Cellular and Molecular Alterations Underlying Abnormal Bone Growth in X-Linked Hypophosphatemia

Int J Mol Sci. 2022 Jan 15;23(2):934. doi: 10.3390/ijms23020934.

Abstract

X-linked hypophosphatemia (XLH), the most common form of hereditary hypophosphatemic rickets, is caused by inactivating mutations of the phosphate-regulating endopeptidase gene (PHEX). XLH is mainly characterized by short stature, bone deformities and rickets, while in hypophosphatemia, normal or low vitamin D levels and low renal phosphate reabsorption are the principal biochemical aspects. The cause of growth impairment in patients with XLH is not completely understood yet, thus making the study of the growth plate (GP) alterations necessary. New treatment strategies targeting FGF23 have shown promising results in normalizing the growth velocity and improving the skeletal effects of XLH patients. However, further studies are necessary to evaluate how this treatment affects the GP as well as its long-term effects and the impact on adult height.

Keywords: FGF23; GP; Hyp mice; PHEX; X-linked hypophosphatemia; XLH; growth plate; phex.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Neutralizing / pharmacology
  • Antibodies, Neutralizing / therapeutic use
  • Calcitriol / pharmacology
  • Calcitriol / therapeutic use
  • Familial Hypophosphatemic Rickets / drug therapy
  • Familial Hypophosphatemic Rickets / genetics
  • Familial Hypophosphatemic Rickets / pathology*
  • Fibroblast Growth Factor-23 / drug effects
  • Fibroblast Growth Factor-23 / metabolism*
  • Growth Hormone / pharmacology
  • Growth Hormone / therapeutic use
  • Growth Plate / drug effects
  • Growth Plate / growth & development
  • Growth Plate / pathology*
  • Humans
  • PHEX Phosphate Regulating Neutral Endopeptidase / genetics*
  • Up-Regulation

Substances

  • Antibodies, Neutralizing
  • FGF23 protein, human
  • Fibroblast Growth Factor-23
  • Growth Hormone
  • PHEX Phosphate Regulating Neutral Endopeptidase
  • PHEX protein, human
  • Calcitriol