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Development of differential diagnostic method for etiology of acquired FGF23 related hypophosphatemic osteomalacia

Research Project

Project/Area Number 18K09018
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56020:Orthopedics-related
Research InstitutionThe University of Tokyo

Principal Investigator

Ito Nobuaki  東京大学, 医学部附属病院, 助教 (10731862)

Co-Investigator(Kenkyū-buntansha) 小林 寛  東京大学, 医学部附属病院, 講師 (20407951)
Project Period (FY) 2018-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords低リン血症 / くる病 / 骨軟化症 / 骨粗鬆症 / FGF23 / 病理 / 免疫染色 / ナノ技術 / X染色体連鎖性低リン血症性くる病 / 腫瘍性骨軟化症 / 骨折 / ナノテクノロジー / ナノ粒子 / 鑑別診断 / 偽骨折 / リン / ビタミンD
Outline of Final Research Achievements

FGF23 is a phosphaturic hormone derived from osteocytes, which physiologically regulates serum phosphate level. Tumor-induced osteomalacia (TIO) due to FGF23 producing tumor is the most common cause of acquired FGF23-related hypophosphatemic osteomalacia, however, the causative tumor couldn’t be recognized among about 20-30% of cases. In TIO patients, FGF23 production in the bone was physiologically suppressed while not suppressed in, such as, inherited FGF23-related hypophosphatemia. However, the conventional immunostaining method could not detect the suppression of FGF23 due to low sensitivity. In this research, PID: nano-immunostaining method with high sensitivity developed by KONICA MINORTA was adopted and the suppression of regional FGF23 in the bone surrounding FGF23 producing tumor in TIO patients was successfully recognized compared to femur bone samples gained during the surgery in the subjects without bone metabolic diseases.

Academic Significance and Societal Importance of the Research Achievements

本検討の結果により、生後にFGF23関連低リン血症性骨軟化症を惹起したと思われる症例において腸骨生検などで骨検体を採取し、高感度ナノ免疫染色(PID)によってFGF23の骨での産生抑制の有無を確認することで、その原因がFGF23産生腫瘍による腫瘍性骨軟化症であるか、それ以外の遺伝性疾患などであるかを明確に鑑別できる技術が完成した。また同時にこれまで悪性腫瘍の発現マーカーなどを定量的に検出し抗癌剤の効果判定などへの応用が期待されていた高感度ナノ免疫染色技術が、今回の検討のようにホルモンの血中濃度が非常に低値である内分泌疾患などでの病因の鑑別などにも用いることができる可能性を示すことが出来た。

Report

(4 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (9 results)

All 2020 2019 2018

All Presentation (9 results) (of which Int'l Joint Research: 1 results,  Invited: 3 results)

  • [Presentation] 蛍光ナノ粒子(PID)染色標本による組織でのFGF23産生定量法の開発2020

    • Author(s)
      古家美菜絵、加藤創生、二谷悦子、小林寛、 田中健之、牧瀬尚大、牛久哲男、伊東伸朗
    • Organizer
      第93回日本内分泌学会学術総会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Histochemical Quantification of FGF23 Expression in the Bone with Phosphor Integrated Dot Nanoparticles2020

    • Author(s)
      古家美菜絵、加藤創生、伊東伸朗
    • Organizer
      The American Society for Bone and Mineral Research 2020
    • Related Report
      2020 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 蛍光ナノ粒子(PID)染色標本による組織でのFGF23産生定量法の開発2020

    • Author(s)
      古家美菜絵、加藤創生、伊東伸朗
    • Organizer
      第38回日本骨代謝学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Ectopic ossification in XLH patients and differential diagnosis of acquired FGF23-related hypophosphatemic osteomalacia2020

    • Author(s)
      伊東伸朗
    • Organizer
      第38回日本骨代謝学会学術集会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] Utility of SRS/SRPET and systemic FGF23 venous sampling for tumor localization in 20 consecutive tumor-induced osteomalacia cases2019

    • Author(s)
      Minae Koga, Hajime Kato, Yuka Kinoshita, Seiji Fukumoto, Nobuaki Ito
    • Organizer
      Forum on Metabolic Bone Disease
    • Related Report
      2019 Research-status Report
  • [Presentation] Utility of SRS/SRPET and systemic FGF23 venous sampling for tumor localization in 20 consecutive tumor-induced osteomalacia cases2019

    • Author(s)
      Minae Koga, Hajime Kato, Yuka Kinoshita, Seiji Fukumoto, Nobuaki Ito
    • Organizer
      ASBMR 2019 Annual Meeting
    • Related Report
      2019 Research-status Report
  • [Presentation] 腫瘍性骨軟化症20症例の局在診断における画像検査および全身静脈FGF23サンプリングの有用性2019

    • Author(s)
      古家美菜絵、加藤創生、木下祐加、伊東伸朗
    • Organizer
      第37回日本骨代謝学会学術集会
    • Related Report
      2019 Research-status Report
  • [Presentation] クリニカルアワー 腫瘍性骨軟化症-基礎と臨床の新知見- 「診断のUpdate」2019

    • Author(s)
      伊東伸朗
    • Organizer
      第92回日本内分泌学会学術総会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] FGF23関連低リン血症性くる病・骨軟化症2018

    • Author(s)
      伊東伸朗
    • Organizer
      第91回日本内分泌学会学術総会
    • Related Report
      2018 Research-status Report
    • Invited

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Published: 2018-04-23   Modified: 2022-01-27  

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