Abstract

Osteoporosis may complicate iron overload diseases such as genetic hemochromatosis. However, molecular mechanisms involved in the iron-related osteoporosis remains poorly understood. Recent in vitro studies support a role of osteoblast impairment in iron-related osteoporosis. Our aim was to analyse the impact of excess iron in Hfe-/- mice on osteoblast activity and on bone microarchitecture. We studied the bone formation rate, a dynamic parameter reflecting osteoblast activity, and the bone phenotype of Hfe−/− male mice, a mouse model of human hemochromatosis, by using histomorphometry. Hfe−/− animals were sacrificed at 6 months and compared to controls. We found that bone contains excess iron associated with increased hepatic iron concentration in Hfe−/− mice. We have shown that animals with iron overload have decreased bone formation rate, suggesting a direct impact of iron excess on active osteoblasts number. For bone mass parameters, we showed that iron deposition was associated with bone loss by producing microarchitectural impairment with a decreased tendency in bone trabecular volume and trabecular number. A disorganization of trabecular network was found with marrow spaces increased, which was confirmed by enhanced trabecular separation and star volume of marrow spaces. These microarchitectural changes led to a loss of connectivity and complexity in the trabecular network, which was confirmed by decreased interconnectivity index and increased Minkowski’s fractal dimension. Our results suggest for the first time in a genetic hemochromatosis mouse model, that iron overload decreases bone formation and leads to alterations in bone mass and microarchitecture. These observations support a negative effect of iron on osteoblast recruitment and/or function, which may contribute to iron-related osteoporosis.

Highlights

  • Genetic hemochromatosis (GH) related to the p.Cys282Tyr (C282Y) mutation in the HFE gene is one of the most prevalent genetic diseases worldwide

  • We found that bone contains excess iron associated with increased hepatic iron concentration in Hfe−/− mice

  • We have shown that animals with iron overload have decreased bone formation rate, suggesting a direct impact of iron excess on active osteoblasts number

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Summary

Introduction

Genetic hemochromatosis (GH) related to the p.Cys282Tyr (C282Y) mutation in the HFE gene is one of the most prevalent genetic diseases worldwide. Genetic predisposition to the disease is homozygosity for the C282Y mutation, which is present in 3 out of every 1000 Caucasian persons with incomplete penetrance. GH leads to the development of progressive iron overload involving several tissues, including the liver, pancreas, or heart [1], resulting in lifethreatening complications, such as cirrhosis, diabetes, and heart failure [2,3]. Other clinical complications that worsen patients quality of life, including osteoporosis [4], have been reported. Osteoporosis is a bone disorder that increases fracture risk with low energy trauma and is defined by the World Health Organization as a decrease in bone mass and deterioration of bone microarchitecture [5]. As suggested by this definition, and demonstrated in many studies [6,7], alteration of the bone microarchitecture is an independent risk factor for fracture

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