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Xie H, Bastepe I, Zhou W, Ay B, Ceraj Z, Portales-Castillo IA, Liu ES, Burnett-Bowie SAM, Jüppner H, Rhee EP, Bastepe M, Simic P. 1,25-Dihydroxyvitamin D3 regulates furin-mediated FGF23 cleavage. JCI Insight 2023; 8:e168957. [PMID: 37681408 PMCID: PMC10544208 DOI: 10.1172/jci.insight.168957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/17/2023] [Indexed: 09/09/2023] Open
Abstract
Intact fibroblast growth factor 23 (iFGF23) is a phosphaturic hormone that is cleaved by furin into N-terminal and C-terminal fragments. Several studies have implicated vitamin D in regulating furin in infections. Thus, we investigated the effect of 1,25-dihydroxyvitamin D3 [1,25(OH)2D] and the vitamin D receptor (VDR) on furin-mediated iFGF23 cleavage. Mice lacking VDR (Vdr-/-) had a 25-fold increase in iFGF23 cleavage, with increased furin levels and activity compared with wild-type (WT) littermates. Inhibition of furin activity blocked the increase in iFGF23 cleavage in Vdr-/- animals and in a Vdr-knockdown osteocyte OCY454 cell line. Chromatin immunoprecipitation revealed VDR binding to DNA upstream of the Furin gene, with more transcription in the absence of VDR. In WT mice, furin inhibition reduced iFGF23 cleavage, increased iFGF23, and reduced serum phosphate levels. Similarly, 1,25(OH)2D reduced furin activity, decreased iFGF23 cleavage, and increased total FGF23. In a post hoc analysis of a randomized clinical trial, we found that ergocalciferol treatment, which increased serum 1,25(OH)2D, significantly decreased serum furin activity and iFGF23 cleavage, compared with placebo. Thus, 1,25(OH)2D inhibits iFGF23 cleavage via VDR-mediated suppression of Furin expression, thereby providing a mechanism by which vitamin D can augment phosphaturic iFGF23 levels.
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Affiliation(s)
- Han Xie
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Isinsu Bastepe
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wen Zhou
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Birol Ay
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Zara Ceraj
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ignacio A. Portales-Castillo
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eva S. Liu
- Endocrine Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Harald Jüppner
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Pediatric Nephrology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eugene P. Rhee
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Murat Bastepe
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Petra Simic
- Nephrology Division and
- Endocrine Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Portales-Castillo IA, Aksu C, Zhao S, Strohbehn I, Sise M, Yu EW, Nigwekar SU. Prescription Patterns of Osteoporosis Medications in Patients With Advanced CKD: A Retrospective Cohort Study. Kidney Med 2021; 3:1112-1115. [PMID: 34939026 PMCID: PMC8664743 DOI: 10.1016/j.xkme.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ignacio A. Portales-Castillo
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Address for Correspondence: Ignacio A. Portales-Castillo, MD, 165 Cambridge St, Ste 302, Boston, MA 02114.
| | - Cagri Aksu
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Sophia Zhao
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ian Strohbehn
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Meghan Sise
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Elaine W. Yu
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Sagar U. Nigwekar
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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