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The PTH/Vitamin D/FGF23 Axis

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Hypoparathyroidism

Abstract

Calcium and phosphorus are essential for a myriad of intracellular functions and also form the basis for the structural integrity of bone. As such, mechanisms have evolved to ensure exquisite control over their circulating concentrations. These concentrations are largely maintained by fluxes of these mineral ions across the intestine, kidney, and bone and are regulated by three major hormones, parathyroid hormone (PTH), the active form of vitamin D, 1,25-dihydroxyvitamin D, and fibroblast growth factor-23 (FGF23). Each hormone acts to directly influence mineral ion transport across intestine or kidney and may also regulate mineral ion entry into and out of bone. The production and secretion of each hormone may in turn be modulated by circulating concentrations of these mineral ions and by the action of the other hormones, producing a complex network of negative and positive feedback systems. Disruption of these homeostatic systems can produce dramatic disease profiles but improved understanding of the underlying molecular mechanisms may lead to more salutary approaches to therapy.

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Authors and Affiliations

  1. Calcium Research Laboratory and Department of Medicine, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Ave West, Montreal, QC, H3A1A1, Canada

    David Goltzman MD

  2. Departments of Medicine and Physiology, McGill University, Montreal, QC, Canada

    David Goltzman MD

  3. Division of Endocrinology, Department of Medicine and Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, QC, Canada

    Andrew C. Karaplis

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  1. David Goltzman MD
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Correspondence to David Goltzman MD .

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Editors and Affiliations

  1. Unit of Metabolic and Bone Diseases, University of Florence, Florence, Italy

    Maria Luisa Brandi

  2. Division of Endocrinology, Diabetes and Hypertension, Harvard Medical School and Brigham & Women's Hospital, Boston, Massachusetts, USA

    Edward Meigs Brown

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Goltzman, D., Karaplis, A.C. (2015). The PTH/Vitamin D/FGF23 Axis. In: Brandi, M., Brown, E. (eds) Hypoparathyroidism. Springer, Milano. https://doi.org/10.1007/978-88-470-5376-2_8

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