Disturbed endochondral ossification in X-linked hypophosphatemia indicates an involvement of P i in chondrogenesis.We studied the role of the sodium-dependent P i cotransporters (NPT), which are a widely recognized regulator of cellular P i homeostasis, and the downstream events in chondrogenesis using Hyp mice, the murine homolog of human X-linked hypophosphatemia. Hyp mice showed reduced apoptosis and mineralization in hypertrophic cartilage. Hyp chondrocytes in culture displayed decreased apoptosis and mineralization compared with WT chondrocytes, whereas glycosaminoglycan synthesis, an early event in chondrogenesis, was not altered. Expression of the type III NPT Pit-1 and P i uptake were diminished, and intracellular ATP levels were also reduced in parallel with decreased caspase-9 and caspase-3 activity in Hyp chondrocytes. The competitive NPT inhibitor phosphonoformic acid and ATP synthesis inhibitor 3-bromopyruvate disturbed endochondral ossification with reduced apoptosis in vivo and suppressed apoptosis and mineralization in conjunction with reduced P i uptake and ATP synthesis in WT chondrocytes. Overexpression of Pit-1 in Hyp chondrocytes reversed P i uptake and ATP synthesis and restored apoptosis and mineralization. Our results suggest that cellular ATP synthesis consequent to P i uptake via Pit-1 plays an important role in chondrocyte apoptosis and mineralization, and that chondrogenesis is ATP-dependent.Endochondral ossification is critical to the development and growth of mammals. The process begins with condensation of undifferentiated mesenchymal cells, and these cells differentiate into proliferating chondrocytes that express type II, IX, and XI collagen and sulfated glycosaminoglycans (GAG) 2 (1). Proliferating chondrocytes further differentiate into hypertrophic chondrocytes expressing type X collagen, undergo apoptosis, mineralize, and are ultimately replaced by bone. Disturbance of the endochondral ossification leads to a variety of skeletal disorders.The genetic disease X-linked hypophosphatemia (XLH) is the most common form of inherited rickets in humans and is related to the dominant disorder of P i homeostasis (2). XLH has been shown to be caused by inactive mutations of the PHEX gene and characterized by hypophosphatemia secondary to renal P i wasting, growth retardation due to disturbed endochondral ossification, osteomalacia resulting from reduced mineralization, and abnormally regulated vitamin D metabolism (3). Hyp mice also display similar biochemical and phenotypic abnormalities to human XLH, including hypophosphatemia, osteomalacia, and skeletal abnormalities. Hyp mice thus are a mouse homolog of human XLH (4). Previous studies reported that Hyp mice exhibited disorganized hypertrophic cartilage with reduced apoptotic chondrocytes and hypomineralization (5). We have reported previously that osteoclast number was decreased in Hyp mice compared with WT mice and that a high-P i diet partially restored this, showing that P i influences osteoclastogenesis and suggesting that this P...