C-type natriuretic peptide attenuates renal osteodystrophy through inhibition of FGF-23/MAPK signaling

Exp Mol Med. 2019 Jul 1;51(7):1-18. doi: 10.1038/s12276-019-0265-8.

Abstract

Renal osteodystrophy (ROD) occurs as early as chronic kidney disease (CKD) stage 2 and seems ubiquitous in almost all pediatric patients with CKD stage 5. Fibroblast growth factor (FGF)-23, a bone-derived endocrine regulator of phosphate homeostasis, is overexpressed in CKD and disturbs osteoblast differentiation and matrix mineralization. In contrast, C-type natriuretic peptide (CNP) acts as a potent positive regulator of bone growth. In the present study, we infused CNP into uremic rats and observed whether CNP could attenuate ROD through the inhibition of FGF-23 cascades. In uremic rats, CNP administration significantly alleviated renal dysfunction, calcium phosphate metabolic disorders, hypovitaminosis D, secondary hyperparathyroidism, the decrease in bone turnover markers and retarded bone pathological progression. More importantly, within FGF-23/mitogen-activated protein kinase (MAPK) signaling, the fibroblast growth factor receptor-1, Klotho and alternative (STAT-1/phospho-STAT-1) elements were upregulated by CNP, whereas FGF-23, RAF-1/phospho-RAF-1, and downstream (ERK/phospho-ERK and P38/phospho-P38) elements were paradoxically underexpressed in bone tissue. Therefore, CNP exerts a therapeutic effect on ROD through inhibition of FGF-23/MAPK signaling at the RAF-1 level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Remodeling*
  • Bone and Bones / pathology
  • Calcium / blood
  • Cell Differentiation / drug effects
  • Chronic Kidney Disease-Mineral and Bone Disorder / drug therapy*
  • Chronic Kidney Disease-Mineral and Bone Disorder / pathology
  • Disease Models, Animal
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / genetics
  • Fibroblast Growth Factors / metabolism*
  • Gene Expression Regulation
  • Humans
  • Kidney / pathology
  • MAP Kinase Signaling System / drug effects*
  • Male
  • Natriuretic Peptide, C-Type / administration & dosage*
  • Proto-Oncogene Proteins c-raf / genetics
  • Proto-Oncogene Proteins c-raf / metabolism
  • Rats
  • Rats, Sprague-Dawley
  • Up-Regulation
  • Uremia

Substances

  • FGF23 protein, human
  • Fgf23 protein, rat
  • Natriuretic Peptide, C-Type
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23
  • Proto-Oncogene Proteins c-raf
  • Raf1 protein, rat
  • Calcium