Hypophosphatemia Clinical Trial
Official title:
Observing the Changes of Fibroblast Growth Factor 23 in Patients of Tumor Induced Osteomalacia
Fibroblast froth factors (FGFs) are humoral factors identified by their ability to stimulate
cell proliferation1. They play different roles in the regulation of cell proliferation,
differentiation and function. Most FGF family members act as paracrine factors. But
FGF19(FGF19) subfamily members, including FGF19, 21, and 23, work as endocrine factors to
regulate bile acid, carbohydrate and phosphate metabolism2. Of these, FGF23 plays an
important role in phosphate and bone metabolism3. FGF23 gene encodes 251 amino acids,
including a 24-amino acid signal peptide4. The secreted FGF23 is a protein consisted of 227
amino acids. It works by binding to a Klotho-FGF receptor 1c (FGF1c) complex5. FGF
suppresses the expression of type 2a and 2c sodium-phosphate cotransporters, which mediate
phosphate reabsorption in proximal tubules.6 FGF23 decreases 25-hydroxyvitamin
D-1α-hydroxylase expression and enhances 25-hydroxyvitamin D-24-hydroxylase expression6.
Therefore, FGF23 reduces serum 1,25-dihydroxyvitamin D〔1,25(OH)2D〕, which stimulates
intestinal calcium and phosphate absorption. FGF23 decreases serum phosphate through the
above mechanisms FGF23 over-expression might result in hypophosphatemic rickets and
osteomalacia.
Tumor induced osteomalacia (TIO) is a paraneoplastic syndrome usually caused by benign
phosphaturic mesenchymal tumors. Symptoms are nonspecific, such as general weakness,
fatigue, and bone pain. Sometimes fracture may occurs. The responsible tumors are sometimes
small and difficult to detect. Tumors secrete FGF23. FGF23 reduced phosphate reabsorption in
the proximal tubules and decrease 1,25(OH)2D levels, which result in hypophosphatemia and
then osteomalacia.
The investigators would like to observe the changes of FGF23 in patients who receive
operation or medical treatment and hope this will benefit future treatment.
n/a
Observational Model: Case Control, Time Perspective: Prospective
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