Therapeutic Effects of Anti-FGF23 Antibodies in Hypophosphatemic Rickets/Osteomalacia

Authors

  • Yukiko Aono,

    1. Pharmacological Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Yuji Yamazaki,

    1. Innovative Drug Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Junichi Yasutake,

    1. Innovative Drug Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Takehisa Kawata,

    1. Pharmacological Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Hisashi Hasegawa,

    1. Pharmacological Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Itaru Urakawa,

    1. Innovative Drug Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Toshiro Fujita,

    1. Division of Nephrology and Endocrinology, Department of Medicine, The University of Tokyo Hospital, Tokyo, Japan
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  • Michihito Wada,

    1. Pharmacological Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Takeyoshi Yamashita,

    1. Innovative Drug Research Laboratories, Kyowa Hakko Kirin
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.

  • Seiji Fukumoto,

    Corresponding author
    1. Division of Nephrology and Endocrinology, Department of Medicine, The University of Tokyo Hospital, Tokyo, Japan
    • Seiji Fukumoto, MD, PhD, Division of Nephrology and Endocrinology, Department of Medicine, The University of Tokyo Hospital, 7–3–1 Hongo, Bunkyo-Ku, Tokyo 113–8655, Japan
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  • Takashi Shimada

    1. Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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    • Drs. Aono, Yamazaki, Yasutake, Kawata, Hasegawa, Urakawa, Wada, Yamashita, and Shimada are employees of Kyowa Hakko Kirin. All other authors state that they have no conflicts of interest.


  • Parts of this manuscript were presented at the 25th Annual Meeting of the American Society of Bone and Mineral Research, September 19–23, 2003, Minneapolis, Minnesota, USA,.

  • Published online on May 4, 2009

Abstract

X-linked hypophosphatemia (XLH), characterized by renal phosphate wasting, is the most common cause of vitamin D-resistant rickets. It has been postulated that some phosphaturic factor plays a causative role in XLH and its murine homolog, the Hyp mouse. Fibroblast growth factor 23 (FGF23) is a physiological phosphaturic factor; its circulatory level is known to be high in most patients with XLH and Hyp mice, suggesting its pathophysiological role in this disease. To test this hypothesis, we treated Hyp mice with anti-FGF23 antibodies to inhibit endogenous FGF23 action. A single injection of the antibodies corrected the hypophosphatemia and inappropriately normal serum 1,25-dihydroxyvitamin D. These effects were accompanied by increased expressions of type IIa sodium-phosphate cotransporter and 25-hydroxyvitamin-D-1α-hydroxylase and a suppressed expression of 24-hydroxylase in the kidney. Repeated injections during the growth period ameliorated the rachitic bone phenotypes typically observed in Hyp mice, such as impaired longitudinal elongation, defective mineralization, and abnormal cartilage development. Thus, these results indicate that excess actions of FGF23 underlie hypophosphatemic rickets in Hyp mice and suggest a novel therapeutic potential of the FGF23 antibodies for XLH.

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