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Endocrinology Vol. 138, No. 9 3849-3858
Copyright © 1997 by The Endocrine Society


ARTICLES

Multiple Extracellular Signals Promote Osteoblast Survival and Apoptosis1

Peter A. Hill, Anthony Tumber and Murray C. Meikle

Department of Orthodontics and Pediatric Dentistry, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, University of London, London, United Kingdom SE1 9RT

Address all correspondence and requests for reprints to: Dr. Peter A. Hill, Department of Orthodontics and Pediatric Dentistry, United Medical and Dental Schools of Guy’s and St. Thomas’ Hospitals, London Bridge, London, United Kingdom SE1 9RT.


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Programed cell death (PCD) or apoptosis is a naturally occurring cell suicide pathway induced in a variety of cell types. In many cases, PCD apparently arises as a result of competition for limiting amounts of survival signals. In this study, we have investigated the potential role of growth factors (GF), cytokines, and osteotropic hormones on osteoblast survival in vitro. Our results indicate that in the absence of any of these factors, osteoblasts rapidly undergo PCD, as determined by cell morphology, mitochondrial function, and nuclei fragmentation. Osteoblast survival was promoted by insulin-like growth factor I (IGF-I), IGF-II, insulin, and basic fibroblast growth factor (bFGF). Platelet-derived growth factor had no effect on osteoblast survival, but this GF potentiated the survival-promoting effects of IGF-I, IGF-II, and insulin. A similar effect occurred when bFGF was added in combination with either of the IGFs or insulin. The effects of the IGFs were blocked by {alpha}IR-3, an antibody to the type I IGF receptor, whereas the effects of insulin were only partially blocked. This antibody blocked the potentiating effects of platelet-derived growth factor on IGF-I-mediated osteoblast survival, but only partially blocked those of bFGF. Although a 100% survival of osteoblasts was seen in the presence of 2% FCS, the highest level attained by any of the above GF combinations was ~75%. The monocyte-derived factor, tumor necrosis factor-{alpha} (TNF{alpha}) was the only agent that enhanced PCD in this study. These results suggest that osteoblast survival is promoted by those GFs sequestrated in bone matrix and that the type I, but not the type II, IGF receptor is involved in the response. Our data also indicate that other unidentified GFs or components of the extracellular matrix may be involved in promoting osteoblast survival and that TNF{alpha} may abrogate their effects in vivo. We propose that these GFs may be released from bone matrix during phases of bone resorption and promote osteoblast survival, thereby playing an important role in bone remodeling, and that PCD induced by TNF{alpha} may contribute to the bone loss in inflammatory bone disease.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
PROGRAMMED cell death (PCD), or apoptosis, is the process by which cells are induced to activate their own death or cell suicide. PCD occurs in a wide variety of cell types and is recognized to have a major impact on the development of numerous systems (1, 2). Historically the term apoptosis refers to the characteristic morphology of cells undergoing PCD. Apoptotic cells appear shrunken, with extensive membrane blebbing and nuclear fragmentation (1). The end point in PCD involves the fragmentation of the cells into membrane-bound vesicles containing cellular remnants of protein and fragmented chromatin, referred to as apoptotic bodies. These membrane-bound vesicles are eventually phagocytosed by macrophages without the involvement of an inflammatory reaction (1). In contrast, cells undergoing necrosis swell and rupture, releasing their cellular contents, thereby eliciting an inflammatory reaction (1). Whereas the ultrastructural features of the cytoplasm in cells undergoing PCD are rather nonspecific, the nucleus undergoes a relatively characteristic metamorphosis: first chromatin condensation, then nuclear fragmentation. Studies have shown that DNA degradation requires the activation of an endogenous deoxyribnonuclease The latter enzyme is specific for nuclear, rather than mitochondrial, DNA and results in an oligonucleosomal ladder-type fragmentation such that the degraded DNA will form a 200-bp ladder pattern when separated by gel electrophoresis (2). However, a recent study using enucleated cells (cytoplasts) has invalidated the concept that alterations of the nucleus are obligatory events in PCD (3). It would seem that a reduction in mitochondrial activity precedes nuclear apoptosis, yet signifies a stage in which cells are irreversibly committed to apoptosis.

In many models of PCD, cells are induced to die as a result of changes in environmental stimuli (4, 5, 6). In general, these studies of PCD suggest that the absence of a survival factor, such as a particular hormone or growth factor, will induce a cell to initiate its own cell death.

Skeletal cells and other cells within the bone microenvironment, synthesize a variety of growth factors (GFs) and cytokines (7). The extracellular matrix of bone has been shown to be an abundant source of several polypeptide factors, most notably transforming growth factor-ß (TGFß) (8), insulin-like growth factors (IGF-I and -II), platelet-derived growth factor (PDGF), and acidic and basic fibroblast growth factors (FGFs) (9). When released and presented to responsive cells during phases of bone resorption, these GFs influence bone remodeling in conjunction with interleukin-1 (IL-1) and tumor necrosis factor-{alpha} (TNF{alpha}), cytokines produced mainly by bone marrow mononuclear cells. IGFs are important skeletal GFs not only because of their abundance in bone, but also because they have important actions on bone cell function and are expressed by skeletal cells (10). These various GFs and cytokines influence the differentiated function of osteoblasts and bone resorption by interacting with cell surface receptors present on osteoblasts. These effects are critical to the formation of new bone and to the maintenance of bone matrix.

Based on the importance of GFs and cytokines in bone remodeling we have investigated their effects on osteoblast survival and apoptosis in vitro. We report that IGF-I, IGF-II, and basic FGF (bFGF) are the only GFs that enhanced the survival of osteoblasts in this study and that the effect of the IGFs is mediated via an interaction with the type I IGF receptor. Although PDGF had no effect on osteoblast survival, this GF increased the survival-promoting activity of IGF-I, IGF-2, and insulin. In contrast, the monocyte-derived product TNF{alpha} is the only factor that induced osteoblast apoptosis in this study.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Materials
Human recombinant TNF{alpha} was purchased from R&D Systems (Minneapolis, MN). {alpha}IR-3, a monoclonal antibody to the type I IGF receptor was obtained from Oncogene Sciences (Cambridge, UK). Terminal deoxynucleotidyl transferase, biotinylated deoxy (d)-UTP, and streptavidin fluorescein were purchased from Boehringer Mannheim (Mannheim, Germany). Human recombinant IGF-I and II, insulin from bovine pancreas, bFGF, epidermal growth factor (EGF), PDGF, TGFß, 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), and all cell culture reagents were purchased from Sigma Chemical Co. (St. Louis, MO). Macrophage colony-stimulating factor (M-CSF), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-{gamma} (IFN{gamma}), and murine leukemia inhibitory factor (LIF) were purchased from British Biotechnology. 1,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] was a gift from Roche (Welwyn Garden City, UK). Deoxy-[5-3H]cytidine (SA, 888 gigabecquerels/mmol) was purchased from Amersham International (Aylesbury, UK).

Preparation of osteoblasts from neonatal mouse calvariae
Calvarial osteoblasts were prepared and characterized as previously described (11). Briefly, neonatal mouse calvariae were dissected free from adherent soft tissue, washed in Ca2+- and Mg2+-free Tyrode’s solution (10 min), and sequentially digested with 1 mg/ml trypsin (10 min), 2 mg/ml dispase (30 min), and 2 mg/ml collagenase (twice, 30 min each time). Cells released by the last two collagenase digestions were washed and grown in {alpha}-modified MEM ({alpha}MEM) containing 10% FBS and antibiotics for 4 days before use. All cultures were maintained at 37 C in a humidified atmosphere of 5% CO2-95% air. For survival assays, osteoblasts were plated in 100 µl serum-free CMRL-1066 medium containing 10-3 M thymidine to block cell proliferation, with or without added cytokines.

Cell survival assays
MTT assay.
Mitochondrial function was assayed by the ability of viable cells to convert soluble MTT into an insoluble dark blue formazan reaction product (12). In the bulk cell photometric MTT assay, the bulk conversion of MTT in the well of a 96-well plate was measured photometrically as previously described (12). MTT was dissolved in PBS at a concentration of 5 mg/ml and sterilized by passage through a 0.22-µm filter. This stock solution was added (one part to 10 parts medium) to each well of a 96-well tissue culture plate, and the plate was incubated at 37 C for 4 h. Acid-isopropanol (400 µl 10 M HCl in 100 ml isopropanol) was added to all wells and mixed thoroughly to dissolve the dark blue crystals. After a few minutes at room temperature, to ensure that all the crystals were dissolved, the plates were read on a microplate reader at a wavelength of 570–630 nm. A standard curve was set up using 200–50,000 cells/well, and the absorbance was directly proportional to the number of cells over this range. The percent survival was defined as [(experimentalabsorbance - blankabsorbance)/controlabsorbance - blankabsorbance)] x 100, where the controlabsorbance was the value obtained for 10,000 cells/well, which is the number plated at the start of the experiment, and blankabsorbance was the value obtained in wells containing medium and MTT without cells. A linear relationship existed between the absorbance values and the number of cells in the range of 1,000–50,000 cells/well.

Plasma membrane permeability.
Plasma membrane permeability was assessed using the membrane-impermeant DNA dye, ethidium homodimer, which labels dead cells. Live cells were labeled using the membrane-permeant dye calcein AM. Calcein AM is a nonfluorescent dye that is converted into the fluorescent dye, calcein, by intracellular esterases and is retained only in cells with an intact plasma membrane. The concentrated dyes were prepared according to the manufacturers (Molecular Probes, Eugene, OR) instructions and were added to unwashed cells in culture to final concentrations of 4 µM for ethidium homodimer and 2 µM for calcein AM.

Cell proliferation assay
Primary osteoblasts were plated at a density of 1 x 104 cells/well in a 96-well plate and cultured for 48 h in CMRL-1066 medium with GFs or FCS in the presence or absence of cold thymidine (10-3 M). The cells were pulsed for the last 6 h with 1 µCi [3H]cytidine, and DNA-associated radioactivity was performed at the end of the experiment by fixing the cells with 5% trichloroacetic acid at 4 C for 10 min and washing in PBS, and the cells were detached with trypsin-EDTA solution (0.5%:0.02%).

Analysis of DNA fragmentation by agarose gel electrophoresis
DNA fragmentation was analyzed by agarose gel electrophoresis. Primary mouse osteoblasts were cultured in serum free CMRL-1066 medium in 75-cm2 flasks with or without TNF{alpha}. Adherent cells were lysed with 0.1 M NaCl, 10 mM Tris-HCl (pH 7.5), and 1 mM EDTA in 0.3% SDS and incubated with proteinase K (500 µg/ml) at 55 C for 15 h. Samples were extracted with an equal volume of phenol/chloroform, and the total DNA contained in the aqueous phase was precipitated with 0.1 vol sodium acetate (3 M; pH 6.6) and 2.5 vol ethanol at -80 C for 15 h. DNA pellets were obtained by centrifugation (13,000 x g for 15 min) and resuspended in 50 µl 10 mM Tris-HCl (pH 8.0) and 1 mM EDTA. Samples were then treated with 10 U/ml deoxyribonuclease-free ribonuclease for 1 h at 37 C. Electrophoresis was performed on a 1% agarose gel at 50 V for 1.5 h in the presence of 0.5 µg/ml ethidium bromide.

Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling
DNA cleavage was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) reaction, as described by Gavrieli et al. (13). Primary mouse osteoblasts were cultured in Lab-Tek chamber slides (Nunc, Copenhagen, Denmark) in serum free CMRL-1066 medium, containing thymidine (10-3 M) with or without GFs. After 48 h in culture, the cells were fixed in 4% paraformaldehyde for 10 min, washed in 10 mM Tris-HCl, pH 8.0, and then permeabilized in 0.1% Triton X-100 in 10 mM Tris-HCl, pH 8.0, for 5 min. After washing in 10 mM Tris-HCl, pH 8.0, the cells were preincubated for 10 min at room temperature in the reaction buffer for terminal deoxynucleotidyl transferase (200 mM potassium cacodylate, 0.22 mg/ml BSA, and 25 mM Tris-HCl, pH 6.6). After 10 min, the preincubation buffer was removed, and reaction mixture containing 500 U/ml terminal deoxynucleotidyl transferase, 2.5 mM CoCl2, and 40 µM biotinylated dUTP was added. After 60 min at 37 C, the reaction was terminated by the addition of 300 mM NaCl and 30 mM sodium citrate. After 25 min at room temperature, cells were washed with PBS and incubated with streptavidin fluorescein for 60 min at room temperature in the dark. After extensive washing in PBS, the cells were examined in a Leica fluorescence microscope.

Electron microscopy
Primary mouse osteoblasts were plated at 2 x 105 cells/ml on glass coverslips that had been previously coated with poly-L-lysine. Cells were cultured for 48 h in serum-free CMRL-1066 medium with or without TNF{alpha}. After 48 h, cells were fixed with 2.5% glutaraldehyde in 0.2 M phosphate buffer (pH 7.3) at 4 C for 4 h. After washing in PBS, the cells were postfixed in 1% osmium tetroxide in phosphate buffer at 4 C for 30 min. The cells were then dehydrated in ascending grades of ethyl alcohol and embedded in resin. After removing the glass coverslip, thin sections were cut on a Reichert ultramicrotome. The sections were stained with a saturated solution of uranyl acetate and a 4% solution of lead citrate and examined using a Hitachi H7000 electron microscope (Tokyo, Japan).

Statistical analysis
Data are presented as the mean ± SEM of 6–12 cultures/group. Each experiment was repeated three times. Differences between control and treatment groups were determined by the Mann-Whitney U test.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Characterization of murine osteoblasts
Histochemical staining of unstimulated primary cultures for alkaline phosphatase was strongly positive; 95.3 ± 3.1% of cells from six separate bone cell preparations exhibited positive staining. The intracellular accumulation of cAMP levels in response to PTH was determined; treatment with PTH (10-8 M) for 10 min resulted in a cAMP level of 12.3 ± 1.2 pmol/ml compared with the control level of less than 0.125 pmol/ml.

Survival of primary osteoblasts in culture
When osteoblasts were cultured in serum-free and insulin-free CMRL 1066 medium containing thymidine (10-3 M), it was found that about 67% of cells survived after 24 h, whereas only about 28% of cells survived in this medium after 48 h (Table 1Go). However, when the osteoblasts were cultured with 2% FCS in the presence of thymidine (10-3 M), which blocks cell proliferation (14) and therefore permits the assessment of factors on cell survival, there was a 100% survival of the cells at both time intervals.


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Table 1. Effects of growth factors and osteotropic hormones on the survival of primary mouse osteoblasts

 
As shown in Table 1Go, bFGF, IGF-I, IGF-II, or a concentration of insulin (10-6 M) high enough to activate IGF-I receptors increased the number of surviving osteoblasts after a 48-h culture period, but had no effect on their survival after 24 h. In contrast, the immunoregulatory cytokine TNF{alpha} induced cell death in the 24- and 48-h osteoblast cultures (Table 1Go). A variety of other GFs and osteotropic factors that were tested had no effect on either osteoblast survival or cell death, namely PDGF, EGF, TGFß, IL-1, IL-3, IL-6, IL-11, LIF, IFN{gamma}, M-CSF, and GM-CSF, G-CSF, and the osteotropic hormones PTH and 1,25-(OH)2D3.

The effects of bFGF, IGF- I, IGF-II, and insulin on cell number were due to effects on osteoblast survival rather than to those on cell proliferation, as the addition of thymidine to the culture medium at a 10-3-M concentration effectively blocked the proliferative effects of these factors. As shown in Table 2Go, these factors both increased the number of surviving cells and proportionally decreased the number of dead cells, so that the total numbers of cells in the factor-containing microwells were not statistically different from the numbers in medium alone, thereby confirming that thymidine had effectively blocked DNA synthesis. The addition of thymidine did not induce cell death, as the proportion of live/dead cells was similar in its presence/absence (Table 2Go).


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Table 2. Effects of IGF-I, IGF-II, bFGF, and insulin on the numbers of live and dead osteoblasts

 
Labeling osteoblast DNA with [3H]cytidine confirmed that cold thymidine effectively blocked the effects of FCS and the various GF combinations on osteoblast proliferation (Table 3Go).


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Table 3. Assessment of the effects of cold thymidine (10-3 M) on osteoblast proliferation in the presence of IGF-I, bFGF, and PDGF using [3H]cytidine

 
Mechanism of osteoblast cell death
The morphology of the cells that died by 24 h in the absence of survival factors and in the presence of either TNF{alpha} (10-10 M) or a high concentration (10-6 M) of the protein kinase inhibitor staurosporine was consistent with their having died by PCD rather than by necrosis. The cells exhibited the typical apoptotic morphology described by Wyllie et al. (1), specifically, cell shrinkage and membrane blebbing (Fig. 1Go). We next asked whether the cells exhibited any of the other characteristics common to apoptosis. One such feature is nuclear fragmentation (1), which can be visualized by fluorescence microscopy using the membrane-impermeant dye ethidium homodimer and the membrane-permeant dye calcein. As shown in Fig. 2AGo cells cultured in the presence of 2% FCS for 48 h contained intact nuclei, which was identical to that in cells that were cultured in the absence of serum for only 2 h. Cells cultured in the absence of serum for 24 h, however, showed extensive nuclear fragmentation (Fig. 2BGo). In many cases these fragments were associated with apoptotic bodies, the small membrane-bound vesicles released by apoptotic cells (1).



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Figure 1. Phase contrast micrograph of osteoblasts maintained in the absence of serum for 24 h. Arrows show degenerating cells. Bar = 20 µm.

 


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Figure 2. Plasma membrane permeability of osteoblasts assessed using the membrane-impermeant DNA dye ethidium homodimer and the membrane-permeant dye calcein. Osteoblasts (5000 cells/well) were cultured in Lab-Tek slide chambers in the presence of 2% FCS (A) or in its absence (B) for 48 h. The cells were then stained with ethidium homodimer and calcein and examined by fluorescence microscopy. A, Typical appearance of live cells. B, Typical examples of dead cells. Bar = 10 µm.

 
Many investigators have reported that endogenous deoxyribonucleases are activated in cells undergoing PCD (Compton, 1992), with DNA being degraded to form 200-bp ladders (1). To assay for DNA degradation, DNA was analyzed by agarose gel electrophoresis. As shown in Fig. 3Go, DNA isolated from osteoblasts cultured in the absence of serum migrated as a single, high mol wt band (Fig. 3Go, lane 3). On the other hand, in four separate experiments, DNA extracted from osteoblasts that were cultured for 3, 6, 12, or 24 h in the presence of either TNF{alpha} or staurosporine, an agent that induces DNA degradation in many cell types, showed no evidence of DNA degradation into oligonucleosome fragments (Fig. 3Go, lanes 1 and 2, respectively), which is often observed in PCD (1). In contrast, U937 leukemia cells cultured under identical conditions exhibited the characteristic pattern of DNA degradation in response to either TNF{alpha} or staurosporine (Fig. 3Go, lanes 4, and 5), whereas no degradation was observed when the cells were cultured in serum (Fig. 3Go, lane 6).



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Figure 3. DNA fragmentation. Primary murine osteoblasts or U937 leukemia cells were lysed, and cellular DNA was isolated and subjected to gel electrophoresis on a 1% agarose gel. Lane 1, DNA isolated from osteoblasts cultured in serum-free medium containing TNF{alpha} (10-10 M) for 24 h. Lane 2, DNA isolated from osteoblasts cultured in serum-free medium containing staurosporine (10-6 M) for 24 h. Lane 3, DNA isolated from osteoblasts cultured in the absence of serum. Lanes 4 and 5, U937 cells that were cultured as described for osteoblasts in lanes 1 and 2, respectively. Lane 6, U937 cells cultured with FCS. A, DNA size marker.

 
As we were unable to demonstrate DNA degradation by gel electrophoresis of a pooled DNA extract, we assessed DNA fragmentation in individual cells by specific labeling of double strand DNA breaks using the TUNEL method (13). As shown in Fig. 4AGo, osteoblasts cultured in the presence of 2% FCS for 48 h demonstrated negligible DNA fragmentation by TUNEL. However, TUNEL of osteoblasts cultured with TNF{alpha} for 24 h confirmed that substantial cell death (~30%) had taken place in accordance with the results obtained with the MTT assay (Fig. 4BGo). The TUNEL method showed innumerable cells with clear-cut staining indicative of chromatin condensation at the nuclear membrane.



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Figure 4. In situ DNA labeling by the TUNEL technique. Mouse osteoblasts were cultured as described in Materials and Methods in the absence (A) or presence (B) of TNF{alpha} (10-10 M). After 48 h, the cells were fixed, permeabilized, and processed for TUNEL. A, Typical example of osteoblasts showing negligible DNA fragmentation; B, cells cultured in the presence of TNF{alpha} show extensive DNA fragmentation.

 
Electron microscopy confirmed that TNF{alpha} induced PCD in osteoblasts, as the chromatin was usually seen to be compacted and segregated into sharply defined masses under the nuclear membrane (Fig. 5AGo), although margination of chromatin was observed in about 50% of these cells (Fig. 5AGo); the cytoplasmic organelles, in particular the mitochondria, remained largely intact. As a basis for comparison, a swollen necrotic osteoblast is shown in Fig. 4BGo. In contrast to apoptosis, there was a total disruption of the internal structure of the cell undergoing necrosis, whereas the normal morphology of the osteoblast was preserved when culture was performed in the presence of IGF-I (Fig. 5CGo).



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Figure 5. Electron microscopy. Electron micrographs of cultured primary mouse osteoblasts. A, After treatment with TNF{alpha} for 6 h, the chromatin is highly condensed against the margins of the nuclei, which retain only an amorphous fibrillar network throughout their interior. Cytoplasmic organelles, in particular mitochondria, remain intact. B, After treatment with sodium nitroprusside (2 mmol/liter) for 16 h, necrotic cells could be seen that contained swollen nuclei (n), with few identifiable cytoplasmic organelles. For comparison, a normal osteoblast cultured in the presence of IGF-I for 24 h is shown in C. Bar = 5.7 µm.

 
Having established that TNF{alpha} induced apoptosis in mouse osteoblasts, we investigated the effects of graded concentrations of this cytokine on PCD in murine osteoblasts using the MTT cell survival assay. TNF{alpha} dose-dependently (10–14–10-9 M) decreased the survival of primary mouse osteoblasts over a 24-h culture period from a level of survival of 67 ± 2.8% at 10-14 M to 18 ± 1.1% at 10-9 M (Fig. 6Go).



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Figure 6. Effect of TNF{alpha} on survival of primary mouse osteoblasts in vitro. Mouse osteoblasts were cultured as described in Materials and Methods in the presence of increasing concentrations of TNF{alpha}. Vehicle (CMRL-1066 medium) was used as a control. After 48 h in culture, cell survival was assessed by the MTT cell survival assay. Each point is the mean ± SEM of six wells.

 
Effects of insulin, IGF-I, IGF-2, and bFGF on osteoblast survival in vitro
To determine the survival effects of different concentrations of insulin and IGFs on primary osteoblasts, we cultured these cells in CMRL 1066 serum-free medium with thymidine (10-3 M) to prevent proliferation and assessed their survival after 48 h with the MTT assay. In the presence of plateau concentrations of insulin, IGF-I, IGF-II, or bFGF, about two thirds of the cells survived for 2 days (Fig. 7Go, a, b, c, and d, respectively). The concentration that promoted half-maximal survival (the ED50) was about 10-9 M for IGF-I and 10-8 M for IGF-II, as expected if both IGFs promote survival by binding to IGF-I receptors (15). The ED50 for insulin-induced survival was about 10-7 M, and the dose-response curve was very broad, extending over about 5 log units. The ED50 for bFGF was about 5 ng/ml.



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Figure 7. Effects of insulin, IGF-I, IGF-2, and bFGF, alone and in combination, on the survival of primary mouse osteoblasts in vitro. Mouse osteoblasts were cultured as described in Materials and Methods in the presence of increasing concentrations of insulin (a), IGF-I (b), IGF-II (c), or bFGF (d). These GFs were also added in combination. CMRL-1066 medium without FCS was used as a control. After 48 h, cell survival was assessed by MTT cell survival assay. Each point is the mean ± SEM of six wells. The experiment was repeated three times.

 
Effects of multiple factors on osteoblast survival
Because single factors did not promote 100% survival of osteoblasts, we investigated whether combinations of different GFs would improve short term survival. The combination of insulin, IGF-I, or IGF-II, for example, did not promote survival better than insulin, IGF-I, or IGF-II alone (data not shown). In contrast, the combination of a plateau concentration of bFGF with either insulin, IGF-I, or IGF-II produced an additive effect on survival (Fig. 7Go, a–c), with a maximum of about 75%. A similar effect was seen when a plateau concentration of IGF-I was used in combination with graded concentrations of bFGF (Fig. 7dGo). Surprisingly, although PDGF did not promote survival on its own, when combined with insulin, IGF-I, or IGF-II, survival was enhanced (Fig. 8Go, a–c). The combination of bFGF and PDGF with IGF-I did not promote survival better than that of bFGF with IGF-I (data not shown). A similar situation was found with bFGF/PDGF/IGF-II and bFGF/PDGF/insulin combinations (data not shown). There was also no additive effect on survival when several of the other GFs, such as TGFß, EGF, IL-1, and IL-11, were used in combination with the IGFs or insulin (data not shown).



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Figure 8. Effect of PDGF in combination with insulin (a), IGF-I (b), or IGF-II (c) on the survival of primary mouse osteoblasts in vitro. Mouse osteoblasts were cultured as described in Materials and Methods in the presence of increasing concentrations of insulin, IGF-I, or IGF-II, alone or in combination with PDGF (10-9 M). Vehicle (CMRL-1066 medium) was used as a control. After 48 h, cell survival was assessed by the MTT cell survival assay. Each point is mean ± SEM of six wells. Each experiment was repeated three times.

 
Effect of {alpha}IR-3 on IGF-I- and IGF-II-promoted survival of mouse osteoblasts
To determine which receptor was responsible for mediating the effects of the IGFs and insulin on osteoblast survival, we used a murine monoclonal antibody, {alpha}IR-3, raised against the type I IGF receptor. This antibody binds specifically to the type I receptor and does not cross-react with either the type II IGF or insulin receptor.

As shown in Fig. 9Go, {alpha}IR-3 (1 µg/ml) was a potent competitive inhibitor of both IGF-I- and IGF-II-mediated cell survival, indicating that in serum-free culture, both IGF-I and IGF-II mediate their effects on osteoblast survival by interacting with the type I IGF receptor. However, {alpha}IR-3 did not completely inhibit the survival-promoting effects of insulin, which suggests that insulin may be acting via an interaction with insulin receptors. {alpha}IR-3 had no effect on bFGF-mediated survival and only partially blocked the effect of the bFGF/IGF-I combination on osteoblast survival, which suggests that bFGF mediates its effects via an interaction with FGF receptors (Fig. 9Go). Finally, {alpha}IR3 blocked the action of PDGF/IGF-I on osteoblast survival, which indicates that PDGF may be altering the number and/or affinity of the type I IGF receptors on murine osteoblasts (Fig. 9Go).



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Figure 9. Effects of {alpha}IR-3 on IGF-I, IGF-II, and insulin and of {alpha}IR-3 in combination with bFGF or PDGF on osteoblast survival. Mouse osteoblasts were cultured at a cell density of 10,000 cells/well in a 96-well plate in the presence of {alpha}IR-3 (1 µg/ml) and IGF-I (10-8 M), IGF-II (10-7 M), insulin (10-6 M), bFGF (20 ng/ml), bFGF/IGF-I, or PDGF (10-9 M)/IGF-I. Vehicle (CMRL-1066 medium) was used as a control. After 48 h in culture, cell survival was assessed by the MTT cell survival assay. Data are expressed as the mean ± SEM of six wells. *, P < 0.05; **, P < 0.01 (compared with treatment in the absence of {alpha}IR3).

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
We report that osteoblast survival in vitro is significantly increased by IGF-I, IGF-II, bFGF, and insulin. Although PDGF was without effect on its own, this GF as well as bFGF enhanced the survival-promoting effects of the IGFs and insulin, although they were unable to achieve a 100% survival rate. It is increasingly believed that most normal cell deaths in invertebrate and vertebrate development depend on the activation of a suicide program in the cells that die (1, 16). Our findings from these in vitro studies indicate that these GFs seem to promote survival by inhibiting PCD rather than by inducing proliferation, as cold thymidine effectively prevented the proliferative effects of the GFs. A variety of other GFs, cytokines, and osteotropic hormones, including TGFß, EGF, IL-1, IL-3, IL-6, IL- 11, LIF, IFN{gamma}, G-CSF, M-CSF, GM-CSF, PTH, and 1,25-(OH)2D3 had no effect on either osteoblast survival or apoptosis. In fact, the only factor that induced osteoblast apoptosis in this study was the immunoregulatory cytokine, TNF{alpha}.

The effects of the IGFs on osteoblast survival is in agreement with their activity on the survival of oligodendrocytes (17) and rat Schwann cell precursors (18). However, a notable difference between these reports and the present study was that the IGFs were capable of promoting a 100% survival rate of neuron-derived cells as opposed to the 60–70% survival of osteoblasts achieved in the present study.

It would appear that insulin can promote survival of osteoblasts by binding to its own receptor, because insulin had a significant effect at a 10-8-M concentration, which is sufficient to bind to insulin receptors but not IGF-I receptors (15). This is supported by the fact that insulin receptors have been demonstrated on rodent osteoblasts, and insulin can maintain the growth of these cells at a similar concentration (19). Although osteoblasts express type I and II IGF receptors (20, 21), the role of the type II receptor in mediating the metabolic and proliferative activities of IGF-II is controversial. It is known that the type I IGF receptor is recognized by both IGF-I and -II and insulin (22), and several lines of evidence from this study indicate that the type I IGF receptor is responsible for mediating the effects of IGF-I and -II as well as high concentrations of insulin. Firstly, the order of potency in stimulating osteoblast survival (IGF-I > IGF-II > insulin) is similar to the relative affinities of these hormones for binding to the type I IGF receptor (23) and is consistent with a common mechanism involving this receptor. Similar potencies have been reported for the effects of the IGFs and insulin on other cellular activities, and the type I IGF receptor seems to mediate the responses in these cell types (24). Secondly, our findings that the combination of IGF-I and IGF-II did not enhance the level of osteoblast survival over that produced by IGF-I suggests that the type II receptor is not involved in the response. Thirdly, {alpha}IR-3, a monoclonal antibody specific for the type 1 IGF receptor, inhibited the survival-promoting effects of both IGFs and almost prevented those of insulin.

The finding in the present study that bFGF increased the survival of osteoblasts is similar to the situation for Schwann cell precursors (25). As osteoblasts may be derivatives of the neural crest cell lineage, of relevance to the results reported here is the observation that bFGF can rescue chick nonneuronal neural crest cell derivatives in vitro (26). Therefore, it seems likely that osteoblasts have retained the requirement of an FGF for survival displayed by their developmental ancestors.

Although PDGF has been shown to stimulate some cells to make IGF-I (27), this GF inhibits the synthesis of IGF-I and IGF-II by osteoblasts (28, 29). This may explain why PDGF was incapable of inducing osteoblast survival on its own. The mechanism underlying the synergy between IGFs and FGFs/PDGF may be due in part to the ability of these GFs to modulate type-I IGF receptors. It has been shown, for example, that bFGF and PDGF increase the number of type I IGF receptors expressed by purified glial cells derived from hypothalamic cultures without affecting receptor affinity (30). It is, therefore, conceivable that in the experiments we report here, bFGF/PDGF may increase type I IGF receptor number or affinity, resulting in an enhanced response to IGF-I, IGF-II, and insulin. This is supported by the fact that the type I receptor antibody, {alpha}IR3, prevented the survival-enhancing effects of both bFGF/IGF-I and PDGF/IGF-I on osteoblast survival.

The action of IGFs is known to be regulated by the synthesis and secretion of one of six IGF-binding proteins. Furthermore, bFGF has been reported to modulate the synthesis of one of the IGF-binding proteins in purified hypothalamic neural crest cell cultures. Modulation of these proteins by bFGF/PDGF, therefore, represents another way in which these GFs might alter cellular responses to IGFs (30, 31).

IGF-I is probably one of the most important regulators of bone mass because it is synthesized by bone cells, and it is present in substantial concentrations in bone tissue. Although bFGF, TGFß, PDGF, IGF-I, and IGF-II are all present in the bloodstream, it is apparent that the paracrine biosynthesis of GFs is more important in the modulation of cellular activity (32). In skeletal tissue, osteoblasts express messenger RNA transcripts for these GFs, and the proteins have been shown to influence osteoblast proliferation and bone matrix synthesis (33, 34, 35). Furthermore, studies on the quantification and characterization of GFs present in human bone have revealed that human bone matrix contains multiple GFs, including IGF-I, IGF-II, TGFß, bFGF, and PDGF. IGF-II and TGFß are the two most abundant GFs present in human bone, whereas bFGF, PDGF, and IGF-I are several-fold less abundant (36). It seems likely that GFs, released from the extracellular matrix and neighboring cells as well as osteoblasts, are responsible for promoting the survival of osteoblasts in bone as they do in vitro.

Interestingly, TGFß was the only GF present in bone matrix that did not have an effect on either osteoblast survival or PCD in this study. Osteoblast production of IGF-I and IGF-II is stimulated by TGFß (37); however, the absence of a survival-promoting effect suggests that this GF is unable to induce a single cell to produce enough IGF-I or IGF-II to save itself in microculture. The effects of TGFß on apoptosis and cell survival are variable and seem to depend upon cell phenotype. For example, although it induces PCD in a variety of epithelial and myeloid cells (38, 39), it prevents the process in synovial cells (40) and has no effect on the survival of teratocarcinoma cells (41), similar to its effect on osteoblasts in this study. A possible explanation for this is unclear, although it may relate to the density at which the cells are cultured, as Mathieu et al. (42) found that PCD in vitro exhibits a correlation with this parameter.

As complete survival of osteoblasts in this study could only be achieved using culture medium supplemented with FCS, this would suggest either that unidentified GFs or extracellular matrix (ECM) components are responsible for promoting osteoblast survival. Among cells that have been shown to require survival factors, we are not aware of any example where a single signaling molecule on its own permits long term survival in culture (43, 44, 45). The significance of the ECM in cell survival has recently been demonstrated for endothelial cells, which rapidly undergo PCD in the absence of integrin-mediated adhesion with components of the ECM (46). It seems possible that all cells require multiple survival factors for long term survival.

The effects of inflammatory cytokine TNF{alpha} on osteoblast apoptosis in this study is in accordance with its effects on several other mammalian cell lines, including the human leukemia cell lines HL-60 and U937 (47) and the murine fibrosarcoma cell lines L929 and WEHI (48).

Although we demonstrated biochemical and morphological features of osteoblast apoptosis, we could not detect evidence of DNA fragmentation by gel electrophoresis in dying osteoblasts, suggesting either that DNA fragmentation is not an important part of the death mechanism in these cells or that our methods were insufficiently sensitive to detect it. DNA fragmentation, however, seems not to be an invariable feature of PCD (16, 49), and condensation of the chromatin at the membrane of an apoptotic nucleus is not always associated with activation of an endonuclease with subsequent DNA degradation (50). TNF{alpha} inhibits bone formation and has been found to inhibit collagen synthesis and alkaline phosphatase activity in osteoblasts, actions that contrast with those GFs that promote osteoblast survival in this study. This suggests that those factors exerting a catabolic action on osteoblasts may also induce PCD while, conversely, agents with an anabolic action may promote survival.

The present findings may contribute to our understanding of bone loss induced by the inflammatory cytokine, TNF{alpha}, in conditions such as rheumatoid arthritis, tumor osteolysis, and periodontal disease and the role of endogenous GFs in modulating bone turnover.


    Footnotes
 
1 This work was supported by a grant from the Medical Research Council. Back

Received February 20, 1997.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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