众所周知,Klotho 蛋白和 FGF23 在衰老过程中起着重要作用,但在个体发育过程以及儿童和青少年的某些疾病中却被低估了--系统综述

Agnieszka Wiernik, Lidia Hyla-Klekot, Paulina Brauner, G. Kudela, Mirosław Partyka, T. Koszutski
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摘要

引言和目的:FGF23-Klotho 内分泌轴不仅在与衰老相关的过程中起着关键作用,而且在新陈代谢途径中也起着关键作用,对儿科疾病也有影响。本研究旨在系统回顾有关儿科人群中 Klotho 和 FGF23 的现有文献。材料和方法:基于 PubMed 和 Web of Science 数据库,我们严格按照 PRISMA 指南,使用(klotho)和(儿童);(FGF23)和(儿童)进行了 PRISMA 引导下的检索,并对证据质量进行了评估。结果系统综述包括 66 项研究。在儿科代谢性疾病(慢性肾病、糖尿病)、心血管疾病、生长和肌肉骨骼疾病中观察到了 Klotho 和 FGF23 血清水平的变化。在其中一些研究中,Klotho 和 FGF23 血清水平随着疾病治疗而发生变化。肾功能衰竭患者的 FGF23 升高和 Klotho 缺乏会对心血管系统产生不利影响。早产新生儿的 Klotho 水平较低,尤其是患有支气管肺发育不良的早产儿。在支气管肺发育不良模型中早期补充 Klotho 可减轻肺组织的变化并改善心脏功能。接受心脏手术的 Klotho 水平较低的儿童术后出现并发症的风险较高,尤其是急性肾损伤。在 X 连锁低磷血症中,过量的 FGF23 会导致肌肉骨骼方面的后果。FGF23血清水平有助于诊断低磷性佝偻病,而抗FGF23抗体则成为治疗X-连锁低磷血症的常用方法。结论Klotho和FGF23可作为儿科代谢紊乱的早期标记物,为评估并发症风险提供了有价值的工具。补充 Klotho 有望成为特定儿科疾病的治疗方法,而抗 FGF23 抗体已在 X 连锁低磷血症治疗中得到确立。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Klotho protein and FGF23 as well-known players in the aging process but underestimated in the process of individual development and selected diseases of childhood and adolescence – a systematic review
Introduction and objective: The FGF23–Klotho endocrine axis plays a pivotal role not only in processes associated with aging but also in metabolic pathways, with implications for paediatric disorders. The aim of this study was to systematically review the existing literature on Klotho and FGF23 in the paediatric population. Materials and methods: Based on the PubMed and Web of Science databases, we conducted a PRISMA-guided search using (klotho) AND (children); (FGF23) AND (children), adhering strictly to the PRISMA guidelines, and assessed evidence quality. Results: The systematic review included 66 studies. Altered Klotho and FGF23 serum levels were observed in paediatric metabolic conditions (chronic kidney disease, diabetes), cardiovascular, and growth and musculoskeletal disorders. In some of them, Klotho and FGF23 serum levels changed with disorder treatment. Elevated FGF23 and Klotho deficiency in renal failure adversely impacted the cardiovascular system. Lower Klotho levels were found in preterm neonates, especially with bronchopulmonary dysplasia. Early Klotho supplementation in a bronchopulmonary dysplasia model mitigated lung tissue changes and improved the cardiac function. Children with lower Klotho levels undergoing cardiac surgeries faced a higher risk of postoperative complications, especially acute kidney injury. In X-linked hypophosphataemia, excess FGF23 led to musculoskeletal consequences. FGF23 serum levels aided the diagnosis of hypophosphataemic rickets, and anti-FGF23 antibody emerged as a common X-linked hypophosphataemia treatment. Conclusions: Klotho and FGF23 serve as promising early markers for paediatric metabolic disorders, offering a valuable tool for assessing complication risks. Klotho supplementation holds promise as a treatment method for specific paediatric disorders, while anti-FGF23 antibody is already established in X-linked hypophosphataemia treatment.
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