The value of fibroblast growth factor 21 in health and pathology

The article presents current ideas about the role of fibroblast growth factor 21 (FGF21) in the regulation of carbohydrate and lipid metabolism, as well as its contribution to the development of systemic inflammation in rheumatoid arthritis, both in laboratory animals and in humans. The classification of the fibroblast growth factor family, regulation of expression and receptor apparatus is considered. Positive effects of FGF21 have been noted in the form of normalization of carbohydrate and lipid metabolism, body weight; drugs analogues of FGF21 have proven themselves well as a therapeutic agent for the treatment of metabolic complications such as diabetes and fatty liver disease. At the same time, data are provided on the connection between elevated levels of FGF21 in blood serum and a number of pathological conditions, such as type 2 diabetes mellitus, coronary heart disease, obesity, non-alcoholic fatty liver disease, and end-stage renal failure. The facts about the controversial role of FGF21 against the background of systemic inflammation in patients with rheumatoid arthritis (RA) are reviewed. On the one hand, FGF21 may have a protective effect in patients with RA; on the other hand, serum FGF21 can be considered as a predictor of future decline in functional status and a potential marker for the progression of systemic inflammation in patients with RA. The prospects for using FGF21 for therapeutic purposes are assessed.