Myles Wolf
Director, Clinical Research, Assistant Dean for Translational and Clinical Research,
University of Miami Miller School of Medicine, Florida, USA
The primary focus of Dr. Wolf’s research is to understand mechanisms of disordered mineral
metabolism in patients with chronic kidney disease (CKD) including the role of fibroblast
growth factor-23 (FGF23), vitamin D and parathyroid hormone in phosphorus and calcium
metabolism in CKD. In addition, Blacks and Hispanics bear a disproportionate burden of
CKD with more rapid progression to dialysis and worse CVD outcomes. Although there are
known differences in mineral metabolism among dialysis and healthy patients according to
race/ethnicity, data are sparse in pre-dialysis CKD. Thus, a special emphasis of Dr. Wolf’s
research is characterizing the racial and ethnic differences in mineral metabolism in CKD
and their impact on adverse outcomes. FGF23 is a 251 amino acid protein secreted by
osteocytes that induces phosphaturia and inhibits renal 1-alpha hydroxylase leading to
decreased synthesis of calcitriol (1,25D). “Primary” syndromes of FGF23 excess are marked
by hypophosphatemia, renal phosphate wasting, and inappropriately low 1,25D levels. In
contrast, FGF23 null mice and patients with inactivating FGF23 mutations, develop
hyperphosphatemia with excessive 1,25D.
“Secondary” FGF23 excess as in CKD is the primary focus of Dr. Wolf’s lab. FGF23 levels
increase progressively beginning in early CKD, presumably to help maintain normal serum
phosphate levels by inducing phosphaturia and inhibiting production of 1,25D. However, Dr.
Wolf’s lab and others have shown that increased FGF23 is strongly associated with CKD
progression, CVD, and death, even when serum phosphate is normal, suggesting that
increased FGF23 may represent an earlier and more sensitive biomarker of disordered
phosphorus metabolism than concomitant serum phosphate levels.
Study populations include dialysis patients, patients with early-stage CKD, kidney transplant
recipients and donors, and healthy populations. Trainees are fixtures in Dr. Wolf’s laboratory
where they gain specific training in study design, human research subject protection and IRB
procedures, hypothesis and protocol development, recruiting strategies, informed consent,
data analysis, scientific writing and presentation and grant preparation.
Dr. Wolf’s commitment to mentorship and the success of his trainees is reflected in the fact
the over the last 5 years virtually all of his original research was lead authored by trainees,
who have presented their work at national meetings. In addition, many of his trainees have
successfully competed for foundation grants during their training and many have written or
already secured K23 applications as a result of their mentored work.