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Alterations in the levels of extracellular phosphate exert effects on both skeletal and extra-skeletal tissues, and accumulating evidence has suggested that phosphate itself evokes signal transduction to regulate gene expression and cell behavior. Several in vitro studies have demonstrated that an elevation in extracellular P\n                    <jats:sub>i<\/jats:sub>\n                    activates fibroblast growth factor receptor, Raf\/MEK (mitogen-activated protein kinase\/ERK kinase)\/ERK (extracellular signal-regulated kinase) pathway and Akt pathway, which might involve the type III Na\n                    <jats:sup>+<\/jats:sup>\n                    \/P\n                    <jats:sub>i<\/jats:sub>\n                    cotransporter PiT-1. Excessive phosphate loading can lead to various harmful effects by accelerating ectopic calcification, enhancing oxidative stress, and dysregulating signal transduction. The responsiveness of mammalian cells to altered extracellular phosphate levels suggests that they may sense and adapt to phosphate availability, although the precise mechanism for phosphate sensing in mammals remains unclear. Unicellular organisms, such as bacteria and yeast, use some types of P\n                    <jats:sub>i<\/jats:sub>\n                    transporters and other molecules, such as kinases, to sense the environmental P\n                    <jats:sub>i<\/jats:sub>\n                    availability. Multicellular animals may need to integrate signals from various organs to sense the phosphate levels as a whole organism, similarly to higher plants. Clarification of the phosphate-sensing mechanism in humans may lead to the development of new therapeutic strategies to prevent and treat diseases caused by phosphate imbalance.\n                  <\/jats:p>","DOI":"10.1152\/physrev.00022.2017","type":"journal-article","created":{"date-parts":[[2018,8,15]],"date-time":"2018-08-15T08:30:31Z","timestamp":1534321831000},"page":"2317-2348","source":"Crossref","is-referenced-by-count":172,"title":["Phosphate as a Signaling Molecule and Its Sensing Mechanism"],"prefix":"10.1152","volume":"98","author":[{"given":"Toshimi","family":"Michigami","sequence":"first","affiliation":[{"name":"Department of Bone and Mineral Research, Research Institute, Osaka Women\u2019s and Children\u2019s Hospital, Osaka Prefectural Hospital Organization, Izumi, Osaka, Japan; and Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, 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