Endocrinology Vol. 140, No. 10 4699-4705
Copyright © 1999 by The Endocrine Society
Recombinant Human Insulin-Like Growth Factor-Binding Protein-5 Stimulates Bone Formation Parameters in Vitro and in Vivo1
C. Richman,
D. J. Baylink,
K. Lang,
C. Dony and
S. Mohan
J. L. Pettis Veterans Administration Medical Center and Loma
Linda University (C.R., D.J.B., S.M.), Loma Linda, California 92357;
and Roche Diagnostics Boehringer Mannheim GmbH,
Pharma
Research, Bone Metabolism, Am Nonnenwald (K.L., C.D.), D-82372
Penzberg, Germany
Address all correspondence and requests for reprints to: Subburaman Mohan, Ph.D., Musculoskeletal Disease Center, J. L. Pettis Veterans Administration Medical Center, 11201 Benton Street (151), Loma Linda, California 92357. E-mail: mohans{at}llvamc.va.gov
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Abstract
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Insulin-like growth factor-binding protein-5 (rhIGFBP-5) is stored in
bone and stimulates osteoblast cell proliferation in
vitro. Bone formation is dependent on the number and activity
of osteoblasts. We therefore evaluated the ability of recombinant human
(rh) IGFBP-5 to increase osteoblast activity in vitro;
both alkaline phosphatase (ALP) activity and osteocalcin levels showed
a dose-dependent increase. In in vivo time-course
studies, daily sc administration of 50 µg rhIGFBP-5/day/mouse
significantly increased serum osteocalcin levels by day 7, and these
levels were sustained through day 21. We further evaluated whether
rhIGFBP-5 was as effective as IGF-I. Daily sc administration of
rhIGFBP-5 (50 µg/day), IGF-I (13 µg/day), or IGF-I plus rhIGFBP-5
complex for 9 days increased serum osteocalcin levels by 58%, 65%,
and 81% (P < 0.001 in all) and femoral bone
extract ALP activity by 85% (P < 0.001), 29%
(P < 0.05), and 13% (P = NS),
respectively, and decreased carboxyl-terminal cross-linked telopeptide
of type I collagen by 29% (P < 0.05), 20%
(P = NS), and 12.5% (P =
NS), respectively. One sc injection of rhIGFBP-5 (50 µg/mouse)
increased serum osteocalcin and bone ALP activity by 21%
(P < 0.05) and 27% (P <
0.02), respectively, after 5 days, but did not significantly increase
serum IGF-I (1, 6, or 24 h/postinjection), suggesting that the effects
of rhIGFBP-5 on bone are not mediated by increasing circulating IGF-I.
Our data demonstrate that systemic administration of rhIGFBP-5, either
alone or in combination with IGF-I, increases bone formation parameters
in vivo.
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Introduction
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THE INSULIN-LIKE growth factor (IGF) system
has been shown to modulate growth in many tissues, such as nervous
tissue, lymphoid tissue, reproductive tissue, smooth muscle,
endothelium, and bone (1, 2). A number of in vitro and
in vivo findings demonstrate that IGF-I and IGF-II are
important regulators of bone formation. When added exogenously, both
increase osteoblast cell proliferation and differentiation in
vitro, and bone formation in vitro and in
vivo (2, 3, 4, 5, 6, 7). Mice lacking functional IGF-I gene exhibit severe
impairment of bone formation (8). In addition, an adolescent male human
with a disrupted IGF-I gene had a bone mineral density significantly
less than that found in other studies of healthy adolescent human males
(9).
Both IGF-I and IGF-II are produced by osteoblasts, and their mitogenic
effects are mediated by their binding to the IGF plasma membrane
receptors. The IGF type 1 receptor, which binds both IGF-I and IGF-II,
appears to be the predominate receptor involved in mediating the
effects of these growth factors in most cell types, including
osteoblasts (10, 11). IGF-binding proteins (IGFBPs) modulate the
actions of secreted IGFs by binding to them and increase the IGF
half-life in the extracellular milieu and circulation by sequestering
them in this bound form. IGFBPs either enhance or inhibit IGF actions
on target cells (12, 13); in bone, the individual IGFBPs either inhibit
or potentiate IGF effects on osteoblasts (4, 12, 13, 14, 15, 16, 17). Of the various
IGFBPs secreted by bone cells, rhIGFBP-5 has several unique features
that suggest that it is a key component of the IGF system in bone.
rhIGFBP-5 is the most abundant IGFBP stored in bone, having a high
specific binding affinity for hydroxyapatite and extracellular matrix
proteins, therefore fixing it and its bound IGFs within bone (18, 19, 20).
We have previously proposed that the local release of these sequestered
IGFs and rhIGFBP-5 in bone could provide the mechanism by which
osteoclastic bone resorption during remodeling gives rise to a coupled
increase in bone formation. Therefore, the significant age-related
decline in the skeletal content of IGF-I, which is positively
correlated with decreasing rhIGFBP-5, could contribute in part to the
age-related impairment in the coupling of bone formation to resorption
(18, 19, 21).
rhIGFBP-5 is also unique, in that it is the only IGFBP that has been
shown to consistently stimulate osteoblast cell proliferation in
vitro (20, 22, 23, 24), thus increasing the number of osteoblasts.
Recent studies suggest that the mitogenic effects of rhIGFBP-5 may in
part be independent of IGFs and mediated through rhIGFBP-5s own
signal transduction pathway (14, 25). Because bone formation is
dependent not only on the number but also on the activity of
osteoblasts, in this study we evaluated whether recombinant human
rhIGFBP-5 (rhIGFBP-5) also increases the activity of osteoblasts
in vitro. Based on our findings that rhIGFBP-5 treatment
increases osteoblast cell activity [increases osteocalcin production
and alkaline phosphatase (ALP) activity], we further investigated the
effect of rhIGFBP-5 on bone formation in an intact animal model.
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Materials and Methods
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The human osteosarcoma cell line, MG63, was purchased from
American Type Culture Collection (Manassas, VA).
Untransformed normal human bone cells were a gift from Dr. Jon Wergedal
(Loma Linda, CA) (26). DMEM, calf serum, 1,25-dihydroxyvitamin
D3 [1,25-(OH)2D3], and IGF-I was
purchased from Mediatech, Inc. (Herndon, VA), HyClone Laboratories, Inc. (Logan, UT), Biomol (Plymouth Meeting, PA),
and GroPep Pty. Ltd. (Adelaide, Australia), respectively.
rhIGFBP-5 was expressed in Escherichia coli and purified to
homogeneity as described previously (14). This preparation did not
contain detectable levels of IGF-I or IGF-II as measured by specific
RIA. rhIGFBP-5 has been shown to have similar IGF binding and
biological activity as native human rhIGFBP-5 (14). BSA and
paranitrophenol phosphate were purchased from Fluka (Buchs,
Switzerland). All other chemicals were enzyme grade and purchased from
Fisher Scientific (Tustin, CA) or Sigma Chemical Co. (St. Louis, MO). Of the inbred mouse strains used, BALB/c
was purchased from B&K Suppliers (Fremont, CA), and C3H/HeJ was
obtained from The Jackson Laboratory (Bar Harbor, ME).
In vitro experiments
Cells were grown at 37 C in humidified incubators with 5%
CO2. For osteocalcin experiments, conditioned medium was
collected from serum-free (DMEM-0.1% BSA) cultures of MG63 or normal
human bone cells treated with various concentrations of rhIGFBP-5 and
10-8 M
1,25-(OH)2D3. This conditioned medium was
frozen at -70 C until assayed for osteocalcin by specific RIA (27),
the cells were extracted, and this extract was assayed for protein
concentration (28).
For ALP activity experiments, serum-free (DMEM-0.1% BSA) cultures of
MG63 or normal human bone cells were treated with various
concentrations of rhIGFBP-5 in the presence or absence of
10-8 M 1,25-(OH)2D3.
The cell lysate was assayed for ALP activity (29).
In vivo experiments
Seven-week-old BALB/c or C3H/HeJ inbred mice were used for the
in vivo experiments. The animals were housed in a controlled
environment with 12-h light, 12-h dark cycles at 70 F, with food and
water ad libitum. In each experiment the treatment was
injected sc at the nape of the neck of each mouse at the same time each
day (0900 h). The vehicle used throughout was 150 mM
arginine phosphate buffer, pH 7. When IGF-I and rhIGFBP-5 were
administered together, IGF-I and rhIGFBP-5 were mixed and allowed to
incubate at room temperature for 1 h before administration so as
to form an IGF-I/rhIGFBP-5 complex before administration. Size
separation of this IGF-I/rhIGFBP-5 complex showed that more than 80%
of the IGF-I eluted in the 50-kDa fractions, suggesting that the
majority of the IGF-I exists as a complex in the IGF-I/rhIGFBP-5
treatment solution. The mice were killed with ethrane and decapitated.
Blood and both femurs were collected and used for biochemical
measurements of bone turnover. The experimental procedures performed in
this study are in compliance with the NIH Guide for the Care and Use of
Laboratory Animals. All animals studies were reviewed and monitored by
the animal studies subcommittee at the Jerry L. Pettis Veterans
Administration Medical Center (Loma Linda, CA).
Exp 1. BALB/c mice were divided into three groups of eight
animals each. Group 1 received vehicle, group 2 received 13 µg/day
IGF-I, and group 3 received 50 µg/day rhIGFBP-5. All groups received
treatment for 20 days. The 13 µg/20 g mouse dose of IGF-I (7.7 kDa)
was determined based on previous studies of biological effects of IGF-I
on body and cartilage growth in mice (30). rhIGFBP-5 (29 kDa) was
administered in an equimolar dose (50 µg/20 g mouse) to that of
IGF-I. The mice were tail bled on days 7 and 14. On day 21 the mice
were killed.
Exp 2. C3H/HeJ mice were divided into four groups of eight
animals each. Group 1 received vehicle, group 2 received 13 µg/day
IGF-I, group 3 received 50 µg/day rhIGFBP-5, and group 4 received 13
µg/day IGF-I and 50 µg/day of rhIGFBP-5. All groups received
treatment for 9 days. On day 10 the mice were killed.
Exp 3. C3H/HeJ mice were divided into two groups of six
animals each. These animals received only one injection (day 1); group
1 received vehicle, and group 2 received 50 µg/day rhIGFBP-5. On day
6 the mice were killed.
Exp 4. C3H/HeJ mice were divided into seven groups of six
animals each. Groups 24 received 50 µg/mouse rhIGFBP-5, and groups
57 received 13 µg/mouse IGF-I. Group 1 was killed at time zero as
the baseline group; groups 2 and 5 were killed at 1 h, groups 3
and 6 were killed at 6 h, and groups 4 and 7 were killed at
24 h post injection.
Serum collection. Whole blood was collected in 50-ml tubes
and centrifuged at 3500 rpm in a cold IEC Centra-7R centrifuge
(International Equipment Co., Needham, MA), and serum was
skimmed off and stored at -70 C until assayed.
Femur collection. Both femurs were dissected out of each
carcass and cleaned of soft tissue, being careful not to destroy the
periosteum. Each bone was sectioned in the middiaphysis and rinsed in
PBS at 4 C for 24 h, followed by extraction in 0.01% Triton X-100
at 4 C for 72 h. This bone extract was used for the ALP activity
measurements.
Immunoblot. Serum from animals in Exp 4 was subjected to
electrophoresis on a 12% acrylamide gel under denaturing conditions
and transferred to a nitro-cellulose membrane, and the membrane was
immunoblotted for rhIGFBP-5 using the same antibody as that used in the
rhIGFBP-5 RIA, as described previously (31).
Gel filtration of treatment solution. To evaluate the extent
of complex formation between IGF-I and rhIGFBP-5, an aliquot of the
IGF-I/rhIGFBP-5 treatment solution used for these in vivo
studies was subjected to size separation using Sephadex G-75. The
proteins were eluted with PBS containing 0.1% BSA and 0.02% sodium
azide, pH 7.2. The fractions were collected and assayed for IGF-I after
separation of IGF-I from the IGFBPs by a biospin protocol (see below).
Molecular mass standards were used to determine the elution positions
of the 40-kDa (IGF-I/rhIGFBP-5 complex) and 7.7-kDa (IGF-I)
proteins.
Biochemical assays
ALP activity assay. The ALP activity of the cell and bone
extract was determined as previously described (29).
Protein assay. The protein concentrations were determined
using the Lowry Folin assay (28).
IGF-I RIA. Serum IGF-I was measured by specific RIA after
separation from the IGFBPs. Because IGFBPs produce artifacts in IGF
RIAs, it is essential to completely separate the IGFBPs from the IGFs
for the IGF-I determinations to be valid, as previously described (32).
The cross-reactivity of IGF-II in the IGF-I RIA is less than 0.5%. The
sensitivity of the IGF-I RIA is less than 50 ng/liter; the intra- and
interassay coefficients of variation are less than 10% (33). This
assay was used to measure both endogenous mouse IGF-I and administered
IGF-I.
rhIGFBP-5 RIA. Serum rhIGFBP-5 was measured by specific RIA
using rhIGFBP-5 as standard and tracer as previously described (34).
None of the other high affinity IGFBPs cross-react with the antiserum
used in this assay. The sensitivity of the rhIGFBP-5 RIA is less than 5
ng/ml; the intra- and interassay coefficients of variation are less
than 8%.
Osteocalcin assay. Human osteocalcin levels in conditioned
medium and serum were measured by specific RIA (27). Mouse osteocalcin
standard and tracer were purchased from BTI (Stoughton, MA). The mouse
osteocalcin RIA had less than 8% interassay variability. We have
previously developed and validated the mouse osteocalcin RIA (35).
Carboxyl-terminal cross-linked telopeptide of type I collagen
(C-telopeptide) assay. C-telopeptide was measured in the
mouse serum according to the manufacturers instructions using a Rat
ICTP RIA Double Antibody Kit purchased from DiaSorin, Inc.
(Stillwater, MN). The sensitivity of this assay is 0.5 µg/liter, and
the mean recovery was 108.5%. The intra- and interassay coefficients
of variation are less than 11% (36).
Statistics
Results are reported as the mean ± SEM for six
replicates for in vitro studies or six to eight animals per
group for in vivo studies and were compared by Students
t test, ANOVA, and Duncans post-hoc test as
appropriate. Results were considered significantly different for
P < 0.05.
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Results
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In vitro experiments
The effect of rhIGFBP-5 on osteoblast activity was evaluated by
measurement of ALP activity and osteocalcin production (37, 38).
rhIGFBP-5 treatment increased osteocalcin levels in the conditioned
medium of MG63 and human osteoblast cells in a dose-dependent manner
with a maximal increase (184 ± 12% of control; P
< 0.01) at 100 ng/ml rhIGFBP-5 in normal human bone cells and
(204 ± 11% of control; P < 0.0001) at 300 ng/ml
rhIGFBP-5 in MG63 cells (Fig. 1
). To
evaluate that the rhIGFBP-5-induced increase in osteocalcin level was
not due to increased cell number, osteocalcin levels were standardized
on the basis of cell protein to correct for changes in cell number.
rhIGFBP-5 (100 ng/ml) caused a significant increase in osteocalcin
levels even when the values were corrected for cellular protein
(0.2 ± 0.02 ng osteocalcin/µg cell protein in control
vs. 0.31 ± 0.06 ng osteocalcin/µg cell protein in
rhIGFBP-5-treated cells; P < 0.01). The specific
activity of ALP in cell extracts also showed a dose-dependent increase
with and without 10-8 M
1,25-(OH)2D3 (178 ± 18% and 169 ±
9% of control, respectively, at 100 ng/ml rhIGFBP-5; P
< 0.01; Fig. 2
). Similar results were
obtained with normal human osteoblasts (data not shown).
1,25-(OH)2D3 has been shown to be essential for
the expression of osteocalcin in human osteoblasts and to increase ALP
activity (39). Based on the previous findings that rhIGFBP-5 increased
osteoblast cell proliferation (14, 20, 25) and the findings in this
study that rhIGFBP-5 increased the differentiative functions of
osteoblasts in vitro, we predicted that rhIGFBP-5 may
have a stimulatory effect on bone formation parameters in
vivo. We therefore tested the effect of rhIGFBP-5 on bone
formation parameters in vivo using a mouse model.

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Figure 1. Effect of rhIGFBP-5 on osteocalcin production in
MG63 and normal human osteoblasts. Serum-free cultures of MG63 or human
osteoblasts were treated for 48 h with different concentrations of
rhIGFBP-5 in the presence of 10-8 M
1,25-(OH)2D3. Values are given in nanograms of
osteocalcin per ml conditioned medium and are expressed as the
mean ± SEM (n = 6 wells/group). *,
P < 0.01 (by Duncans post-hoc test).
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Figure 2. Effect of rhIGFBP-5 on ALP activity in MG63 cells.
Serum-free cultures of MG63 were treated for 72 h with different
concentrations of rhIGFBP-5 in the presence or absence of
10-8 M 1,25-(OH)2D3.
ALP activity was then determined in the cell extract. Values are
expressed as a percentage of the vehicle-treated control value and are
the mean ± SEM (n = 6 wells/group). *,
P < 0.01 (by Duncans post-hoc
test). The specific activities of ALP in the control cultures in the
absence and presence of 10-8 M
1,25-(OH)2D3 were 1.2 ± 0.27 and 3.0
± 0.38 mU/mg protein, respectively.
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In vivo experiments
To assess the effect of rhIGFBP-5 on bone formation and resorption
parameters in vivo, we measured bone-derived ALP activity
and serum osteocalcin as well as C-telopeptide.
Exp 1. Daily sc administration of rhIGFBP-5 (50 µg/day)
caused a significant increase in serum osteocalcin levels as early as
day 7 in BALB/c mice (Fig. 3
); this
increase was maintained up to day 21. The magnitude of the
rhIGFBP-5-induced increase in osteocalcin was similar to that induced
by an equimolar dose of IGF-I.

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Figure 3. Effect of rhIGFBP-5 or IGF-I on serum levels of
osteocalcin in mice. BALB/c mice were treated with rhIGFBP-5 (50
µg/day), IGF-I (13 µg/day), or vehicle for 20 days. Animals were
tail bled on days 7 and 14 to obtain blood in which to measure the
serum osteocalcin levels. Values are expressed as a percentage of the
vehicle-treated control value and are the mean ± SEM
(n = 6 mice/group). *, P < 0.05 (by
Duncans post-hoc test). The vehicle-treated control
value is 437 ng osteocalcin/ml serum on day 7, 358 ng/ml on day 14, and
209 ng/ml on day 21.
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Exp 2. To eliminate BALB/c strain-specific effects of
rhIGFBP-5 on serum osteocalcin, we evaluated rhIGFBP-5 effects in a
different strain of mice. Consistent with the data in BALB/c mice, 9
days of rhIGFBP-5 treatment of C3H/HeJ mice significantly increased
serum osteocalcin levels (58%; P < 0.001; Fig. 4
). As in the case of the BALB/c mice, in
C3H/HeJ mice the rhIGFBP-5-induced increase in serum osteocalcin was
similar to that which resulted from administration of an equimolar dose
of IGF-I (65%; P < 0.001; Fig. 4
) and the combination
of IGF-I and rhIGFBP-5 (81%; P < 0.001; Fig. 4
).
rhIGFBP-5 treatment caused a significantly greater increase in ALP
activity in femoral bone extract compared to an equimolar dose of
IGF-I or the combination of IGF-I and rhIGFBP-5 (Fig. 5
). To determine whether rhIGFBP-5
modulates bone resorption as well as bone formation parameters, we
measured serum C telopeptide levels. These were significantly reduced
by 20% and 29% of the control value (P < 0.05),
respectively, in IGF-I- and rhIGFBP-5-treated animals (Fig. 6
).

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Figure 4. Effect of rhIGFBP-5 on serum levels of osteocalcin
in C3H/HeJ mice. Equimolar doses of rhIGFBP-5 (50 µg/day) and/or
IGF-I (13 µg/day) were given daily for 9 days before the serum
osteocalcin determination. Values are expressed as nanograms of
osteocalcin per ml serum ± SEM (n = 6
mice/group). *, P < 0.001 (by Duncans
post-hoc test).
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Figure 5. Effect of rhIGFBP-5 on bone ALP in C3H/HeJ mice.
Equimolar doses of rhIGFBP-5 (50 µg/day) and/or IGF-I (13 µg/day)
were given daily for 9 days before the determination of bone ALP
activity. Values are expressed as milliunits of ALP activity per mg
total protein in the bone extract ± SEM (n = 6
mice/group). *, P < 0.001 (by Duncans
post-hoc test).
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Figure 6. Effect of rhIGFBP-5 on carboxyl-terminal
cross-linked telopeptide (C-telo) of type I collagen in C3H/HeJ mice.
Equimolar doses of rhIGFBP-5 (50 µg/day) and/or IGF-I (13 µg/day)
were given daily for 9 days before the serum C-telopeptide
determination. Values are expressed as nanograms of C-telo per ml
serum ± SEM (n = 6 mice/group). *,
P < 0.05 (by Duncans post-hoc
test).
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Exp 3. To determine whether a single administration of
rhIGFBP-5 would cause an increase in serum osteocalcin and bone ALP
activity, we administered a single injection of rhIGFBP-5 on day 1, and
on day 6 collected serum and performed biochemical measurements of bone
formation parameters. The time frame for this experiment is based on
studies in which systemic IGF-I administration was evaluated for
several days to determine the optimal time to evaluate the changes in
serum levels of bone formation markers (our unpublished data).
In this experiment, both serum osteocalcin (124% of control;
P < 0.001) and bone ALP (184% of control;
P < 0.001) were increased at the lowest dose tested
(Fig. 7
).

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Figure 7. Effect of rhIGFBP-5 on serum levels of serum
osteocalcin or bone ALP in C3H/HeJ mice. rhIGFBP-5 of varying doses was
given daily for 9 days before determination of serum osteocalcin or
bone ALP activity. Values are expressed as a percentage of the
vehicle-treated control value and are the mean ± SEM
(n = 6 mice/group). *, P < 0.01 (by Duncans
post-hoc test). The mean values for the vehicle-treated
control are 198 ng osteocalcin/ml serum and 128 mU ALP/mg protein.
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Exp 4. To evaluate whether rhIGFBP-5 increases bone formation
parameters by a mechanism involving an increase in circulating levels
of IGF-I, we measured serum IGF-I levels in mice after the
administration of rhIGFBP-5. As a control, we administered an equimolar
dose of IGF-I. Serum IGF-I levels were not significantly increased at
1, 6, or 24 h (Fig. 8
) after
rhIGFBP-5 injection; however, in the control IGF-I-treated animals,
serum IGF-I levels were increased by 111% of the baseline
(P < 0.01) at 1 h, indicating that the
administered IGF-I had reached the circulation. In addition, serum
rhIGFBP-5 levels were increased from 103 ± 24 ng/ml (at baseline)
to 353 ± 52 ng/ml 1 h after rhIGFBP-5 administration and had
returned to baseline value at 24 h (102 ± 40 ng/ml). To
determine whether the administered rhIGFBP-5 remains in an intact form,
pooled sera from baseline and rhIGFBP-5-treated groups (1 h after
treatment) were subjected to immunoblot analysis. Figure 9
shows that serum levels of both intact and fragment forms of rhIGFBP-5
were increased 1 h after rhIGFBP-5 administration.

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Figure 8. Serum levels of total IGF-I in the IGF-I- and
rhIGFBP-5-treated animals. After a single administration of IGF-I or
rhIGFBP-5, animals were killed at 1, 6, and 24 h postinjection,
and serum was collected and used for IGF-I determination. Values are
expressed as a percentage of the baseline control value and are the
mean ± SEM (n = 6 mice/group). *,
P < 0.001 (by Students t test).
The mean value for the baseline control is 209 ± 17 ng IGF-I/ml
serum.
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Figure 9. Western immunoblot analysis of pooled mouse sera
before and 1 h after treatment with rhIGFBP-5. Serum proteins were
separated by SDS-PAGE, transferred to a nitro-cellulose membrane, and
immunoblotted with rhIGFBP-5 antiserum. The molecular markers in
kilodaltons are shown on the left. Both intact (29 kDa)
and fragment (21 kDa) forms of rhIGFBP-5 were increased after rhIGFBP-5
treatment.
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Discussion
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In the present study, we describe for the first time that in
vivo systemic administration of rhIGFBP-5 alone or in combination
with IGF-I stimulates bone formation parameters in mice over the short
term. Our data also demonstrate that rhIGFBP-5 treatment alone
increased the activity of osteoblast-line cells in serum-free culture
in vitro (increased ALP activity and osteocalcin
production). This together with previously published data showing that
rhIGFBP-5 also increases osteoblast cell proliferation (14, 40) provide
evidence that rhIGFBP-5 has a unique role among the IGFBPs in promoting
osteoblast cell proliferation and activity, and consequently bone
formation.
Osteoblasts have been shown to produce all six of the high affinity
IGFBPs known to date (4, 12, 16), although the amount of each IGFBP
varies from cell line to cell line (41). There have been a number of
in vitro studies that examined the effects of various IGFBPs
on modulating the biological effects of IGF on various cell types,
including osteoblasts (4, 12, 13, 16); however, there have been very
few studies on the in vivo effects of IGFBPs, but those that
exist are limited to IGFBP-3. In this regard, Bagi et al.
(42, 43, 44) have shown that systemic administration of IGFBP-3 in
combination with IGF-I increased bone formation in ovariectomized rats
in a dose-dependent manner, with optimal effects at 7.5 mg/kg IGF-I
complexed to an equimolar dose of IGFBP-3. In these studies, the
complex of IGFBP-3/IGF-I produced consistently greater effects than
IGF-I alone in stimulating bone formation. According to the
researchers, this complex has a much longer half-life in the
circulation and lowers blood glucose levels to a lesser extent than
IGF-I alone because the IGF-I/IGFBP-3 binary complex binds to the
circulating free acid-labile subunit (ALS) in the blood to form a
150-kDa complex that does not cross the vascular endothelium.
Surprisingly, in our study the combination of IGF-I and rhIGFBP-5 was
less effective than rhIGFBP-5 alone in modulating changes in
biochemical measurements of bone turnover in some, but not in other,
experiments. The reason for this discrepancy is not clear at this time.
One potential explanation is that, similar to IGFBP-3, rhIGFBP-5 when
complexed to IGF-I has been shown to bind ALS (45). It is therefore
possible that upon administration of IGF-I/rhIGFBP-5, some of this
complex may exist in the 150-kDa complex by binding the ALS. This large
molecular mass complex may trap the administered IGF-I as well as the
rhIGFBP-5 in the serum, as the 150-kDa complex is too large to cross
the vascular endothelium. Further studies are needed to test this
possibility.
In contrast to the IGF-I/IGFBP-3 studies, our study shows that systemic
administration of rhIGFBP-5 alone increased bone formation parameters
in mice. rhIGFBP-5 treatment at the dose used in this experiment (50
µg/mouse) did not significantly alter the circulating levels of total
IGF-I or the relative ratio of serum IGF-I in the 150- and 50-kDa forms
(data not shown). Because rhIGFBP-5 has been shown to bind to ALS only
when complexed to IGF-I and because only a small amount (<1%) of
total IGF-I is present in the free form, it is possible that the
majority of rhIGFBP-5 administered remains in a free form and is thus
freely available to target tissues. We and others have reported
indirect evidence showing that rhIGFBP-5 may affect osteoblasts by an
IGF-independent mechanism (14, 40), raising the possibility that the
bone-forming effects of rhIGFBP-5 may in part be mediated by an
IGF-independent mechanism.
Although IGFBP-5 administration did not modulate circulating levels of
IGF-I, we did not determine the effects of administered rhIGFBP-5 on
local production of IGF-I or other IGF system components, which could
provide a mechanism for the bone-forming effects of rhIGFBP-5. In
addition, rhIGFBP-5 has been shown to bind to hydroxyapatite and
extracellular matrix proteins and thereby may be involved in fixing
locally produced IGFs in bone. Thus, it is possible that rhIGFBP-5
treatment may increase IGF-I content in bone and bring about the
increases in bone formation parameters seen in this study. IGFBP-3 has
also been shown to bind to certain extracellular matrix proteins, but
not to hydroxyapatite (18, 46). Because the IGFBP-3 content in bone is
much less than that of rhIGFBP-5 (18), this mechanism of action may not
be as important in mediating IGFBP-3 effects to increase bone formation
in the presence of IGF-I. Further studies are needed to establish that
the mechanism by which rhIGFBP-5 mediates its bone-forming effects
in vivo is different to that of IGFBP-3.
Our present study does not identify the target cells involved in
mediating the bone-forming effects of rhIGFBP-5, as we indirectly
evaluated bone formation by biochemical measurements of osteoblast cell
activity and osteoblast cell products and not by direct
histomorphometric methods. In this regard, the findings that serum
osteocalcin and ALP activity in bone were increased by day 5 after a
single injection of rhIGFBP-5 suggest that rhIGFBP-5 may affect
existing osteoblastic cells. Further long term studies using
histomorphometric techniques are needed to evaluate the target cells of
rhIGFBP-5, as biochemical markers in serum and bone extracts are only
indirect measurements of osteoblast cell number and activity.
In contrast to the effects on bone formation parameters, short term
administration of both rhIGFBP-5 and IGF-I decreased serum
C-telopeptide levels, a marker of bone resorption. In contrast to these
effects in mice, short term administration of IGF-I has been shown to
increase bone resorption markers in elderly postmenopausal women (47).
There are a number of potential explanations for the observed
differences between IGF-I effects in mice and humans. IGF-I may have
different effects in mice than in humans, Jonsson et al.
(48) showed that IGF-I had no effect on 45Ca release from
prelabeled neonatal mouse calvarial bones, although IGF-I pretreatment
increased the formation of multinucleate tartrate-resistant acid
phosphate-positive cells in murine bone marrow cultures. In addition,
IGF-I treatment inhibited bone resorption-induced by PGE2
and 1,25-(OH)2D3 (48). Alternatively, the IGF-I
effects on bone resorption may be different depending on estrogen
status. The mice used in these studies were intact young animals (7
weeks old) as opposed to the human IGF-I studies that were performed in
postmenopausal women. Further studies are needed to evaluate whether
IGF-I also decreases bone resorption in estrogen-deficient
(ovariectomized) older mice and, if so, what is the molecular basis for
the observed differences in IGF-I effects on bone resorption between
mice and humans.
In conclusion, this study demonstrates for the first time that a
single administration of rhIGFBP-5 increases bone formation parameters;
however, this increase in bone formation parameters is not mediated by
increases in serum IGF-I levels. We also show that rhIGFBP-5
administration decreases bone resorption parameters in mice. We have
shown that rhIGFBP-5 is as potent as IGF-I in stimulating bone
formation parameters. Long term studies on the effects of rhIGFBP-5 on
bone histomorphometry, bone density, and bone strength are essential to
confirm the anabolic effects of rhIGFBP-5 on bone.
 |
Acknowledgments
|
|---|
The authors acknowledge the expert technical assistance
provided by Daniel Bruch, Joe Rung-Aroon, and Tuan Pham in this
study.
 |
Footnotes
|
|---|
1 This work was supported by NIH Research Grant AR-31062,
Roche Diagnostics, the V.A., and Loma Linda University
(Loma Linda, CA). 
Received February 22, 1999.
 |
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