DESCRIPTION (provided by applicant): Fibroblast Growth Factor 23 (FGF23) is the major phosphate regulator in human pathologic disorders associated with abnormal bone mineralization and renal phosphate wasting (Pi). However the regulators of FGF23 production, the signal pathway(s) for FGF23 induced Pi wasting and defective mineralization are not fully understood. Our studies support an important role for the nuclear isoforms of Fibroblast Growth Factor 2 (FGF2) in FGF23 production and biologic function. Using novel mouse models expressing HMW isoforms in osteoblast lineage cells (HMWTg) mice, and mice with selective deletion of the HMW isoforms (HMWKO) mice we demonstrate that HMWTg mice have increased FGF23 in serum and bone, dwarfism, decreased bone mineral density (BMD), osteomalacia, hypophosphatemia, and abnormal FGF23/FGFReceptor/ klotho/MAPK and Wnt signaling in bone and kidney. Preliminary data shows that ablation of the HMWFGF2 isoforms increased BMD, increased serum phosphate and significantly reduced FGF23 mRNA in mice. We also observed increased expression of nuclear HMWFGF2 in osteoblasts/osteocytes in Hyp mice, a murine model of X-linked hypophosphatemic rickets (XLH). We also have exciting preliminary data that HMW isoforms are overexpressed in B-lymphocytes from a patient with XLH supporting clinical relevance of these studies. Our Central Hypotheses are that HMWFGF2: i) plays an important role in Pi homeostasis in kidney by increasing FGF23 production in bone. ii) regulates bone matrix mineralization via FGF23 dependent and independent effects. iii) contributes to Pi wasting and defective matrix mineralization in Hyp mice. Aim 1 will determine the role of HMWFGF2 isoforms in Pi homeostasis in the kidney of HMW transgenic mice: Our working hypothesis is that HMWFGF2 isoforms increase FGF23 production in bone and that endocrine FGF23 mediates abnormal FGFR/klotho/MAPK signaling in kidney that leads to Pi wasting. Aim 2 will assess the role of HMWFGF2 isoforms/FGF23/FGFR and Wnt signaling in osteoblast differentiation and mineralization. Effects of blockade of FGF23, FGFR, MAPK/ERK and sclerostin on bone formation in HMWTg mice will be determined. Aim 3 will examine functional effects of knockout of HMWFGF2 on Pi and bone homeostasis and whether HMWFGF2 is important in the abnormal Pi wasting and matrix mineralization defect in Hyp mice. Our working hypothesis is that HMWFGF2 isoforms mediate abnormal Pi homeostasis and defective bone mineralization. Examining phosphate homeostasis, the skeletal and kidney phenotypes of HMW-/- mice and Hyp mice with deletion of HMWFGF2 versus wild type littermates will test this hypothesis. We will also assess FGF/FGF Receptor and downstream signaling pathways in these mice. The proposed studies will greatly enhance our understanding of the role of HMWFGF2 isoforms in Pi homeostasis and matrix mineralization and may provide novel and fundamental insights into the mechanisms that regulate these processes in human phosphate wasting disorders.

PUBLIC HEALTH RELEVANCE: Fibroblast Growth Factor 23 (FGF23) is the major phosphate regulator in human pathologic disorders associated with abnormal bone mineralization and renal phosphate wasting. However the regulators of FGF23 production, the signal pathway(s) for FGF23 induced phosphate wasting and the etiology of the bone mineralization defect in these disorders have not been fully identified. We have identified the nuclear high molecular weight (HMW) isoforms of fibroblast growth factor-2 (FGF2) as novel regulators of FGF23. The proposed studies will greatly enhance our understanding of the role of HMWFGF2 isoforms in phosphate homeostasis and matrix mineralization and may provide novel and fundamental insights into the mechanisms that regulate these processes in human phosphate wasting disorders.