Soluble α-klotho and heparin modulate the pathologic cardiac actions of fibroblast growth factor 23 in chronic kidney disease.

Fibroblast growth factor (FGF) 23 is a phosphate-regulating hormone that is elevated in patients with chronic kidney disease and associated with cardiovascular mortality. Experimental studies showed that elevated FGF23 levels induce cardiac hypertrophy by targeting cardiac myocytes via FGF receptor isoform 4 (FGFR4). A recent structural analysis revealed that the complex of FGF23 and FGFR1, the physiologic FGF23 receptor in the kidney, includes soluble α-klotho (klotho) and heparin, which both act as co-factors for FGF23/FGFR1 signaling. Here, we investigated whether soluble klotho, a circulating protein with cardio-protective properties, and heparin, a factor that is routinely infused into patients with kidney failure during the hemodialysis procedure, regulate FGF23/FGFR4 signaling and effects in cardiac myocytes. We developed a plate-based binding assay to quantify affinities of specific FGF23/FGFR interactions and found that soluble klotho and heparin mediate FGF23 binding to distinct FGFR isoforms. Heparin specifically mediated FGF23 binding to FGFR4 and increased FGF23 stimulatory effects on hypertrophic growth and contractility in isolated cardiac myocytes. When repetitively injected into two different mouse models with elevated serum FGF23 levels, heparin aggravated cardiac hypertrophy. We also developed a novel procedure for the synthesis and purification of recombinant soluble klotho, which showed anti-hypertrophic effects in FGF23-treated cardiac myocytes. Thus, soluble klotho and heparin act as independent FGF23 co-receptors with opposite effects on the pathologic actions of FGF23, with soluble klotho reducing and heparin increasing FGF23-induced cardiac hypertrophy. Hence, whether heparin injections during hemodialysis in patients with extremely high serum FGF23 levels contribute to their high rates of cardiovascular events and mortality remains to be studied.

FGF21-FGFR4 signaling in cardiac myocytes promotes concentric cardiac hypertrophy in mouse models of diabetes.

Fibroblast growth factor (FGF) 21, a hormone that increases insulin sensitivity, has shown promise as a therapeutic agent to improve metabolic dysregulation. Here we report that FGF21 directly targets cardiac myocytes by binding ß-klotho and FGF receptor (FGFR) 4. In combination with high glucose, FGF21 induces cardiac myocyte growth in width mediated by extracellular signal-regulated kinase 1/2 (ERK1/2) signaling. While short-term FGF21 elevation can be cardio-protective, we find that in type 2 diabetes (T2D) in mice, where serum FGF21 levels are elevated, FGFR4 activation induces concentric cardiac hypertrophy. As T2D patients are at risk for heart failure with preserved ejection fraction (HFpEF), we propose that induction of concentric hypertrophy by elevated FGF21-FGFR4 signaling may constitute a novel mechanism promoting T2D-associated HFpEF such that FGFR4 blockade might serve as a cardio-protective therapy in T2D. In addition, potential adverse cardiac effects of FGF21 mimetics currently in clinical trials should be investigated.

Hyperphosphatemia increases inflammation to exacerbate anemia and skeletal muscle wasting independently of FGF23-FGFR4 signaling.

Elevations in plasma phosphate concentrations (hyperphosphatemia) occur in chronic kidney disease (CKD), in certain genetic disorders, and following the intake of a phosphate-rich diet. Whether hyperphosphatemia and/or associated changes in metabolic regulators, including elevations of fibroblast growth factor 23 (FGF23) directly contribute to specific complications of CKD is uncertain. Here, we report that similar to patients with CKD, mice with adenine-induced CKD develop inflammation, anemia, and skeletal muscle wasting. These complications are also observed in mice fed high phosphate diet even without CKD. Ablation of pathologic FGF23-FGFR4 signaling did not protect mice on an increased phosphate diet or mice with adenine-induced CKD from these sequelae. However, low phosphate diet ameliorated anemia and skeletal muscle wasting in a genetic mouse model of CKD. Our mechanistic in vitro studies indicate that phosphate elevations induce inflammatory signaling and increase hepcidin expression in hepatocytes, a potential causative link between hyperphosphatemia, anemia, and skeletal muscle dysfunction. Our study suggests that high phosphate intake, as caused by the consumption of processed food, may have harmful effects irrespective of pre-existing kidney injury, supporting not only the clinical utility of treating hyperphosphatemia in CKD patients but also arguing for limiting phosphate intake in healthy individuals.

The bone at the intersection of kidney and heart disease.

Systemic inflammation and elevations in the hormone fibroblast growth factor 23 (FGF23) contribute to cardiac injury and death in patients with kidney disease. A new mechanistic study by Courbon et al. suggests that the bone connects the damaged kidney with the damaged heart by serving as the target for a kidney-derived proinflammatory factor and responding with FGF23 secretion.

Small-Scale Propellers Deliver Miniature Versions of Themselves.

Small-scale actuators and propellers have benefited from advances in materials and manufacturing to become more lifelike. Inspired by animal species, multi-generational chemically powered artificial propellers that carry small versions of themselves and deliver them "on-the-fly" are described. The released replicas are capable of autonomous propulsion and propelling immediately after detachment. Release occurs without human involvement and relies solely on sacrificial layers separating the carriers and replicas. These layers are composed of transient natural polymers, which dissolve under the swimming conditions to release the confined replicas. Judicious selection of the responsive transient materials, layer thickness, and solution conditions (e.g., pH), leads to programmable delivery of the replicas. Finally, the ability of the same carrier propellers to carry and transport multiple generations of propellers and deliver them at predetermined times is demonstrated.

Utilizing Iron's Attractive Chemical and Magnetic Properties in Microrocket Design, Extended Motion, and Unique Performance.

All-in-one material for microrocket propulsion featuring acid-based bubble generation and magnetic guidance is presented. Electrochemically deposited iron serves as both a propellant, toward highly efficient self-propulsion in acidic environments, and as a magnetic component enabling complete motion control. The new microrockets display longer lifetime and higher propulsion efficiency compared to previously reported active metal zinc-based microrockets due to the chemical properties of iron and the unique structure of the microrockets. These iron-based microrockets also demonstrate unique and attractive cargo towing and autonomous release capabilities. The latter is realized upon loss of the magnetic properties due to acid-driven iron dissolution. More interestingly, these bubble-propelled microrockets assemble via magnetic interactions into a variety of complex configurations and train structures, which enrich the behavior of micromachines. Modeling of the magnetic forces during the microrocket assembly and cargo capture confirms these unique experimentally observed assembly and cargo-towing behaviors. These findings provide a new concept of blending propellant and magnetic components into one, toward simplifying the design and fabrication of artificial micro/nanomachines, realizing new functions and capabilities for a variety of future applications.

Transient Micromotors That Disappear When No Longer Needed.

Transient self-destroyed micromotors that autonomously disappear in biological media at controlled rates upon completing their task, without leaving a toxic residue, are presented. The propulsion and degradation characteristics of the self-destroyed Mg/ZnO, Mg/Si, and Zn/Fe Janus micromotors and single-component Zn micromotors are described. The degradation of the Janus micromotors relies on the different corrosion rates of their core-shell components. Inductively coupled plasma optical emission spectrometry measurements are used to probe the time-dependent degradation of the different constituents of the micromotors. The toxicity of the transient micromotors is discussed toward their potential use in biomedical applications. This concept of transient micromotors offers considerable potential for diverse practical applications in the near future.

Degeneration and the origins of Mexico's war on drugs.

In the early twentieth century, the concept of "degeneration" helped to turn "drugs" into a problem of national importance in Mexico. By invoking this concept, Mexico's sanitary authorities secured provisions in the Constitution of 1917 which specifically authorized a newly constituted Department of Public Sanitation to lead a nation-wide campaign against drug abuse. That Department then inaugurated Mexico's modern war on drugs when, in 1920, it declared a law governing the import and distribution of the opiates, cocaine, and marijuana nationwide. This essay examines the idea of degeneration and how it came to play this crucial role in the foundation of Mexico's modern war on drugs.