Increased bone resorption and osteopenia in Dlx5 heterozygous mice.

Distal-less (Dlx) homeobox transcription factors play a central role in the control of osteogenesis. In particular, Dlx5 regulates osteoblasts/osteoclasts coupling during perinatal bone formation. We analyze here the effect of Dlx5 allelic reduction in the control of bone remodeling. We first show that Dlx5 expression persists during postnatal bone development. We then compare the skeletal phenotype of 10- and 20-week-old Dlx5(+/-) mice to that of wild-type (WT) littermates. Dlx5(+/-) male mice exhibit lower bone mineral density (BMD) at both ages while only 20-week-old females are affected. microCT analyses reveal a reduction in cortical thickness of femoral midshafts in Dlx5(+/-) mice. Histomorphometry on distal femora shows no changes in trabecular structure and confirms a reduction in Dlx5(+/-) cortical thickness. The cortical decrease of 10-week-old mice does not derive from a reduction in periosteal bone apposition, but results from increased bone resorption with a significantly higher number of endosteal osteoclasts per bone surface and a larger marrow diameter. Urinary level of deoxypyridinoline is also higher in heterozygous mice confirming an increase in bone resorption activity. Our findings might be relevant for understanding complex, multifactorial diseases such as osteoporosis in which quantitative deregulation of gene expression leads to disruption of bone homeostasis.

Dlx5, a positive regulator of osteoblastogenesis, is essential for osteoblast-osteoclast coupling.

The homeodomain protein Dlx5 is an activator of Runx2 (a key regulator of osteogenesis) and is thought to be an important regulator of bone formation. At present, however, the perinatal lethality of Dlx5-null mice has hampered the elucidation of its function in osteogenesis. Here we provide the first analysis of the effects of Dlx5 inactivation on bone development. Femurs of Dlx5-null mouse embryos at the end of gestation exhibit a reduction in both total and trabecular bone volume associated with increased trabecular separation and reduced trabecular number. These parameters are often associated with pathological conditions characterized by reduced osteoblast activity and increased bone resorption. Dlx5(-/-) osteoblasts in culture display reduced proliferation and differentiation rate and reduction of Runx2, Osx, Osteocalcin and Bone Sialoprotein expression. In addition to impaired osteoblast function, Dlx5(-/-) femurs exhibit significant increases in osteoclast number. As Dlx5 is not expressed by osteoclasts, we suggest that its osteoblastic expression might control osteoblast/osteoclast coupling. Cultured Dlx5(-/-) osteoblasts displayed a higher RANKL/OPG ratio. Furthermore, Dlx5(-/-) osteoblasts induced a higher number of TRAP-positive multinucleated cells in normal spleen cultures with a globally increased resorption activity. These findings suggest that Dlx5 is a central regulator of bone turnover as it activates bone formation directly and bone resorption indirectly.

Role of DLX regulatory proteins in osteogenesis and chondrogenesis.

Bone development is a complex process in which several cell types interact, proliferate, differentiate, and die to give rise to skeletal structures. These processes are highly integrated and require continuous and coordinated regulation by soluble molecular signals and transcription factors to assure harmonious bone development and morphogenesis. In the bone, transcription factors often have multiple functions and control the differentiation of more than one skeletal cellular component. In particular, Distal-less (Dlx) homeobox transcription factors play a central role in regulating the proliferation and differentiation of the three major cell types that constitute bone: chondrocytes, osteoblasts, and osteoclasts. The aim of this review is to summarize what is known about the role of Dlx genes in osteogenesis and to emphasize their role as coordinators at different levels of skeletal development. The elucidation of these unifying roles could improve our understanding not only of bone development but also of adult bone anabolism and catabolism resulting in bone homeostasis and might thus help to further our understanding of the genetic factors responsible for predisposition to multifactorial conditions such as osteoporosis.