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Phosphocitrate is a naturally occurring phosphorylated polycarboxylic acid originally identified in mammalian mitochondria. It acts as a highly potent inhibitor of biological crystallization (calcification) by binding stereospecifically to the faces of calcium crystals, thereby preventing their nucleation, growth, and aggregation. This includes basic calcium phosphate (BCP), calcium oxalate, and calcium pyrophosphate dihydrate (CPPD) crystals. In addition to its physical-chemical anti-calcification properties, phosphocitrate modulates crystal-induced cellular signaling pathways, reducing the expression of inflammatory mediators (such as interleukin-1 beta and cyclooxygenase-2) and matrix metalloproteinases (such as MMP-1). It is being investigated in preclinical models for the treatment of crystal-associated osteoarthritis, pseudoxanthoma elasticum (PXE), nephrolithiasis, and vascular calcification.
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