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Equine veterinary journal2018; 50(6); 739-746; doi: 10.1111/evj.12946

The FGF-23/klotho axis and its relationship with phosphorus, calcium, vitamin D, PTH, aldosterone, severity of disease, and outcome in hospitalised foals.

Abstract: Fibroblast growth factor-23 (FGF-23) and klotho are key regulators of vitamin D and parathyroid hormone (PTH) synthesis as well as phosphorus and calcium homeostasis; however, information on the FGF-23/klotho axis in healthy and hospitalised foals is lacking. Objective: The aims of this study were to measure serum FGF-23 and klotho concentrations and determine their association with serum phosphorus, total calcium (TCa), vitamin D metabolite [25(OH)D, 1,25(OH)2 D], PTH, and aldosterone concentrations, disease severity, and mortality in hospitalised foals. Methods: Prospective, multicentre, cross-sectional study. Methods: A total of 91 foals ≤72 h old were classified as hospitalised (n = 81; 58 septic; 23 sick non-septic [SNS]) and healthy (n = 10). Blood samples were collected on admission. Hormone concentrations were determined by immunoassays. Results: Serum FGF-23, PTH, phosphorus, and aldosterone concentrations were higher while klotho, 25(OH)D, 1,25(OH)2 D, and TCa concentrations were lower in septic and SNS compared to healthy foals (P<0.05). In hospitalised and septic foals, increased FGF-23 and aldosterone concentrations were associated with high phosphorus and PTH but not with TCa and vitamin D metabolite concentrations. Hospitalised foals with the highest FGF-23 and lowest klotho concentrations were more likely to die (odds ratio (OR): 3.3; 95% confidence interval (CI): 1.1-10.3 and OR: 3.1; CI: 1.1-8.0, respectively). Conclusions: Blood gas, ionised calcium, blood culture information not being available for many foals, and use of the sepsis score to classify hospitalised foals. Conclusions: Imbalances in the FGF-23/klotho axis may contribute to mineral dyshomeostasis and disease progression in critically ill foals. Elevated FGF-23 and reduced klotho, together with high phosphorus and PTH concentrations suggests FGF-23 resistance. FGF-23 and klotho are good markers of disease severity and likelihood of mortality in hospitalised foals. Aldosterone may influence phosphorus and PTH dynamics in hospitalised foals. Routine measurement of phosphorus concentrations in sick foals is recommended.
© 2018 EVJ Ltd.
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Publication Date: 2018-05-11 PubMed ID: 29660161DOI: 10.1111/evj.12946Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article studies the relationship between FGF-23 or fibroblast growth factor-23 and klotho with various elements such as phosphorus, calcium, and vitamin D, as well as their impacts on the severity of the disease and mortality in hospitalized foals.

Objective and Methodology

  • The research aimed to measure the serum FGF-23 and klotho concentrations in foals and determine their associations with various serum factors such as phosphorus, total calcium (TCa), Vitamin D metabolites, parathyroid hormone (PTH), and aldosterone concentrations. It also looked at their relationship with disease severity and mortality in hospitalized foals.
  • The study employed a prospective, multi-centre, cross-sectional methodology. A total of 91 foals, 72 hours or less old, were classified as hospitalized (81 in number, including 58 septic and 23 sick non-septic [SNS]) and healthy (10 foals).
  • Blood samples were collected upon admission, and hormone concentrations were determined using immunoassays.

Results and Findings

  • The result showed that serum FGF-23, PTH, phosphorus, and aldosterone concentrations were higher while klotho, 25(OH)D, 1,25(OH) D, and TCa concentrations were lower in septic and SNS compared to healthy foals.
  • In hospitalized and septic foals, increased FGF-23 and aldosterone concentrations were associated with high phosphorus and PTH but not with TCa and vitamin D metabolite concentrations.
  • Hospitalized foals with the highest FGF-23 and lowest klotho concentrations were more likely to die, highlighting their potential as markers of disease severity and likelihood of mortality.

Conclusions

  • Imbalances in the FGF-23/klotho axis may contribute to mineral dyshomeostasis and disease progression in critically ill foals.
  • A combination of elevated FGF-23 and reduced klotho with high phosphorus and PTH concentrations suggests FGF-23 resistance, which could be detrimental to the health of the foals.
  • The study also found indication of the influence aldosterone may have over phosphorus and PTH dynamics in hospitalized foals.
  • The researchers recommend routine measurement of phosphorus concentrations in sick foals for early detection and effective treatment.

Cite This Article

APA
Kamr AM, Dembek KA, Hildreth BE, Morresey PR, Rathgeber RA, Burns TA, Zaghawa AA, Toribio RE. (2018). The FGF-23/klotho axis and its relationship with phosphorus, calcium, vitamin D, PTH, aldosterone, severity of disease, and outcome in hospitalised foals. Equine Vet J, 50(6), 739-746. https://doi.org/10.1111/evj.12946

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 50
Issue: 6
Pages: 739-746

Researcher Affiliations

Kamr, A M
  • College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
  • Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.
Dembek, K A
  • College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Hildreth, B E
  • College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Morresey, P R
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
Rathgeber, R A
  • Hagyard Equine Medical Institute, Lexington, Kentucky, USA.
Burns, T A
  • College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Zaghawa, A A
  • Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.
Toribio, R E
  • Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.

MeSH Terms

  • Aldosterone / blood
  • Animals
  • Calcium / blood
  • Creatinine / blood
  • Cross-Sectional Studies
  • Female
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood
  • Glucuronidase / blood
  • Horse Diseases / blood
  • Horse Diseases / mortality
  • Horses / blood
  • Klotho Proteins
  • Logistic Models
  • Male
  • Parathyroid Hormone / blood
  • Phosphorus / blood
  • Prospective Studies
  • Sepsis / blood
  • Sepsis / mortality
  • Sepsis / veterinary
  • Severity of Illness Index
  • Treatment Outcome
  • Vitamin D / blood

Grant Funding

  • USDA Formula Grants
  • Grayson-Jockey Club Research Foundation
  • OSU Equine Research Funds
  • Egyptian Cultural and Educational Bureau

Citations

This article has been cited 8 times.
  1. Kamr AM, Bartish C, Summers J, Horton J, Hostnik LD, Orr K, Browne N, Dembek KA, Saliba C, Gomez DE, Toribio RE. Longitudinal Evaluation of Vitamin D, Parathyroid Hormone, Antimicrobial Peptides, and Immunomodulatory Genes in Hospitalized Foals. J Vet Intern Med 2025 Mar-Apr;39(2):e70012.
    doi: 10.1111/jvim.70012pubmed: 40008921google scholar: lookup
  2. Xu C. Extra-adrenal aldosterone: a mini review focusing on the physiology and pathophysiology of intrarenal aldosterone. Endocrine 2024 Feb;83(2):285-301.
    doi: 10.1007/s12020-023-03566-6pubmed: 37847370google scholar: lookup
  3. Bayer J, Vaghela R, Drechsler S, Osuchowski MF, Erben RG, Andrukhova O. The bone is the major source of high circulating intact fibroblast growth factor-23 in acute murine polymicrobial sepsis induced by cecum ligation puncture. PLoS One 2021;16(5):e0251317.
    doi: 10.1371/journal.pone.0251317pubmed: 33989306google scholar: lookup
  4. Hurst EA, Homer NZ, Mellanby RJ. Vitamin D Metabolism and Profiling in Veterinary Species. Metabolites 2020 Sep 15;10(9).
    doi: 10.3390/metabo10090371pubmed: 32942601google scholar: lookup
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    doi: 10.1016/j.numecd.2020.01.003pubmed: 32127338google scholar: lookup
  7. Contreras-Aguilar MD, Escribano D, Martínez-Subiela S, Martín-Cuervo M, Lamy E, Tecles F, Cerón JJ. Changes in saliva analytes in equine acute abdominal disease: a sialochemistry approach. BMC Vet Res 2019 Jun 6;15(1):187.
    doi: 10.1186/s12917-019-1933-6pubmed: 31170977google scholar: lookup
  8. Hu S, Wang D, Zhang R, Cao Y, Jin H, Mao Y, Wei L, Ren K, Zhang X, Wang Y. [Effect of Ronghuang Granule on serum FGF23, FGFRs and Klotho in non-dialysis patients with CKD-MBD and kidney deficiency and damp-heat syndrome]. Nan Fang Yi Ke Da Xue Xue Bao 2018 Dec 30;38(12):1427-1432.
    doi: 10.12122/j.issn.1673-4254.2018.12.05pubmed: 30613009google scholar: lookup
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