Phosphate in Physiological and Pathological Mineralization: Important yet Often Unheeded

Phosphate is an important element in biological processes, particularly in the formation and metabolism of mineralized tissues such as bones and teeth. The imbalance of phosphate is also closely related with pathological mineralization. Restoring the phosphate homeostasis is an attractive target to treat diseases related with pathological mineralization. However, the inherent consistency of phosphate's role in both physiological and pathological mineralization has been overlooked in previous investigations. This review highlights the multifaceted role of phosphate as a building block, and as a signaling molecule that regulates the activity of mineralizing cells in both physiological and pathological mineralization. This direct and indirect role of phosphate acts as a bridge between physiological and pathological mineralization. The review also discusses the genetic mutations associated with phosphate-related mineralization disorders, emphasizing the need for further genetic and molecular research to uncover additional factors and mechanisms. Future research directions proposed include enhancing our understanding of phosphate sensing and regulation mechanisms, investigating new therapeutic agents, and developing reliable biomarkers for early diagnosis and treatment of phosphate-related mineralization disorders. By advancing our knowledge in these areas, we can improve the prevention, diagnosis, and treatment of phosphate-related mineralization disorders to enhance patient outcomes and their quality of life.