Klotho: A Potential Therapeutic Target in Aging and Neurodegeneration Beyond Chronic Kidney Disease

Abstract Klotho, a multifunctional protein, acts as a co-receptor in FGF23, and exerts its impact through various molecular pathways, including Wnt, HIF, IGF-1 pathways. The physiological significance of Klotho is the regulation of vitamin D and phosphate metabolism, as well as serving as a vital component in aging and neurodegeneration. The role of Klotho in aging and neurodegeneration in particular has gained considerable attention. Hereby, in this narrative review, we highlighted several key insights into the molecular basis and physiological function of Klotho and synthesized current research on the role of Klotho in neurodegeneration and aging. Klotho deficiency was associated with cognitive impairment, reduced growth, diminished longevity, and the development of age-related diseases in vivo. Serum Klotho levels showed a decline in individuals with advanced age and those affected by chronic kidney disease, establishing its potential diagnostic significance. Additionally, multiple medications have been demonstrated to influence Klotho levels. Therefore, this comprehensive review suggests that Klotho could open the door to novel interventions aimed at addressing the challenges of aging and neurodegenerative disorders.