Combined injury: irradiation with skin or bone wounds in rodent models.

A radiation combined injury is defined as an injury that occurs in the setting of irradiation, such as those expected after a nuclear accident, radiation dispersal device release (a 'dirty bomb'), or a nuclear weapon detonation. There is much research on irradiation-associated burns and their healing, but there is less known about other injuries sustained in the context of irradiation. Animal models are limited in their correlations to clinical situations but can support research on specific questions about injuries and their healing. Mouse models of irradiation with skin or bone wounds are validated as highly reproducible and quantitative. They show dose-dependent impairment of wound healing, with later recovery. Irradiation-induced delay of bone wound healing was mitigated to different extents by single doses of gramicidin S-nitroxide JP4-039, a plasmid expressing manganese superoxide dismutase, amifostine/WR2721, or the bifunctional sulfoxide MMS-350. These models should be useful for research on mechanisms of radiation dermal and osseous damage and for further development of new radioprotectors. They also provide information of potential relevance to the effects of clinical radiation therapies.

Megalin mediates 25-hydroxyvitamin D3 actions in human mesenchymal stem cells.

Osteoblast differentiation of human mesenchymal stem cells (hMSCs) is stimulated by 1α,25-dihydroxycholecalciferol [1α,25(OH)2D3] and 25-hydroxycholecalciferol [25(OH)D3]; the latter's effects require intracellular hydroxylation to 1α,25(OH)2D3. Thus, hMSCs are both a source of and target for 1α,25(OH)2D3. Megalin is a transmembrane receptor for serum d-binding protein (DBP) in kidney cells and is required for uptake of the 25(OH)D3-DBP complex. We tested the hypothesis that megalin is required for D actions in hMSCs with cells from surgically discarded marrow for RT-PCR, for effects of 25(OH)D3 and 1α,25(OH)2D3, for 1α,25(OH)2D3 biosynthesis, for osteoblastogenesis, and for small interfering RNA for megalin (si-Meg) and control (si-Ctr). In hMSCs with high constitutive megalin expression, both 1α,25(OH)2D3 and 25(OH)D3 stimulated osteoblastogenesis (P < 0.05), but only 1α,25(OH)2D3 did so in hMSCs with lower megalin (lo-Meg, P < 0.001) or in si-Meg cells (P < 0.05). In addition, 1α,25(OH)2D3 biosynthesis was significantly lower in lo-Meg (46%, P = 0.034) and in si-Meg (23%, P < 0.001) than each control. Leptin significantly stimulated megalin expression 2.1-fold in lo-Meg cells (P < 0.01). These studies show that megalin is expressed in hMSCs and is required for the biosynthesis of 1α,25(OH)2D3 and for the 25(OH)D3/DBP complex to stimulate vitamin D receptor targets and osteoblastogenesis.-Gao, Y., Zhou, S., Luu, S., Glowacki, J. Megalin mediates 25-hydroxyvitamin D3 actions in human mesenchymal stem cells.

Dehydroepiandrosterone Stimulation of Osteoblastogenesis in Human MSCs Requires IGF-I Signaling.

Dehydroepiandrosterone (DHEA) is an adrenal steroid that circulates in high concentrations in humans in its sulfated form, DHEAS. Clinical and epidemiological studies suggested that low DHEAS levels may be associated with low bone mass. Previously, we and others showed that the effects of DHEA on the skeleton may be conferred partly by their ability to inhibit skeletal catabolic agents, for example, bone resorptive cytokine IL-6. In this study, we tested the hypothesis that the anabolic effects of DHEA on osteoblastogenesis require IGF-I signaling pathways. Using both primary cultures and a cell line of human bone marrow-derived mesenchymal stem cells (hMSCs), we show that DHEA and other steroids stimulate osteoblastogenesis as shown by alkaline phosphatase activity and osteoblast gene induction. The stimulation by DHEA on both IGF-I gene expression and osteoblastogenesis in hMSCs requires IGF-I receptor, PI3K, p38 MAPK, or p42/44 MAPK signaling pathways. This study adds information to indicate that DHEA may be useful for treating bone diseases through its inhibition of skeletal catabolic IL-6 and stimulation of anabolic IGF-I-mediated mechanisms. J. Cell. Biochem. 117: 1769-1774, 2016. © 2015 Wiley Periodicals, Inc.

Parathyroid hormone and its receptor gene polymorphisms: implications in osteoporosis and in fracture healing.

Parathyroid glands secrete parathyroid hormone (PTH) which plays multiple roles in calcium homeostasis and in bone remodeling. Secretion of PTH is regulated by extracellular calcium levels and other humoral factors including 1α,25(OH)2D3. PTH regulates gene expression and induces biological effects directly and indirectly. The human gene encoding PTH is located on chromosome 11. In this review, we study the diverse PTH along with its receptor gene polymorphisms and their association with osteoporosis and fracture healing. Genetic factors are associated with osteoporosis by influencing bone mineral density (BMD), bone turnover, calcium homeostasis, and susceptibility to osteoporotic fractures. Polymorphisms in genes encoding PTH may contribute to genetic regulation of BMD and thus susceptibility to fracture risk. PTH stimulates the proliferation of osteoprogenitor cells, production of alkaline phosphatise, and bone matrix proteins that contribute to hard callus formation and increases strength at the site of fractured bone. During remodeling, PTH promotes osteoclastogenesis restoring the original shape, structure, and mechanical strength of the bone. Some PTH polymorphisms have shown an association with fracture risk. Further research is needed to elucidate the relative importance of PTH genetics and the mechanisms of genetic contributions to gene-gene interactions in the pathogenesis of osteoporosis and in fracture healing.

Demineralized Bone and BMPs: Basic Science and Clinical Utility.

The clinical demand for bone void fillers led to the development of off-the-shelf banked bone and synthetic and biologic substitute materials to be used either alone or as bone graft volume extenders. Demineralized bone (DB) has a remarkable capacity to induce new bone formation even when implanted subcutaneously in experimental animals, a phenomenon termed "osteoinduction." DB products are now widely available through tissue bank procurement of bone from rigorously screened donors. When properly processed, DB products are useful in craniomaxillofacial, oral, hand, and orthopedic applications. The isolation of proteins believed to be responsible for the osteoinductive activity of DB, termed bone morphogenetic proteins (BMPs), led to the cloning of a family of genes and synthesis of recombinant human BMPs (rhBMPs). They have been approved for distribution and use in specific maxillofacial and orthopedic applications. Clinical trials and studies of orthopedic and craniofacial applications have indicated that supraphysiologic doses of a single recombinant protein are needed to promote bone repair. Information about the biology, chemistry, and actions of rhBMPs and DB has called into question whether a single recombinant BMP would result in clinically useful bone induction and morphogenesis. Compelling preclinical and specific clinical evidence has indicated the efficacy of DB and for rhBMPs either combined with autograft or compared with an autograft alone. In light of questions about potency and safety, however, additional high-level evidence is needed for specific clinical indications and appropriate patient populations that would benefit from their use.

Effect of age on regulation of human osteoclast differentiation.

Human skeletal aging is characterized as a gradual loss of bone mass due to an excess of bone resorption not balanced by new bone formation. Using human marrow cells, we tested the hypothesis that there is an age-dependent increase in osteoclastogenesis due to intrinsic changes in regulatory factors [macrophage-colony stimulating factor (M-CSF), receptor activator of NF-κB ligand (RANKL), and osteoprotegerin (OPG)] and their receptors [c-fms and RANK]. In bone marrow cells (BMCs), c-fms (r = 0.61, P = 0.006) and RANK expression (r = 0.59, P = 0.008) were increased with age (27-82 years, n = 19). In vitro generation of osteoclasts was increased with age (r = 0.89, P = 0.007). In enriched marrow stromal cells (MSCs), constitutive expression of RANKL was increased with age (r = 0.41, P = 0.049) and expression of OPG was inversely correlated with age (r = -0.43, P = 0.039). Accordingly, there was an age-related increase in RANKL/OPG (r = 0.56, P = 0.005). These data indicate an age-related increase in human osteoclastogenesis that is associated with an intrinsic increase in expression of c-fms and RANK in osteoclast progenitors, and, in the supporting MSCs, an increase in pro-osteoclastogenic RANKL expression and a decrease in anti-osteoclastogenic OPG. These findings support the hypothesis that human marrow cells and their products can contribute to skeletal aging by increasing the generation of bone-resorbing osteoclasts. These findings help to explain underlying molecular mechanisms of progressive bone loss with advancing age in humans.

Inhibition of adipocytogenesis by canonical WNT signaling in human mesenchymal stem cells.

The WNT signaling pathway plays important roles in the self-renewal and differentiation of mesenchymal stem cells (MSCs). Little is known about WNT signaling in adipocyte differentiation of human MSCs. In this study, we tested the hypothesis that canonical and non-canonical WNTs differentially regulate in vitro adipocytogenesis in human MSCs. The expression of adipocyte gene PPARγ2, lipoprotein lipase, and adipsin increased during adipocytogenesis of hMSCs. Simultaneously, the expression of canonical WNT2, 10B, 13, and 14 decreased, whereas non-canonical WNT4 and 11 increased, and WNT5A was unchanged. A small molecule WNT mimetic, SB-216763, increased accumulation of ß-catenin protein, inhibited induction of WNT4 and 11 and inhibited adipocytogenesis. In contrast, knockdown of ß-catenin with siRNA resulted in spontaneous adipocytogenesis. These findings support the view that canonical WNT signaling inhibits and non-canonical WNT signaling promotes adipocytogenesis in adult human marrow-derived mesenchymal stem cells.

The Role of Research Experiences in the Training of Oral and Maxillofacial Surgeons.

The importance of active adult learning methods and critical thinking skills is appreciated in dental and OMFS residency training. Known barriers to research are finding time in the curriculum and funding needed for research experiences. These barriers have inspired many institutions to design programs to provide research opportunities, but they can be expensive and of minimal interest to those not planning academic careers. During OMFS residency training, the primary emphasis is on mastery of all aspects of surgical care. Strong partnerships between PhD researchers and OMFS clinical investigators, formed to advance the field, can also have an impact on trainees' involvement in research and their understanding of rigorous evidence-based principles of clinical care.

Reduced osteoclastogenesis and RANKL expression in marrow from women taking alendronate.

Alendronate (AL) is commonly used for the prevention and treatment of osteoporotic fractures. Little is known about the effects of AL administration on osteoclast differentiation from human marrow progenitor cells. We used marrow discarded during orthopedic surgery to test the hypothesis that cultures of bone marrow-derived stem cells (BMCs) from subjects receiving AL (+AL) may differ from control subjects with respect to in vitro osteoclast differentiation and regulatory factors. The number of osteoclasts generated in BMC cultures from control subjects was 4.7-fold greater than that from +AL subjects (P = 0.015). RANKL expression in +AL BMCs was 57% of that in controls (P = 0.001), and OPG expression in +AL BMCs was greater than in controls (153%, P = 0.01). The mean RANKL/OPG ratio in BMCs was 0.65 ± 0.35 for +AL specimens and 1.28 ± 0.53 for controls (P = 0.031). In addition, we assessed the direct effect of AL on expression of RANKL and OPG in marrow stromal cells isolated from nine control women. Treatment with AL downregulated RANKL expression and upregulated OPG expression, with an average 50% decrease in RANKL/OPG ratio at 10(-7) M (P = 0.004). These results show that osteoclast differentiation is dysregulated in marrow isolated from +AL subjects. Furthermore, AL may inhibit human osteoclastogenesis by affecting the key regulatory genes in marrow cells.

Underestimated fracture probability in patients with unilateral hip osteoarthritis as calculated by FRAX.

Osteoporosis (OP) and osteoarthritis (OA) are age-related diseases often considered to be mutually exclusive. We previously found that 25% of women with advanced OA had occult OP and that femoral neck (FN) bone mineral density (BMD) T-scores were significantly higher for osteoarthritic vs contralateral hips. The FRAX calculator incorporates clinical risk factors and FN BMD T-score to estimate 10-yr total fracture probability and hip fracture probability. In 35 women and men aged 41 yr or older with unilateral hip OA scheduled for hip replacement, we tested whether FRAX fracture probability is underestimated when using data for the OA rather than the contralateral hip. There were between-hip differences for FN BMD T-score (p<0.0001), total fracture probability (p =0.0004), and hip fracture probability (p =0.0009). Use of FN BMD T-scores resulted in OP treatment recommendations for 0% and 11% of subjects compared with 11% and 17% for total fracture probability and hip fracture probability, respectively. In 6-11% of subjects in this series, the FRAX calculator underestimated fracture probability with data for the OA hip. With the increased use of FRAX in clinical use, these data suggest that measurement of BMD at the contralateral hip may yield higher calculated FRAX total and hip fracture probabilities.

Autologous cranial particulate bone graft: an experimental study of onlay cranioplasty.

The purpose of this study was to determine whether particulate bone graft maintains its volume when used for onlay cranioplasty. Twenty-five adult, male, New Zealand white rabbits were divided into 5 groups (n = 5/group). Groups 1 to 3 were controls: group 1, untreated; group 2, sham procedure; and group 3, burring the cortical surface. Group s 4 and 5 had augmentation of the parietal bones with particulate graft harvested from the frontal bone with a brace and bit. The particulate graft was placed on native parietal bone (group 4) or on parietal bone that had been abraded to punctuate bleeding with an electric burr (group 5). Volume maintenance and osseointegration of the grafts were determined by micro-computed tomography and histology. At 16 weeks postoperatively, the mean (SD) volumes of the parietal bones in control groups 1, 2, and 3 were 555.8 (29.2), 550.8 (36.8), and 539.0 (39.0) mm, respectively. Immediately after cranioplasty, the mean (SD) volumes of augmented parietal bone were 846.0 (10.8) mm for group 4 and 831.8 (11.8) mm for group 5. Sixteen weeks postoperatively, 100% of the group 4 grafts had resorbed (551.8 [SD, 24.0] mm), and parietal volume was no different from controls (P = 0.89). Group 5 maintained 54.2% of volume (695.6 [SD, 22.0] mm), which was greater than those of the controls (P < 0.0001). Particulate graft may be used for onlay cranioplasty if the recipient site is burred. Approximately one half of the onlay graft is resorbed, and its original shape is not maintained.

Synergistic stimulation of osteoblast differentiation of rat mesenchymal stem cells by leptin and 25(OH)D3 is mediated by inhibition of chaperone-mediated autophagy.

BACKGROUND: Vitamin D is important for the mineralization of bones by stimulating osteoblast differentiation of bone marrow mesenchymal stem cells (BMMSCs). BMMSCs are a target of vitamin D action, and the metabolism of 25(OH)D3 to biologically active 1α,25(OH)2D3 in BMMSCs promotes osteoblastogenesis in an autocrine/paracrine manner. Our previous study with human BMMSCs showed that megalin is required for the 25(OH)D3-DBP complex to enter cells and for 25(OH)D3 to stimulate osteoblast differentiation in BMMSCs. Furthermore, we reported that leptin up-regulates megalin in those cells. Leptin is a known inhibitor of PI3K/AKT-dependent chaperone-mediated autophagy (CMA). In this study, we tested the hypothesis that leptin acts synergistically with 25(OH)D3 to promote osteoblastogenesis in rat BMMSCs by a mechanism that entails inhibition of PI3K/AKT-dependent CMA. METHODS: BMMSCs were isolated from rat bone marrow (4-week-old male SD rats); qRT-PCR and western immunoblots or immunofluorescence were used to evaluate the expression of megalin, ALP, COL1A1, RUNX2, OSX, OSP, and CMA in rBMMSCs. The osteoblast differentiation was evaluated by ALP activity, ALP staining, and calcium deposition. The viability of rBMMSCs was assessed with the CCK-8 kit. Biosynthesis of 1α,25(OH)2D3 was measured by a Rat 1α,25(OH)2D3 ELISA Kit. RESULTS: The combination of leptin and 25(OH)D3 treatment significantly enhanced osteoblast differentiation as shown by ALP activity, ALP staining, and calcium deposition, the expression of osteogenic genes ALP, COL1A1, RUNX2, OSX, and OSP by qRT-PCR and western immunoblots in rBMMSCs. Leptin enhanced the expression of megalin and synthesis of 1α,25(OH)2D3 in rBMMSCs. Our data showed that leptin inhibited CMA activity of rBMMSCs by activating PI3K/AKT signal pathway; the ability of leptin to enhance 25(OH)D3 promoted osteoblast differentiation of rBMMSCs was weakened by the PI3K/AKT signal pathway inhibitor. CONCLUSIONS: Our data reveal the mechanism by which leptin and 25(OH)D3 promote osteoblast differentiation in rBMMSCs. Leptin promoted the expression of megalin by inhibiting CMA, increased the utilization of 25(OH)D3 by rBMMSCs, and enhanced the ability of 25(OH)D3 to induce osteoblast differentiation of rBMMSCs. PI3K/AKT is at least partially involved in the regulation of CMA. These data indicate the importance of megalin in BMMSCs for vitamin D's role in skeletal health.

Discordance in femoral neck bone density in subjects with unilateral hip osteoarthritis.

Osteoarthritis (OA) is a common disease that increases in incidence with age and currently affects an estimated 27 million Americans. To determine whether site-specific hip bone mineral density (BMD) measures are confounded by the presence of OA, we measured bilateral hip BMD by dual X-ray absorptiometry in 34 subjects (19 women and 15 men) scheduled for hip replacement for confirmed advanced unilateral hip OA. The femoral neck (FN) BMD (p=0.035) and T-score (p=0.017) for the hip with OA was higher than those of the contralateral hip. There was a difference in osteoporosis classification depending on which hip was considered: for 11 of the 34 subjects (32%), the FN T-score was normal for OA hip, but the contralateral hip was classified as osteopenic (T-score between -1.0 and -2.5). For 1 subject, the FN T-score was normal for OA hip, but the contralateral hip was classified as osteoporotic (T-score below -2.5). Discordance was also present for trochanter values and not for total hip values. These data indicate that advanced hip OA can be associated with a higher bone density at the FN and trochanter but not at total hip and that the discrepancy between hips at the FN may have an impact on patient treatment decisions.

Small molecule GS-nitroxide ameliorates ionizing irradiation-induced delay in bone wound healing in a novel murine model.

We studied radioprotection and mitigation by mitochondrial-targeted Tempol (GS-nitroxide, JP4-039), in a mouse injury/irradiation model of combined injury (fracture/irradiation). Right hind legs of control C57BL/6NHsd female mice, mice pretreated with MnSOD-PL, JP4-039, or with amifostine were irradiated with single and fractionated doses of 0 to 20 Gy. Twenty-four hours later, unicortical holes were drilled into the tibiae of both hind legs; at intervals, tibias were excised, radiographed, and processed for histology. Bone wounds irradiated to 20 or 30 Gy showed delayed healing at 21 to 28 days. Treatment with JP4-039 MnSOD-PL or amifostine, before or after single fraction 20 Gy or during fractionated irradiation followed by drilling accelerated wound healing at days 21 and 28. Orthotopic 3LL tumors were not protected by JP4-039 or amifostine. In nonirradiated mice, pretreatment with JP4-039 accelerated bone wound healing. This test system should be useful for the development of new small molecule radioprotectors.

A minipig model of maxillary distraction osteogenesis.

PURPOSE: To establish a porcine model for maxillary distraction osteogenesis and to document the sequence of bone formation in the zone of advancement. MATERIALS AND METHODS: Female Yucatan minipigs (n = 9) in the mixed dentition stage underwent modified Le Fort I osteotomy through a vestibular incision under general anesthesia. A unidirectional, semiburied Le Fort I distraction device was fixed across the osteotomy. The distraction protocol was 0-day latency, 1-mm/d rate for 12 days, and 24 days of fixation. Maxillary specimens (n = 9) were harvested and divided in half at the end of distraction (n = 6 sides), midfixation (n = 6), and the end of fixation (n = 6). Clinical stability, volume, and radiographic density across the zone of advancement were graded on semiquantitative scales. Specimens were stained with hematoxylin and eosin and examined with light microscopy. RESULTS: Animals tolerated the operation, the distraction and fixation periods. There were no infections and no devices failed. At the end of the distraction period, bone trabeculae were present at the periphery and fibrous tissues, and vessels, preosteoblasts, and osteoblasts were present in the center of the zone of advancement. Islands of chondrocyte-like cells appeared in 1 specimen each at midfixation and the end of fixation. At the end of fixation, clinical stability and radiographic density were graded 3/3 and bone formation was complete across the advancement zone in all specimens. CONCLUSION: A model for Le Fort I distraction osteogenesis was established. Intramembranous bone formation was the predominant mechanism of healing in the zone of advancement. Latency was not necessary for bone formation in this minipig model.

Histological differences in iliac and tibial bone graft.

BACKGROUND: Cancellous bone graft is frequently used during orthopedic procedures. While the iliac crest has traditionally been the most common donor site, the proximal tibia is an alternative donor site, especially for foot and ankle procedures. This study tested the null hypothesis that the histologic composition of iliac and tibial bone grafts is similar. MATERIALS AND METHODS: Specimens from the iliac crest (n = 10) and tibia (n = 10) in excess of that needed for patients undergoing foot or ankle fusion were examined histologically. Iliac samples were taken from the anterior iliac crest. Tibial samples were harvested from the region of Gerdy's tubercle. Specimens were graded based on the percent of bone surfaces that opposed active hematopoietic marrow, with Grade I at 0%, through Grade VI at 81% to 100%. Differences between iliac and tibial grafts were evaluated with Fisher's Exact Test. RESULTS: Iliac crest and tibial bone grafts both showed trabecular fragments with abundant osteocytes. All iliac grafts contained active hematopoietic marrow. In contrast, the medullary space of tibial grafts contained fat and little hematopoietic marrow. Nine iliac grafts were graded V or VI; whereas the ten tibial bone grafts were all graded I or II (p = 0.0001). The difference in the numbers of samples in each group ranked as grade VI was also statistically significant (p = 0.005). CONCLUSION: Iliac bone grafts contained active hematopoietic marrow, whereas quiescent medullary fat predominated in tibial grafts. CLINICAL RELEVANCE: These findings raise questions about the cellular contributions of different sources of bone graft to bone healing.

Obesity and leptin influence vitamin D metabolism and action in human marrow stromal cells.

Obesity is associated with low serum 25-hydroxyvitamin D [s25(OH)D], high serum leptin, and generally high bone mineral density (BMD). Human Marrow Stromal Cells (hMSCs) differentiate to osteoblasts and are both a target and source of vitamin D metabolites in bone marrow. There is no information about the influence of obesity on vitamin D metabolism and osteoblastogenesis in hMSCs and little about direct effects of leptin on hMSCs. In this study, we tested the hypotheses that 1) obesity has an influence on the ex vivo constitutive expression of vitamin D-hydroxylase genes in hMSCs, and 2) recombinant human (rh) Leptin regulates the D-hydroxylases and promotes osteoblastogenesis in hMSCs. In a cohort of female subjects undergoing joint replacement surgery, the effects of Body Mass Index (BMI) and Fat Mass Index (FMI) on BMD T-scores and s25(OH)D were evaluated. hMSCs were isolated from bone tissues discarded during surgery. The direct effects of rh-Leptin on osteoblast differentiation and D-related genes in hMSCs were examined in vitro. There were positive correlations for BMD T-score of femoral neck and spine with BMI and FMI. Serum 25(OH)D levels in obese subjects were 71% of that in non-obese counterparts (p = 0.001). hMSCs from obese women had higher constitutive expression of CYP27A1/25-hydroxylase and vitamin D receptor. Those findings raised the mechanistic question of how obesity could influence vitamin D metabolism and osteoblast differentiation in hMSCs. Treating hMSCs with rh-Leptin in vitro significantly stimulated osteoblastogenesis. In addition, leptin downregulated CYP24A1 and upregulated CYP27B1, CYP27A1 and VDR, which play vital roles in vitamin D metabolism. Furthermore, co-treatment with leptin and vitamin D3 metabolites promoted ALP activity compared with either alone. This research demonstrates links between obesity, vitamin D metabolism, and osteoblastogenesis by which leptin's direct effects on D-metabolism and osteoblast differentiation in hMSCs may protect bone from low s25(OH)D in obese subjects.

Fibroblast growth factor 23 counters vitamin D metabolism and action in human mesenchymal stem cells.

Chronic kidney disease (CKD) is associated with elevated circulating fibroblast growth factor 23 (FGF23), impaired renal biosynthesis of 1α,25-dihydroxyvitamin D (1α,25(OH)2D), low bone mass, and increased fracture risk. Our previous data with human mesenchymal stem cells (hMSCs) indicated that vitamin D metabolism in hMSCs is regulated as it is in the kidney and promotes osteoblastogenesis in an autocrine/paracrine manner. In this study, we tested the hypothesis that FGF23 inhibits vitamin D metabolism and action in hMSCs. hMSCs were isolated from discarded marrow during hip arthroplasty, including two subjects receiving hemodialysis and a series of 20 subjects (aged 49-83 years) with estimated glomerular filtration rate (eGFR) data. The direct in vitro effects of rhFGF23 on hMSCs were analyzed by RT-PCR, Western immunoblot, and biochemical assays. Ex vivo analyses showed positive correlations for both secreted and membrane-bound αKlotho gene expression in hMSCs with eGFR of the subjects from whom hMSCs were isolated. There was downregulated constitutive expression of αKlotho, but not FGFR1 in hMSCs obtained from two hemodialysis subjects. In vitro, rhFGF23 countered vitamin D-stimulated osteoblast differentiation of hMSCs by reducing the vitamin D receptor, CYP27B1/1α-hydroxylase, biosynthesis of 1α,25(OH)2D3, and signaling through BMP-7. These data demonstrate that dysregulated vitamin D metabolism in hMSCs may contribute to impaired osteoblastogenesis and altered bone and mineral metabolism in CKD subjects due to elevated FGF23. This supports the importance of intracellular vitamin D metabolism in autocrine/paracrine regulation of osteoblast differentiation in hMSCs.

Effects of age and gender on WNT gene expression in human bone marrow stromal cells.

WNT signaling pathways play important roles in the behavior of human bone marrow stromal cells. Although WNT expression has been examined in human bone marrow stromal cells (hMSCs) with limited numbers of subjects or from commercial sources, there are conflicting results on WNT gene expression in hMSCs. Furthermore, the effects of age and gender on WNT expression in hMSCs are largely unknown. In this study, we evaluated RNA expression of all the WNT genes in hMSCs from 19 subjects, 12 women and 7 men, aged from 36 to 85 years. Analysis of WNT gene expression in young and old groups indicated that WNT7B and 14 were expressed significantly higher in the young group. WNT2 and WNT13 showed a trend of higher expression in young group. WNT7B, 13, and 14 were inversely correlated with age. Further analysis for gender-specific difference indicated that WNT16 was expressed significantly higher in men than in women. WNT11 showed a trend of higher expression in hMSCs from women. For the hMSCs from women, WNT13 was inversely correlated with age and WNT4 was positively correlated with age. For the hMSCs from men, WNT7B and WNT14 were inversely correlated with age. These data indicated that most of the age-related WNT genes belong to the canonical WNT signaling pathway. Further, there are gender-specific differences in the expression of WNT4, 7B, 13, 14, and 16 in hMSCs. Age and gender account for many of the sample-to-sample variations in WNT gene expression in human marrow stromal cells.

Mechanisms of osteoinduction/chondroinduction by demineralized bone.

Demineralized bone is widely used for osseous reconstructive procedures. Bone morphogenetic proteins (BMPs) have been studied as the putative active components of demineralized bone; recombinant BMPs are Food and Drug Administration-approved for use with scaffold carriers. An experimental three-dimensional in vitro model was developed to allow comparison of early changes in signaling and gene expression in cells exposed to demineralized bone particles (DBPs) or to BMP and/or transforming growth factor beta (TGF-beta). The culture device consists of a bilayer of porous collagen lattice that contains either a packet of DBPs or an insert of the dense collagen scaffold with BMP and/or TGF-beta. As expected, BMP and TGF-beta induced distinct signaling pathways and events in human dermal fibroblasts; DBPs signaled both pathways and their target genes. A mixture of BMP and TGF-beta stimulated the production of extracellular matrix chondroitin that approximated the composition that was stimulated by DBPs, but to a lesser amount. Although BMP was originally isolated as the active factor in DBPs, it does not show DBPs' effects on signaling and chondroinduction in vitro. Multiple members of the TGF-beta superfamily and other constituent factors may be involved in skeletal induction of human dermal fibroblasts by DBPs. This in vitro culture system may be useful to provide a rational basis for designing improved osteoinductive/chondroinductive materials.