Piceatannol ameliorates intestinal barrier dysfunction in urosepsis by modulating the Nrf2/ROS/NF-κB pathway.

X-linked hypophosphatemia (XLH) is a rare, progressive, and lifelong metabolic bone disorder and the most common form of heritable rickets (). XLH is caused by pathogenic variants in the phosphate-regulating endopeptidase homolog, X-linked () gene, which results in elevated levels of fibroblast growth factor 23 (FGF23), chronic hypophosphatemia, and impaired bone and tooth mineralization (, , ). In children, this typically leads to delayed motor development, rickets, and lower limb deformities (, , ). Body length is within normal ranges at birth, but effects on bone development usually become evident in infancy, resulting in reduced growth with disproportionate short stature in children and adults (, , , ). Treatment with frequent doses of phosphate salts and active vitamin D analogs (Pi/D) may improve growth in patients with XLH, particularly when initiated early (eg, <1-2 years of age) (), but does not normalize adult height (, , ). Burosumab is a recombinant fully human monoclonal antibody against FGF23 (, ). Burosumab is approved for treating XLH in children and adults (). Randomized controlled trials (RCTs) of burosumab demonstrated improved phosphate homeostasis, effective treatment of rickets in children, and healing of pseudofractures in adults, with an acceptable safety profile (, ). Burosumab modestly improved height Z-scores in children compared with baseline and those treated with Pi/D (, , ). Evidence from real-world studies indicates that switching from Pi/D to burosumab treatment improved height Z-scores from the time of burosumab initiation over a follow-up ranging from 1 year up to a median of 3.3 years (). However, this effect on growth was not apparent in all studies (, ). Several clinical and real-world studies support earlier initiation of burosumab to improve height outcomes (, , ), although these studies are limited by small sample sizes, and long-term outcomes are currently unavailable. Additional studies are required to augment the current body of evidence. The Advancing Patient Evidence in XLH (APEX) program is a global data unification project that combines 3 ongoing observational, longitudinal (10-year) studies (). The APEX program aims to describe the burden and lifelong progression of XLH, collect real-world data on treatment effectiveness and safety, and investigate regional differences in treatment outcomes (). To better understand the impact of burosumab treatment on growth, data from the APEX program were analyzed to assess the impact of treatment over time on growth in burosumab-treated and burosumab-naïve (either treated with Pi/D or entirely untreated) participants with XLH aged 2-17 years.