Fibroblast Growth Factor 23 (FGF23) and Klotho Protein in
                    Beta-Thalassemia

Dimitrios Stefanopoulos; Narjes Nasiri-Ansari; Ismene Dontas; Andromachi Vryonidou; Antonis Galanos; Loukia Psaridi; Ioannis G. Fatouros; George Mastorakos; Athanasios G. Papavassiliou; Eva Kassi; Symeon Tournis

doi:10.1055/a-1104-5326

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2020; 52(03): 194-201
DOI: 10.1055/a-1104-5326

Endocrine Research

Fibroblast Growth Factor 23 (FGF23) and Klotho Protein in Beta-Thalassemia

Dimitrios Stefanopoulos

¹Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Athens, Greece

,

Narjes Nasiri-Ansari

²Department of Biological Chemistry, National and Kapodistrian University of Athens, Athens, Greece

,

Ismene Dontas

¹Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Athens, Greece

,

Andromachi Vryonidou

³Department of Endocrinology, Diabetes, & Metabolism, General Hospital “Korgialenio-Benakio”, Athens, Greece

,

Antonis Galanos

¹Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Athens, Greece

,

Loukia Psaridi

⁴Department of Biochemistry, Hellenic Red Cross Hospital, Athens, Greece

,

Ioannis G. Fatouros

⁵Department of Physical Education & Sport Science, University of Thessaly, Karies, Greece

,

George Mastorakos

⁶Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece

,

Athanasios G. Papavassiliou

²Department of Biological Chemistry, National and Kapodistrian University of Athens, Athens, Greece

,

Eva Kassi‡

²Department of Biological Chemistry, National and Kapodistrian University of Athens, Athens, Greece

⁷First Department of Internal Medicine, Laikon Hospital- National and Kapodistrian University of Athens, Athens, Greece

,

Symeon Tournis‡

¹Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Athens, Greece

› Author Affiliations

Abstract

Derangements in phosphate and calcium homeostasis are common in patients with beta-thalassemia. Fibroblast growth factor 23 (FGF23) is among the main hormones regulating phosphate levels, while several studies underline an interplay between iron (Fe) and FGF23. Herein, we investigated, for the first time, the serum intact molecule (iFGF23) and the carboxyl-terminal fragment (C-FGF23) and Klotho levels simultaneously in patients with beta-thalassemia major receiving iron chelation regimens in comparison to healthy control subjects. We also correlated them with the body iron burden. The observational case-control study included 81 subjects (40 thalassemic patients and 41 healthy controls). Serum iFGF23, C-FGF23 and Κlotho were measured by ELISA. Parathormone, 25-hydroxycholecalciferol, calcium, and phosphorus were measured in blood and/or urine. The degree of hemosiderosis was evaluated by assessing the serum ferritin levels and performing T2* MRI measurements. Serum C-FGF23 levels were significantly lower in patients compared to control subjects (p=0.04), while iFGF23 and Klotho levels did not differ. Serum C-FGF23 levels were negatively correlated with ferritin (r=–0,421, p=0.018), whereas there were no significant correlations of each of the three factors with the iron chelation therapy. Decreased serum C-FGF23 levels were found in βTh patients which may be attributed to inhibition of proteolytic cleavage of iFGF23. Further studies in a greater number of patients will shed more light on the disturbances of the iFGF23, Klotho and C-FGF23 in thalassemia and their possible role in bone disease of such patients.

Key words

FGF23 - C-terminal FGF23 - phosphorus - beta-thalassemia - ferritin - chelation

Full Text

References

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Supplementary Material

Supplementary Material