Iron deficiency drives an autosomal dominant hypophosphatemic rickets (ADHR) phenotype in fibroblast growth factor-23 (Fgf23) knock-in mice

Emily G. Farrow, Xijie Yu, Lelia J. Summers, Siobhan I. Davis, James C. Fleet, Matthew Allen, Alexander Robling, Keith R. Stayrook, Victoria Jideonwo, Martin J. Magers, Holly Garringer, Ruben Vidal, Rebecca Chan, Charles B. Goodwin, Siu Hui, Munro Peacock, Kenneth White

Research output: Contribution to journalArticle

184 Citations (Scopus)

Abstract

Autosomal dominant hypophosphatemic rickets (ADHR) is unique among the disorders involving Fibroblast growth factor 23 (FGF23) because individuals with R176Q/W and R179Q/W mutations in the FGF23 176RXXR 179/S 180 proteolytic cleavage motif can cycle from unaffected status to delayed onset of disease. This onset may occur in physiological states associated with iron deficiency, including puberty and pregnancy. To test the role of iron status in development of the ADHR phenotype, WT and R176Q-Fgf23 knock-in (ADHR) mice were placed on control or low-iron diets. Both the WT and ADHR mice receiving low-iron diet had significantly elevated bone Fgf23 mRNA. WT mice on a low-iron diet maintained normal serum intact Fgf23 and phosphate metabolism, with elevated serum C-terminal Fgf23 fragments. In contrast, the ADHR mice on the low-iron diet had elevated intact and C-terminal Fgf23 with hypophosphatemic osteomalacia. We used in vitro iron chelation to isolate the effects of iron deficiency on Fgf23 expression. We found that iron chelation in vitro resulted in a significant increase in Fgf23 mRNA that was dependent upon Mapk. Thus, unlike other syndromes of elevated FGF23, our findings support the concept that late-onset ADHR is the product of gene-environment interactions whereby the combined presence of an Fgf23-stabilizing mutation and iron deficiency can lead to ADHR.

Original languageEnglish
JournalProceedings of the National Academy of Sciences of the United States of America
Volume108
Issue number46
DOIs
StatePublished - Nov 15 2011

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Iron
Phenotype
Diet
fibroblast growth factor 23
Autosomal Dominant Hypophosphatemic Rickets
Gene-Environment Interaction
Osteomalacia
Messenger RNA
Mutation
Bone Development
Puberty
Serum
Phosphates
Pregnancy

Keywords

  • α-klotho
  • Anemia
  • FGF-23
  • Osteocyte

ASJC Scopus subject areas

  • General

Cite this

Iron deficiency drives an autosomal dominant hypophosphatemic rickets (ADHR) phenotype in fibroblast growth factor-23 (Fgf23) knock-in mice. / Farrow, Emily G.; Yu, Xijie; Summers, Lelia J.; Davis, Siobhan I.; Fleet, James C.; Allen, Matthew; Robling, Alexander; Stayrook, Keith R.; Jideonwo, Victoria; Magers, Martin J.; Garringer, Holly; Vidal, Ruben; Chan, Rebecca; Goodwin, Charles B.; Hui, Siu; Peacock, Munro; White, Kenneth.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 108, No. 46, 15.11.2011.

Research output: Contribution to journalArticle

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abstract = "Autosomal dominant hypophosphatemic rickets (ADHR) is unique among the disorders involving Fibroblast growth factor 23 (FGF23) because individuals with R176Q/W and R179Q/W mutations in the FGF23 176RXXR 179/S 180 proteolytic cleavage motif can cycle from unaffected status to delayed onset of disease. This onset may occur in physiological states associated with iron deficiency, including puberty and pregnancy. To test the role of iron status in development of the ADHR phenotype, WT and R176Q-Fgf23 knock-in (ADHR) mice were placed on control or low-iron diets. Both the WT and ADHR mice receiving low-iron diet had significantly elevated bone Fgf23 mRNA. WT mice on a low-iron diet maintained normal serum intact Fgf23 and phosphate metabolism, with elevated serum C-terminal Fgf23 fragments. In contrast, the ADHR mice on the low-iron diet had elevated intact and C-terminal Fgf23 with hypophosphatemic osteomalacia. We used in vitro iron chelation to isolate the effects of iron deficiency on Fgf23 expression. We found that iron chelation in vitro resulted in a significant increase in Fgf23 mRNA that was dependent upon Mapk. Thus, unlike other syndromes of elevated FGF23, our findings support the concept that late-onset ADHR is the product of gene-environment interactions whereby the combined presence of an Fgf23-stabilizing mutation and iron deficiency can lead to ADHR.",
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AU - Farrow, Emily G.

AU - Yu, Xijie

AU - Summers, Lelia J.

AU - Davis, Siobhan I.

AU - Fleet, James C.

AU - Allen, Matthew

AU - Robling, Alexander

AU - Stayrook, Keith R.

AU - Jideonwo, Victoria

AU - Magers, Martin J.

AU - Garringer, Holly

AU - Vidal, Ruben

AU - Chan, Rebecca

AU - Goodwin, Charles B.

AU - Hui, Siu

AU - Peacock, Munro

AU - White, Kenneth

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