Abnormalities In Bone Formation Research Articles

The Genetic Architecture of High Bone Mass.

The phenotypic trait of high bone mass (HBM) is an excellent example of the nexus between common and rare disease genetics. HBM may arise from carriage of many ‘high bone mineral density [BMD]’-associated alleles, and certainly the genetic architecture of individuals with HBM is enriched with high BMD variants identified through genome-wide association studies of BMD. HBM may also arise as a monogenic skeletal disorder, due to abnormalities in bone formation, bone resorption, and/or bone turnover. Individuals with monogenic disorders of HBM usually, though not invariably, have other skeletal abnormalities (such as mandible enlargement) and thus are best regarded as having a skeletal dysplasia rather than just isolated high BMD. A binary etiological division of HBM into polygenic vs. monogenic, however, would be excessively simplistic: the phenotype of individuals carrying rare variants of large effect can still be modified by their common variant polygenic background, and by the environment. HBM disorders—whether predominantly polygenic or monogenic in origin—are not only interesting clinically and genetically: they provide insights into bone processes that can be exploited therapeutically, with benefits both for individuals with these rare bone disorders and importantly for the many people affected by the commonest bone disease worldwide—i.e., osteoporosis. In this review we detail the genetic architecture of HBM; we provide a conceptual framework for considering HBM in the clinical context; and we discuss monogenic and polygenic causes of HBM with particular emphasis on anabolic causes of HBM.

Collagen and non-collagenous proteins molecular crosstalk in the pathophysiology of osteoporosis

Collagenous and non-collagenous proteins (NCPs) in the extracellular matrix, as well as the coupling mechanisms between osteoclasts and osteoblasts, work together to ensure normal bone metabolism. Each protein plays one or more critical roles in bone metabolism, sometimes even contradictory, thus affecting the final mechanical, physical and chemical properties of bone tissue. Anomalies in the amount and structure of one or more of these proteins can cause abnormalities in bone formation and resorption, which consequently leads to malformations and defects, such as osteoporosis (OP). The connections between key proteins involved in matrix formation and resorption are far from being elucidated. In this review, we resume knowledge on the crosstalk between collagen type I and selected NCPs (Transforming Growth Factor-β, Insulin-like Growth Factor-1, Decorin, Osteonectin, Osteopontin, Bone Sialoprotein and Osteocalcin) of bone matrix, focusing on their possible involvement and role in OP. The different elements of this network can be pharmacologically targeted or used for the design/development of innovative regenerative strategies to modulate a feedback loop in bone remodelling.

Treatment of Human Immunodeficiency Virus Infection With Tenofovir Disoproxil Fumarate-Containing Antiretrovirals Maintains Low Bone Formation Rate, But Increases Osteoid Volume on Bone Histomorphometry.

Bone mineral density (BMD) loss is a known complication of human immunodeficiency virus (HIV) infection and its treatment, particularly with tenofovir disoproxil fumarate (TDF)-containing antiretroviral regimens. Although renal proximal tubular dysfunction and phosphaturia is common with TDF, it is unknown whether BMD loss results from inadequate mineralization. We evaluated change in BMD by dual-energy X-ray absorptiometry (DXA) and bone histomorphometry by tetracycline double-labeled transiliac crest biopsies in young men living with HIV before (n = 20) and 12 months after (n = 16) initiating TDF/lamivudine/efavirenz. We examined relationships between calciotropic hormones, urinary phosphate excretion, pro-inflammatory and pro-resorptive cytokines, and bone remodeling-related proteins with changes in BMD and histomorphometry. Mean age was 29.6 ± 5.5 years, with mean CD4 + T cell count of 473 ± 196 cells/mm3 . At baseline, decreased bone formation rate and increased mineralization lag time were identified in 16 (80%) and 12 (60%) patients, respectively. After 12 months, we detected a 2% to 3% decrease in lumbar spine and hip BMD by DXA. By histomorphometry, we observed no change in bone volume/total volume (BV/TV) and trabecular parameters, but rather, increases in cortical thickness, osteoid volume, and osteoblast and osteoclast surfaces. We did not observe significant worsening of renal phosphate excretion or mineralization parameters. Increases in PTH correlated with decreased BMD but not histomorphometric parameters. Overall, these data suggest abnormalities in bone formation and mineralization occur with HIV infection and are evident at early stages. With TDF-containing antiretroviral therapy (ART), there is an increase in bone remodeling, reflected by increased osteoblast and osteoclast surfaces, but a persistence in mineralization defect, resulting in increased osteoid volume. © 2019 American Society for Bone and Mineral Research.

The genetic implication of scoliosis in osteogenesis imperfecta: a review.

Osteogenesis imperfecta (OI) is a kind of heritable connective tissue disorder, including blue sclerae, hearing loss, skeletal dysplasia causing bone fragility and deformities. It is typically caused by collagen related gene mutations, which could lead to bone formation abnormalities. Scoliosis is one of the most common and severe spinal phenotype which has been reported in approximately 26-74.5% of all OI patients. Recent breakthroughs have suggested that OI can be divided into more than 16 types based on genetic mutations with different degrees of scoliosis. In this review, we summarize the etiology of scoliosis in OI, especially the genetic studies of different types. We aim to provide a systematic review of the genetic etiology and clinical suggestions of scoliosis in OI.

Effects of the 1, 4-dihydropyridine L-type calcium channel blocker benidipine on bone marrow stromal cells.

Osteoporosis (OP) often increases the risk of bone fracture and other complications and is a major clinical problem. Previous studies have found that high blood pressure is associated with bone formation abnormalities, resulting in increased calcium loss. We have investigated the effect of the antihypertensive drug benidipine on bone marrow stromal cell (BMSC) differentiation into osteoblasts and bone formation under osteoporotic conditions. We used a combination of in vitro and in vivo approaches to test the hypothesis that benidipine promotes murine BMSC differentiation into osteoblasts. Alkaline phosphatase (ALP), osteocalcin (OCN), runt-related transcription factor 2 (RUNX2), β-catenin, and low-density lipoprotein receptor-related protein 5 (LRP5) protein expression was evaluated in primary femoral BMSCs from C57/BL6 mice cultured under osteogenic conditions for 2 weeks to examine the effects of benidipine. An ovariectomized (OVX) mouse model was used to investigate the effect of benidipine treatment for 3 months in vivo. We found that ALP, OCN, and RUNX2 expression was up-regulated and WNT/β-catenin signaling was enhanced in vitro and in vivo. In OVX mice that were intragastrically administered benidipine, bone parameters (trabecular thickness, bone mineral density, and trabecular number) in the distal femoral metaphysis were significantly increased compared with control OVX mice. Consistently, benidipine promoted BMSC differentiation into osteoblasts and protected against bone loss in OVX mice. Therefore, benidipine might be a suitable candidate for the treatment of patients with postmenopausal osteoporosis and hypertension.

IBMS oral program—Friday

Bone formation is controlled by a network of transcription factors and signaling molecules. In this issue, Elefteriou et al. (2006), studying the role of the transcription factor ATF4 in a new mouse model of neurofibromatosis type I skeletal defects, demonstrate striking effects of changing dietary protein on bone formation abnormalities.

Protein nutrition as therapy for a genetic disorder of bone?

Bone formation is controlled by a network of transcription factors and signaling molecules. In this issue, , studying the role of the transcription factor ATF4 in a new mouse model of neurofibromatosis type I skeletal defects, demonstrate striking effects of changing dietary protein on bone formation abnormalities.

The effect of vitamin K supplementation on biochemical markers of bone formation in children and adolescents with cystic fibrosis

Impaired vitamin K status in cystic fibrosis (CF) has been considered as a newly emerged pathogenetic factor for reduced bone mineral density (BMD). Our aim was to evaluate the effectiveness of vitamin K supplementation in managing bone formation abnormalities in children and adolescents with CF. The statuses of vitamins K and D in relation to biochemical markers of bone metabolism and BMD were examined in 20 CF children receiving vitamin D supplements but not vitamin K supplements. Laboratory tests were carried out at the beginning of the study period and after 1 year of vitamin K supplementation (10 mg single oral dose/week) and the results were compared; the results were also compared with those of 25 healthy controls. Ten of the CF patients had BMD z-score<or=2.5 (n=5) or between -1 and -2.5 (n=5). Biochemical tests on patients before vitamin K supplementation revealed that the levels of osteoblastic activity markers, namely, bone alkaline phosphatase (BAP), serum osteocalcin (Gla-OC), serum carboxy-terminal propeptide of type I procollagen (PICP) and serum amino-terminal propeptide of type I procollagen (PINP), were significantly reduced compared with those of the controls. These patients had also lower 25-hydroxy-vitamin D (25(OH)D) and vitamin K serum levels, higher undercaboxylated osteocalcin (Glu-OC) and parathormone (PTH) levels and a higher calcium to creatinine ratio (Ca/Cr) than the controls. Vitamin K intake was associated with an increase in Gla-OC, PINP, PICP levels and a decrease in Glu-OC levels. PTH levels were lower after vitamin K supplementation without any difference in BMD z-scores. Our data indicate that vitamin K supplementation may have a beneficial role in bone health in CF children.

Defective bone formation and anabolic response to exogenous estrogen in mice with targeted disruption of endothelial nitric oxide synthase.

Nitric oxide (NO) is a pleiotropic signaling molecule that is produced by bone cells constitutively and in response to diverse stimuli such as proinflammatory cytokines, mechanical strain, and sex hormones. Endothelial nitric oxide synthase (eNOS) is the predominant NOS isoform expressed in bone, but its physiological role in regulating bone metabolism remains unclear. Here we studied various aspects of bone metabolism in female mice with targeted disruption of the eNOS gene. Mice with eNOS deficiency (eNOS KO) had reduced bone mineral density, and cortical thinning when compared with WT controls and histomorphometric analysis of bone revealed profound abnormalities of bone formation, with reduced osteoblast numbers, surfaces and mineral apposition rate. Studies in vitro showed that osteoblasts derived from eNOS KO mice had reduced rates of growth when compared with WT and were less well differentiated as reflected by lower levels of alkaline phosphatase activity. Mice with eNOS deficiency lost bone normally following ovariectomy but exhibited a significantly blunted anabolic response to high dose exogenous estrogen. We conclude that the eNOS pathway plays an essential role in regulating bone mass and bone turnover by modulating osteoblast function.

Endothelial Nitric Oxide Synthase Gene-Deficient Mice Demonstrate Marked Retardation in Postnatal Bone Formation, Reduced Bone Volume, and Defects in Osteoblast Maturation and Activity

Nitric oxide (NO) has been implicated in the local regulation of bone metabolism. However, the contribution made by specific NO synthase (NOS) enzymes is unclear. Here we show that endothelial NOS gene knockout mice (eNOS-/-) have marked abnormalities in bone formation. Histomorphometric analysis of eNOS-/- femurs showed bone volume and bone formation rate was reduced by up to 45% (P: < 0.01) and 52% (P: < 0.01), respectively. These abnormalities were prevalent in young (6 to 9 weeks old) adults but by 12 to 18 weeks bone phenotype was restored toward wild-type. Dual energy X-ray absorptiometry analysis confirmed the age-related bone abnormalities revealing significant reductions in femoral (P: < 0.05) and spinal bone mineral densities (P: < 0.01) at 8 weeks that were normalized at 12 weeks. Reduction in bone formation and volume was not related to increased osteoclast numbers or activity but rather to dysfunctional osteoblasts. Osteoblast numbers and mineralizing activity were reduced in eNOS-/- mice. In vitro, osteoblasts from calvarial explants showed retarded proliferation and differentiation (alkaline phosphatase activity and mineral deposition) that could be restored by exogenous administration of a NO donor. These cells were also unresponsive to 17ss-estradiol and had an attenuated chemotactic response to transforming growth factor-beta. In conclusion, eNOS is involved in the postnatal regulation of bone mass and lack of eNOS gene results in reduced bone formation and volume and this is related to impaired osteoblast function.

Raquitismo e osteomalacia

Raquitismo e osteomalacia são defeitos da mineralização óssea. O raquitismo é caracterizado por anormalidades na formação na placa epifisária de crescimento, com áreas não mineralizadas, desorganização da arquitetura celular e retardo na maturação óssea. A osteomalacia é caracterizada pela deficiente mineralização da matriz osteóide do osso cortical e trabecular com acúmulo do tecido osteóide pouco mineralizado. São processos que, em geral, ocorrem associados. Após o final do crescimento, com o fechamento da cartilagem epifisária, apenas a osteomalacia permanece. A falha do processo de mineralização tem como uma das principais causas a inadequada concentração extracelular de cálcio e fósforo, os dois principais componentes minerais do osso, e a falta ou comprometimento da ação dos elementos responsáveis pela sua absorção, particularmente a vitamina D. As principais manifestações clínicas como as deformidades ósseas e o atraso no crescimento, são semelhantes nos diferentes tipos de raquitismo e osteomalacia existem características que são específicas. As causas são adquiridas ou hereditárias e os recentes avanços em biologia molecular permitem a identificação dos genes envolvidos e das mutações. Essa discussão inclui os principais tipos da patologia.

Effect of 1,25-vitamin D and parathyroidectomy on the uptake of aluminum in bone of rats with renal insufficiency.

Excessive aluminum accumulation in bone is associated with abnormalities in bone formation and mineralization in man and animals. The factors that influence deposition of aluminum in bone are not well understood. In this study the influence of 1,25-vitamin D on bone aluminum accumulation was evaluated in aluminum-loaded parathyroidectomized and nonparathyroidectomized rats with renal insufficiency. All groups of aluminum-loaded rats receiving 1,25-vitamin D had less bone aluminum accumulation. This effect was not influenced by the presence of absence of parathyroid hormone. All rats administered 1,25-vitamin D had elevated serum calcium and depressed serum phosphorus levels and lower body weight compared to controls. The results ascribe a potential role for 1,25-vitamin D in the prevention of aluminum accumulation.

Pathological bone structure (author's transl)

The pathological and anatomical basis of various radiographic changes in a number of diseases of the skeleton is discussed. The conditions include abnormalities of bone formation and bone removal, including osteoporosis, fibrous dysplasia, osteomyelosclerosis, osteitis deformans, posttraumatic changes and ossifying periostitis. The form and structure of the pathological and anatomical substrate determine the radiological appearances and are essential for arriving at a diagnosis.

Experiments on skeletal growth and development in vitro in relation to the problem of avian phokomelia

The experiments to be reported in the following pages were suggested by observations made by one of us on the so-called Creeper fowl. Creeper chickens are characterized by a disproportionate shortness of the long bones of the extremities. Histological study has shown that Creeper chickens belong in the same category as the disproportionate dwarfism of mammals known as chondrodystrophy or achondroplasia (Landauer, 1931) . The Creeper characters are inherited as a Mendelian dominant and are lethal in homozygous condition (Landauer and Dunn, 1930). Homozygous Creeper embryos generally die after about 72 hours of incubation, but in rare cases they survive beyond this stage and continue development up to nearly hatching time. These late stages of homozygous Creeper embryos exhibit striking malformations of the extremities which are known as phokomelia (Landauer, 1933). A study of the early embryonic development of homozygous Creeper embryos (Landauer, 1932) led to the conclusion that the effects of the Creeper mutation are not brought about by specific gene action on those body parts which later show deformities, but by a general retardation of body growth at a definite stage of development. This conclusion was strengthened by a detailed comparison of embryonic and post-natal bone growth in heterozygous Creeper and normal chickens (Landauer, 1934). All evidence which so far has been obtained in this work points to the conclusion that the characteristic traits of heterozygous as well as homozygous Creeper chicks are produced by an unspecific retardation of development at a time when formation of the buds of the extremities (and of the head which in homozygous embryos also shows deformities later on) are proceeding at a particularly rapid rate, thereby causing specific disturbances in the differentiation of these parts. It seemed to us that it should be possible to put these conclusions to an experimental test. The most promising way of approach appeared to be an attempt to produce in vitro the extreme abnormalities of bone formation shown by the extremities of phokomelic homozygous Creeper embryos. These abnormalities chiefly consist in (1) a general retardation of cartilage differentiation; (2) lack of bone formation; and (3) frequent partial fusion of ulna and radius on the one hand, tibia and fibula on the other, or presence of only one bone in these segments instead of two.