Klotho protein, fibroblast growth factor 23, and sclerostin in chronic heart failure: literature review

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Abstract

Chronic heart failure (CHF) is a global medical, social, and economic problem. It is a syndrome caused by imbalanced neurohumoral regulation of the cardiovascular system, which is accompanied by impaired systolic and/or diastolic function of the heart. Currently, the search and study of new biological markers that can help in the early diagnosis of CHF, serve as a laboratory tool for assessing treatment effectiveness, or be used as prognostic markers and risk stratification criteria are ongoing. Researchers focused on studying the role of Klotho protein, fibroblast growth factor 23 (FGF23), and sclerostin in patients with CHF. Klotho expression decreases as the body ages, and impaired production has been reported in various aging-related diseases. The FGF23 / Klotho axis plays a key regulatory role in cardiovascular pathology. Laboratory, clinical, and genetic studies have suggested that sclerostin is associated with heart disease, although available data are not entirely consistent. Clinical work conducted on the study of the Klotho protein, FGF-23, and sclerostin indicates the potentially important diagnostic and prognostic significance of their analysis in patients with CHF. Thus, more studies of the issues related to serial testing of these biological markers, including in the aspect of the multibiomarker model, are needed.

About the authors

Amina M. Alieva

Pirogov Russian National Research Medical University

Author for correspondence.
Email: amisha_alieva@mail.ru
ORCID iD: 0000-0001-5416-8579

MD, Cand. Sci. (Med.), associate professor

Russian Federation, Moscow

Elena V. Reznik

Pirogov Russian National Research Medical University

Email: elenaresnik@gmail.com
ORCID iD: 0000-0001-7479-418X

MD, Dr. Sci. (Med.), department head

Russian Federation, Moscow

Irina A. Kotikova

Pirogov Russian National Research Medical University

Email: kotikova.ia@mail.ru
ORCID iD: 0000-0001-5352-8499

student

Russian Federation, Moscow

Igor G. Nikitin

Pirogov Russian National Research Medical University

Email: igor.nikitin.64@mail.ru
ORCID iD: 0000-0003-1699-0881

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

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2. Fig. 1. Relationship between Klotho protein deficiency and different diseases. Note. ХБП — chronic kidney disease, ХОБЛ — chronic obstructive pulmonary disease.

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3. Fig. 2. Cardiovascular aspects of Klotho protein. Note. Klotho, KL — klotho, ERK1/2 — kinase 1/2, regulated by extracellular signals, p38 — mitogen-activated protein kinase, FGF23 — fibroblast growth factor 23, FGFR — fibroblast growth factor receptor 23, TRPC6 — transient receptor potential channel.

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