sucrosomial iron, ferric citrate complexes, and ferric maltol widen the possibilities of IDA therapy and enable the better selection of iron preparations in various clinical situations. The innovative structure of sucrosomial iron leads to absorption in different ways (through endocytosis, the paracellular pathway, M cells of Peyer's patches), ensures high bioavailability, and good tolerance of therapy. Ferric citrate, in addition to iron supplementation, reduces phosphate levels, and is beneficial to chronic kidney disease. Ferric maltol is currently being studied for IDA treatment with various comorbidities. Some studies indicate that new iron formulas may be used where intravenous intake has been recommended so far. So, we can expect treatment with iron nanoparticles and drugs that affect the intestinal microflora in the future. The paper presents current knowledge about new iron preparations that are already available in everyday practice, but also those that are at various stages of pre-clinical and clinical studies.

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The Role of Fibroblast Growth Factor 23 in Inflammation and Anemia

Cited by 77 publications

References 317 publications

Protective Role of Vitamin D in Renal Tubulopathies

Protective Role of Vitamin D in Renal Tubulopathies

CharXgen-Activated Bamboo Charcoal Encapsulated in Sodium Alginate Microsphere as the Absorbent of Uremic Toxins to Retard Kidney Function Deterioration

Iron deficiency anemia – new possibilities of iron supplementation in various clinical conditions

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