help button home button Endocrine Society Endocrinology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Inoue, D.
Right arrow Articles by Baron, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Inoue, D.
Right arrow Articles by Baron, R.
Endocrinology Vol. 140, No. 3 1060-1068
Copyright © 1999 by The Endocrine Society


ARTICLES

Calcitonin-Dependent Down-Regulation of the Mouse C1a Calcitonin Receptor in Cells of the Osteoclast Lineage Involves a Transcriptional Mechanism1

Daisuke Inoue2, Chung Shih, Deborah L. Galson, Steven R. Goldring, William C. Horne and Roland Baron

Departments of Cell Biology and Orthopedics and Yale Cancer Center, Yale University School of Medicine (D.I., C.S., W.C.H., R.B.), New Haven, Connecticut 06510; the Department of Biology and Anatomy, National Defense Medical Center (C.S.), Taipei, Taiwan 100, Republic of China; and the Department of Medicine, Harvard Medical School, New England Baptist Bone and Joint Institute, Beth Israel Deaconess Medical Center, Harvard Institute of Medicine (D.L.G., S.R.G.), Boston, Massachusetts 02115-5716

Address all correspondence and requests for reprints to: Dr. Roland Baron, Department of Orthopedics, Yale University School of Medicine, P.O. Box 208044, New Haven, Connecticut 06520-8044. E-mail: roland.baron{at}yale.edu


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Although expression of the calcitonin (CT) receptor (CTR) decreases after CT binding, there has been no evidence that it occurs at the transcriptional level. In the present study we investigated the mechanism of CTR messenger RNA (mRNA) down-regulation by CT in mouse cocultures of bone marrow and osteoblasts. Ribonuclease protection analysis revealed that osteoclast-like cells purified from cocultures predominantly express the C1a isoform and do not express an appreciable amount of the brain-specific C1b mRNA (<1% of C1a). Treatment of day 5 cocultures with CT caused a dose- and time-dependent decrease in the steady state level of C1a mRNA. This CT effect was mimicked by the cAMP agonists forskolin and (Bu)2cAMP. Prolonged suppression of C1a mRNA was observed after short treatment with CT, but not with (Bu)2cAMP, suggesting that persistent intracellular cAMP elevation is necessary for the prolonged CT effect. The half-life of the C1a mRNA in cocultures was 4–6 h and was not altered by CT or (Bu)2cAMP. Moreover, competitive RT-PCR analysis revealed that 1-h treatment with CT reduced the level of CTR heterogeneous nuclear RNA to 10% in a cycloheximide-independent manner. These results suggest that CT down-regulates C1a-CTR mRNA expression at least in part by a transcriptional mechanism, thereby contributing to the ligand-induced desensitization in cells of the osteoclast lineage.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
CALCITONIN (CT), a polypeptide hormone composed of 32 amino acids, was originally identified as a hypocalcemic factor present in bovine serum (1). CT exerts its hypocalcemic effects primarily by directly inhibiting osteoclasts (2) and thereby bone resorption. Therefore, it has been widely applied as a therapeutic agent for treating various bone diseases associated with increased resorption, including Paget’s disease of bone, malignancy-associated hypercalcemia, and osteoporosis (3). However, clinical applications of CT have been limited because continuous CT treatment is inevitably followed by a prolonged depression of the osteoclast response to CT, a phenomenon known as escape (4, 5, 6).

Recently, complementary DNAs (cDNAs) encoding the CT receptor (CTR) in pig (7), human (8), rat (9), mouse (10), rabbit (11), and guinea pig (12) have been cloned and sequenced. Those studies revealed that the CTR belongs to a subfamily of G protein-coupled receptors that includes receptors for PTH/PTH-related peptide, secretin, vasoactive intestinal peptide, and others (reviewed in Ref. 13). Although the originally identified CTR in porcine kidney is highly conserved among species, other CTR isoforms (9, 10, 11, 14, 15, 16) have been reported in different species. In murine tissues, at least two different CTR isoforms are expressed: C1a, which corresponds to the common isoform conserved among species, and C1b, containing a 37-amino acid insert in the first extracellular loop (9, 10). Although the C1b isoform was originally identified in rat brain and was shown to be relatively specific to brain (9), its expression in rat and mouse osteoclasts has also been demonstrated by nonquantitative RT-PCR analysis (17). However, the relative expression levels and contributions to the CT-induced signaling of these two isoforms in osteoclasts have not been defined.

Molecular cloning of the CTR has made it possible to investigate the regulatory mechanism of CTR expression at the messenger RNA (mRNA) level. Recent studies have revealed that treatment with CT causes a substantial decrease in the steady state level of CTR mRNA and thus significantly contributes to homologous desensitization in cells of the osteoclast lineage (18, 19, 20, 21, 22, 23). These studies, however, have not resolved some issues regarding the mechanism of CTR mRNA down-regulation by CT, including whether the regulation occurs at the transcriptional level.

In the present study, we investigated the mechanism of CT-induced CTR mRNA down-regulation in cells of the osteoclast lineage, using an in vitro coculture system of mouse bone marrow and osteoblastic cells. By ribonuclease (RNase) protection assay and competitive PCR analysis, we demonstrated that in vitro-generated mouse osteoclast-like cells (OCLs) predominantly express the C1a isoform of the CTR and that its expression is negatively regulated by CT at least in part at the transcriptional level, independently of de novo protein synthesis.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Chemicals
Synthetic salmon and human CT were obtained from Peninsula Laboratories, Inc. (Belmont, CA). SC-9 and A23187 were purchased from Calbiochem (San Diego, CA). Forskolin, (Bu)2cAMP, cycloheximide (CHX), 5,6-dichlorobenzimidazole riboside (DRB), and collagenase type IA were obtained from Sigma Chemical Co. (St. Louis, MO), and dispase was purchased from Boehringer Mannheim (Mannheim, Germany). NuSieve GTG agarose used for analysis of short PCR products was purchased from FMC BioProducts (Rockland, ME).

Animals and cell cultures
Newborn and 8-week-old male CD-1 mice were purchased from Charles River Laboratories, Inc. (Wilmington, MA). A murine macrophage cell line, P388D1, obtained from American Type Culture Collection (Rockville, MD), and a human T cell leukemia cell line, MT-2 (24), a gift from Dr. N. Ruddle (Yale University, New Haven, CT), were maintained in RPMI 1640 supplemented with 10% FBS. TXB-1, a mouse marrow stromal cell line we have established from transgenic animals expressing HTLV-I tax (25), was grown in {alpha}MEM containing 10% FBS. Primary osteoblastic cells were isolated from newborn CD1 mouse calvariae by digestion with 0.1% collagenase type IA and 0.2% dispase as previously described (26). Marrow cells were obtained from aseptically isolated tibiae and femurs of 8-week-old CD1 mice by flushing out the marrow cavity with {alpha}MEM using 25-gauge needles. To generate OCLs in vitro, 2 x 107 marrow cells were cocultured with 2 x 106 primary osteoblasts in a 10-cm culture dish in the presence of 10 nM 1{alpha},25-dihydroxyvitamin D3 [1,25-(OH)2D3] (26, 27). In these cultures, differentiation of OCLs is dependent on calcitriol, and CTR-positive osteoclasts and their precursors appear after 5–6 days. Before purification, the tartrate-resistant acid phosphatase-positive cells comprised between 5–10% of the cells present in the culture. For OCL purification, cocultures on day 6 were treated sequentially for 10 min at 37 C with 0.1% collagenase-0.2% dispase in {alpha}MEM without FBS and 5 mM EDTA in PBS to remove osteoblastic cells, whereas OCLs remained strongly attached to the culture dish. The purified OCLs were highly spread, as previously described (27), and covered 80–90% of the surface of the plate. After purification, more than 80% of the cells were tartrate-resistant acid phosphate-positive, and about 75+ of these were multinucleated, with 3–10 nuclei/cell. The EDTA-resistant fraction similarly obtained from cocultures grown in the absence of calcitriol was used as a bone marrow-derived macrophage-enriched population. To analyze the regulation of CTR mRNA expression, whole cocultures on day 5 were deprived of calcitriol for 6 h before the experiments, treated with various reagents for a period of time specified in each experiment, and harvested for total RNA extraction.

Northern blot analysis
Total RNA was prepared according to an established method (28), and the concentrations were determined by spectrophotometry. For Northern blot analysis, 10 µg total RNA were separated on a 1% denaturing agarose gel, transferred to a Hybond N+ membrane (Amersham, Arlington Heights, IL) and hybridized with 32P-labeled mouse CTR or human glyceraldehyde phosphate dehydrogenase (GAPDH) cDNA probe (106 cpm/ml) prepared by the random primer labeling method (Boehringer Mannheim). The membrane was washed under moderately high stringency (0.1 x SSC and 0.1% SDS at 42 C) and autoradiographed.

RNase protection assay
Labeled complementary RNA (cRNA) probes were prepared by subcloning cDNA fragments of mouse CTR and GAPDH into pBluescript II (Stratagene, La Jolla, CA) and transcribing in vitro in the antisense direction by T7 or T3 RNA polymerase in the presence of [{alpha}-32P]UTP. Cold UTP was also added to the reaction for GAPDH to reduce the specific activity of the probe to approximately 1/15th that of the CTR probe. The CTR probe corresponds to nucleotides 1150–1677 of the reported mouse CTR cDNA sequence (10), and the expected size of protected RNA fragments is 527 and 411 bases for the C1b and the C1a isoforms, respectively. RNase protection assays were performed using an RPA II kit (Ambion, Inc., Woodward, TX) according to the protocol suggested by the supplier. Briefly, total RNA samples were incubated with CTR (50,000 cpm/reaction) and GAPDH cRNA probes (20,000 cpm/reaction) in a single tube at 42 C for 16 h. After digesting single strand RNA with a mixture of RNase A (5 U/ml) and RNase T (200 U/ml) at 37 C for 30 min, protected RNA fragments were precipitated, resolved on a 5% denaturing polyacrylamide gel, and visualized by autoradiography.

RT-PCR analysis
To avoid contamination of genomic DNA, RNA samples were first treated with deoxyribonuclease I (>=20 U/30 µg total RNA; Boehringer Mannheim), extracted with phenol/chloroform, and reprecipitated with isopropanol. RT was performed using random primer (Promega Corp., Madison, WI) and Superscript II reverse transcriptase (Life Technologies, Inc., Gaithersburg, MD) according to the protocol recommended by the supplier. Three micrograms of each RNA sample were reverse transcribed in a 20-µl reaction, and 1 µl, which corresponds to 150 ng RNA, was used for a PCR reaction. All of the PCR reactions were performed under standard conditions using AmpliTaq DNA polymerase (Perkin Elmer, Branchburg, NJ) with cycles of 94 C for 30 sec, 58 C for 30 sec, and 72 C for 40 sec. The oligonucleotides used for the amplification of CTR mRNA (primers 3+/3- in the lower part of Fig. 1Go) were 5'-GTCTTGCAACTACTTCTGGATGC-3' (nucleotides 1308–1330, in exon 9) and 5'-AAGAAGAAGTTGACCACCAGAGC-3' (nucleotides 1562–1540, in exon 10), which amplify 255 bp.



View larger version (22K):
[in this window]
[in a new window]
 
Figure 1. PCR primers and RNase-protected fragments. The locations of PCR primers used to amplify the CTR hnRNA and mRNA and the protected fragments in the RNase protection assay are shown relative to the entire gene transcript (hnRNA) and the mRNA. At the top of the figure, an enlargement of exon 9 (solid line) and adjacent intronic sequences (dashed line) shows the locations of the primers used to amplify this region of CTR hnRNA. Nonquantitative PCR was performed with primer pair 1+/1-; competitive PCR was performed with primer pair 2+/2-. The competitive fragment was generated by amplification using primers C+ and 2-. The sequence of the nonhybridizing 5' end of C+ is identical to that of primer 2+. At the bottom of the drawing, an enlargement of the part of the mRNA encoding transmembrane domain 2 through transmembrane domain 6 shows the location of primer pair 3+/3-, which was used for diagnostic amplification of mRNA. The protected fragments from the RNase protection assay are also shown relative to their positions in the mRNA. The drawing is not to scale.

 
The locations of the primers used to amplify the heterogeneous nuclear RNA (hnRNA) are illustrated in the upper part of Fig. 1Go. For nonquantitative detection of hnRNA, oligonucleotides 5'-TTGGCTCATCAATGCACTCTT-3' (primer 1+, sense) and 5'-GGGTCCCTAGCT-CCTCAGAAT-3' (primer 1-, antisense) were used. These primers are from the two introns that flank the putative exon 9 in the CTR genome (Galson, D. L., et al., manuscript in preparation) and are expected to amplify 255 bp including the whole exon 9 and juxtaposed intronic sequences. For competitive PCR, the primer sets used to amplify the target are 5'-GGCACATGTTGACAAATACTC-3' (primer 2+, sense) and 5'-GGGTCCCTAGCTCCTCAGAAT-3' (primer 2-, antisense), which will amplify a 328-bp fragment that also contains the whole exon 9 and some intronic sequences adjacent to the exon 9. To generate a competitor, a chimeric sense primer, 5'-GGCACATGTTGACAA-ATACTCCAACCACATCTTCAACAA-3' and antisense primer 2- were used. The underlined 3'-half of the primer binds to the sequences 75 bp downstream of the sense target primer-binding site and therefore amplified a shorter, 271-bp competitor fragment with the same target primer-binding sites at both ends. RT-PCR reactions were performed in the same way as described above for the nonquantitative assay, except that an increasing amount of competitor was added together with the sample in the reaction mixes. The authenticity of the PCR products in competitive PCR analysis were verified by Southern blot analysis, using a 32P end-labeled oligonucleotide, 5'-ATGGCTGTGTTTACCGACGAGCAACGC-3' (primer C+), which corresponds to coding sequences 1366–1392 in the exon 9, as a probe.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Before investigating the regulation of CTR mRNA expression in osteoclasts, we first confirmed the osteoclast specificity of CTR expression among bone cells at the mRNA level. As expected, purified OCLs generated in vitro expressed abundant CTR mRNA, which was detected as a single band of approximately 4 kb in the Northern blot analysis shown in Fig. 2AGo. The CTR message was undetectable in all of the other cell types tested, including calvaria-derived osteoblasts cultured with and without 1,25-(OH)2D3, a T cell line (MT-2), a marrow stromal cell line (TXB-1), a macrophage cell line (P-388D1), and the EDTA-resistant fraction from cocultures grown in the absence of 1,25-(OH)2D3, which represents marrow-derived macrophages. These results confirmed that the CTR mRNA is specifically expressed in cells of the osteoclast lineage in a vitamin D-dependent manner in the coculture system used in this study.



View larger version (51K):
[in this window]
[in a new window]
 
Figure 2. Cell type-specific CTR expression at the mRNA level among bone cells (A) and predominant expression of the C1a isoform in osteoclasts (B). A, Ten to 15 µg total RNA from various cell sources were analyzed by Northern blot as described inMaterials and Methods. OCL, Osteoclast-like cells purified from cocultures; BM-M{Phi}, EDTA-resistant fraction obtained from cocultures grown in the absence of calcitriol, which represents marrow-derived macrophages; POB ± D, calvaria-derived primary osteoblasts cultured in the presence or absence of calcitriol; MT-2, human T cell leukemia cell line; P388D1, murine macrophage cell line; TXB-1, murine marrow stromal cell line. B, Various amounts of mouse brain and OCL total RNA were analyzed for the expression of the C1a and C1b CTR isoforms by RNase protection assay. P, Free probe; C, yeast transfer RNA control. The positions of the free probe and the protected fragments for C1a and C1b are indicated by arrows. Each panel is representative of at least three independent experiments.

 
To determine the relative levels of expression of the two isoforms, C1a and C1b, in purified OCLs, the RNase protection analysis was performed using a mouse CTR cRNA probe corresponding to a region containing the 111-bp insert uniquely present in the C1b isoform. (The location of the probe and the expected sizes of the fragments are illustrated in Fig. 1Go.) The results indicated that although C1a mRNA was clearly detectable in OCLs over a wide range of total RNA levels (0.625–40 µg; Fig. 2BGo and data not shown), C1b mRNA was below the detection limits at all doses tested. In contrast, both C1a and C1b were expressed at more or less comparable levels in the brain (Fig. 2BGo). By densitometric analysis, we estimated the ratio of C1b to C1a at approximately 1.6 in the brain and less than 0.01 in OCLs.

Thus, in the mouse, cells of the osteoclast lineage express predominantly the C1a isoform, and among bone cells the expression is osteoclast specific. Based on this fact, we decided to examine the effect of CT on C1a-CTR mRNA expression in whole cocultures rather than purified OCLs for the following reasons: 1) only cells of the osteoclast lineage are expected to respond to CT; 2) the target (CTR) mRNA is only expressed in cells of the osteoclast lineage; and 3) mature OCLs generated in cocultures have a relatively short life span after removal of the osteoblastic cells, which would have made the experiments much more difficult to perform and interpret. We first investigated the effects of varying concentrations of salmon CT (sCT) on CTR mRNA expression in this system. As shown in Fig. 3AGo, when cocultures were treated with various concentrations of sCT for 14 h, the steady state level of C1a-CTR mRNA declined in a dose-dependent manner. The half-maximal effect was observed at approximately 10 pM, which is close to the reported EC50 of sCT-induced cAMP production in osteoclasts (29). We next examined the effect of sCT at shorter times (4 and 8 h) as shown in Fig. 3BGo. Treatment with 1 nM sCT caused a time-dependent decrease in the C1a mRNA level, and down-regulation of the message was detectable as early as 4 h after the addition of sCT. Thus, sCT caused a dose- and time-dependent reduction in the steady state level of C1a-CTR mRNA in cocultures.



View larger version (48K):
[in this window]
[in a new window]
 
Figure 3. Dose- and time-dependent effects of CT on C1a-CTR mRNA expression. A, Cocultures were treated with various concentrations of sCT for 14 h, and the expression of CTR mRNA was examined by RNase protection analysis. Thirty micrograms of total RNA were analyzed for each sample. GAPDH is used as an internal control. Undigested probes are indicated by asterisks. B, Cocultures were treated with 1 nM sCT (CT) or 1 mM (Bu)2cAMP (DB) for 4 or 8 h and analyzed in the manner described in A. Each panel is representative of at least three independent experiments.

 
CTR has been shown to couple to multiple G proteins, leading to activation of several distinct effector molecules (8, 11, 30, 31, 32) (our unpublished results). To investigate the intracellular signaling pathway involved in CTR mRNA down-regulation by CT, cells were treated with agents that increase intracellular cAMP levels, protein kinase C (PKC) activity or intracellular calcium concentrations. As shown in Fig. 4AGo, continuous treatment with 1 mM (Bu)2cAMP or 50 µM forskolin caused a clear reduction in the C1a mRNA level, mimicking the effect of 1 nM sCT. In contrast, neither a PKC stimulator, SC-9 (25 µM), nor a calcium ionophore, A23187 (100 nM), affected the message level significantly. Moreover, the effects of (Bu)2cAMP and sCT, when present throughout the incubation, were almost indistinguishable at all times examined (Figs. 3BGo and 4AGo). These results support the idea that the cAMP/protein kinase A pathway mediates the effect of CT on CTR mRNA expression in osteoclasts (33), although we cannot completely exclude the possibility that the effects of (Bu)2cAMP and forskolin may be in part indirect, due to the heterogeneity of the culture system used for these experiments. To provide further insight into the regulatory mechanism of CTR mRNA expression, we examined the effects of shorter treatment with human and salmon CTs and with forskolin and (Bu)2cAMP. In these experiments, cells were first treated for 1.5 h, then washed twice with PBS and cultured in medium that lacked the agents for another 14 h. The results indicated that a short exposure to sCT was as effective at decreasing CTR mRNA as a continuous treatment (compare Fig. 4Go, A and B), consistent with the extremely slow off-rate of sCT (34) and with earlier reports that CT causes persistent elevation of intracellular cAMP levels in osteoclasts (29, 35). Similar results were obtained with human CT (Fig. 4BGo), suggesting that this peptide may also persistently bind to and stimulate the CTR despite its lower affinity (34). In contrast to the persistent effect of CT, short treatment with (Bu)2cAMP did not cause persistent suppression of CTR mRNA, indicating that cAMP analogs need to be continuously present in the medium to keep CTR mRNA expression suppressed. Short term forskolin treatment, however, elicited a long term suppression of CTR mRNA expression (Fig. 4BGo), suggesting that it may induce signaling events in addition to adenylyl cyclase (AC) activation in cells of the osteoclast lineage.



View larger version (58K):
[in this window]
[in a new window]
 
Figure 4. Effects of continuous and short treatments with CT and various reagents on C1a-CTR mRNA expression in cocultures. A, Effect of 14-h continuous treatment of cocultures. C, Vehicle; sCT, 1 nM sCT; DB, 1 mM (Bu)2cAMP; For, 50 µM forskolin; SC, 25 µM SC-9, a PKC activator; A23, 100 nM A23187, a calcium ionophore. Total RNA (30 µg) was analyzed for the expression of C1a-CTR and GAPDH by RNase protection assay. The results were reproduced in at least three independent experiments. B, Effect of short treatment. Cocultures were first treated with control vehicle, 1 nM sCT, 100 nM human CT, 50 µM forskolin, or 1 mM (Bu)2cAMP for 1.5 h, then washed twice with PBS and cultured without test reagents for another 14 h. Expression of C1a-CTR and GAPDH mRNA was analyzed by RNase protection assay. The results were reproduced in two independent experiments.

 
The central question we asked in this study was whether the regulation of CTR mRNA expression by CT occurs at the transcriptional level or at the posttranscriptional level. To address this issue, we first measured the rate of mRNA decay in the presence of a transcriptional inhibitor, DRB. As shown in Fig. 5Go, treatment of cocultures with DRB caused a rapid decrease in the C1a mRNA level, with an estimated half-life of approximately 4–6 h. The relatively short half-life is compatible with the presence of AU-rich motifs in the 3'-untranslated region of the CTR mRNA (10, 22), which are known to confer instability on mRNA (36). Treatment with sCT or (Bu)2cAMP did not cause any detectable changes in mRNA stability, suggesting that the CTR down-regulation by CT does not involve an acceleration of mRNA degradation. It is also noteworthy that treatments with DRB (Fig. 5AGo) and sCT (Fig. 3BGo) showed similar temporal patterns, indicating that the effect of CT can be mimicked by a transcriptional inhibitor. Taken together, these results suggest that the down-regulation of CTR by CT involves an inhibition of transcription.



View larger version (30K):
[in this window]
[in a new window]
 
Figure 5. Effects of CT and (Bu)2cAMP on the stability of the C1a-CTR mRNA. A, Cocultures were treated with 1 nM sCT or 1 mM (Bu)2cAMP in the presence of 25 µg/ml DRB for the times indicated. Thirty micrograms of total RNA were analyzed for the expression of C1a-CTR and GAPDH by RNase protection assay. Similar results were reproduced in another experiment. B, Densitometric analysis of the results in A. Each point is the mean of two independent experiments and is expressed as a percentage of the control value (time zero). •, Controls; {circ}, sCT; {square}, (Bu)2cAMP.

 
To more directly investigate transcriptional regulation, we then examined the effects of CT treatment on the level of CTR hnRNA, the nascent, as yet unspliced, precursor of CTR mRNA, by RT-PCR using primers from the introns that flank the putative exon 9 of the mouse CTR genome. It has been shown for a number of genes that the level of hnRNA correlates well with the actual transcriptional rate as measured by the conventional nuclear run-on assay (37, 38, 39, 40). In these experiments, cells were treated with either vehicle or 1 nM sCT for 1 h in the presence or absence of CHX, an inhibitor of protein synthesis. As a control, CTR mRNA was also amplified from the same RNA samples, which showed no difference between the treated and untreated cultures (Fig. 6AGo). As the mRNA level is not expected to change appreciably within 1 h, the CTR mRNA level serves as a control for the number of CTR-expressing cells in the culture. As shown in Fig. 6AGo, a clear-cut decrease in CTR hnRNA was detectable 1 h after treatment with sCT by nonquantitative PCR analysis. This effect was independent of de novo protein synthesis, as it was also apparent in the presence of CHX. These results were quantitatively confirmed by competitive PCR analysis (Fig. 6BGo). The estimated amount of CTR hnRNA in 150 ng total RNA was approximately 0.01–0.03 fg in the control and 0.001–0.003 fg in the CT-treated sample, respectively. In these experiments, treatment with CHX did not alter the level of CTR hnRNA expression in either the presence or absence of CT. Thus, treatment with sCT reduced the level of CTR hnRNA to approximately 1/10th of the control level in 1 h, independently of new protein synthesis. Taken together with the lack of sCT effect on the stability of CTR mRNA, these findings strongly suggest that CTR down-regulation by sCT in cells of the osteoclast lineage occurs at least in part at the transcriptional level, and that this effect is mediated by cAMP-dependent posttranslational modifications of preexisting factors.



View larger version (50K):
[in this window]
[in a new window]
 
Figure 6. Effect of 1-h treatment with 1 nM sCT on the level of CTR-hnRNA. Cocultures were treated with vehicle or 1 nM sCT for 1 h in the absence or presence of 10 µg/ml CHX. Deoxyribonuclease I-treated total RNA was reverse transcribed with random primers, and the level of CTR-hnRNA was estimated by either nonquantitative (A) or competitive (B) PCR analysis as described in Materials and Methods. A, CTR hnRNA and CTR mRNA were amplified by RT-PCR with 35 and 30 cycles, respectively, run on 4% NuSieve GTG agarose gel and visualized by ethidium bromide staining. A single band of the expected size (275 and 255 bp for hnRNA and mRNA, respectively) is indicated by an arrowhead. The first two lanes are negative controls without template DNA (no temp) and PCR with mock RT without RNA (no RNA). For each RNA sample, a mock RT reaction without reverse transcriptase was also PCR amplified as a negative control. B, Four of the same RT reactions analyzed in A from cells that had been treated with either vehicle or sCT in the presence or absence of CHX for 1 h were mixed with various amount of competitor DNA fragment and PCR amplified. The PCR products were resolved on a 4% NuSieve agarose gel, alkali blotted onto a positively charged nylon membrane, hybridized with 32P end-labeled internal probe, and visualized by autoradiography. The positions of the amplified CTR hnRNA (target; 328 bp) and the competitor (comp; 271 bp) are indicated. In some samples, a small amount of heteroduplex DNA was detected, which is indicated by an asterisk. Note that in the CT-treated samples (CT and CT+CHX), the amount of the competitor is 10 times less than that in the corresponding lanes in Cont and CHX. The results in A and B are representative of two or more independent experiments.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Two different isoforms, C1a and C1b, have been identified for murine CTR. Although the C1a isoform corresponds to the common isoform conserved among species, the C1b isoform has been shown to be relatively specific to brain (9). However, Ikegame et al. (17) have detected both isoforms in mouse and rat osteoclasts using nonquantitative RT-PCR. As an initial step to investigate the regulation of CTR mRNA expression, we determined the relative amounts of the two CTR isoform expressed in mouse OCLs. Although we were also able to detect C1b-CTR mRNA expression in mouse OCLs by RT-PCR (data not shown), our quantitative data clearly demonstrate that osteoclasts express predominantly C1a (>99% of the total CTR mRNA) and very little (<1%) C1b mRNA. The significance of the presence of the C1b isoform in osteoclasts, therefore, appears to be minor. We cannot, however, exclude the possibility that a specific high affinity ligand for C1b-CTR exists and plays a physiological role in osteoclast regulation as proposed in rat brain (41). Incidentally, the RNase protection analysis also revealed that C1b is the dominant isoform in mouse brain, in contrast with our previous report (10) that a C1b-specific probe failed to detect CTR mRNA in mouse brain by Northern blot analysis. The discrepancy is probably due to weak hybridization of the short C1b-specific probe (106 bp) that was used in the earlier study.

C1a being the only detectable CTR isoform in our experimental system, we next attempted to clarify the CT-induced downstream events leading to suppression of C1a-CTR mRNA expression. The results of the present study confirmed those of others (33), suggesting that cAMP is the key downstream signal mediating the effects of CT on CTR mRNA. (However, as we treated the complete coculture containing both the OCL and the supporting osteoblast-enriched calvarial cells, we cannot completely exclude the possibility that the (Bu)2cAMP and forskolin could also be having an effect on the other cells in the culture that might, in turn, influence the CTR expression by the OCL.) The long term suppression of CTR mRNA expression after a short exposure of the cells to the peptide is consistent with the prolonged effects of sCT on CTR expression in osteoclasts reported by others (19, 21) and with the persistent activation of AC after brief stimulation with CT (29, 35, 42). As (Bu)2cAMP mimicked the CT effect when constantly present in the cultures for longer periods of time, but not after a brief exposure, it is likely that persistent activation of AC by CT is both sufficient and necessary for the prolonged effects of CT on CTR mRNA expression. The persistent AC activation seems to be a unique feature of CT stimulation, as it has not been observed after stimulation by other ligands such as PGE2, which transiently activates AC (29, 42). The molecular basis for the CT-induced persistent AC activation is unclear at present. It is likely to be related at least in part to the prolonged binding of the peptide to the receptor, although the complex array of signals elicited through CTR upon ligand binding and/or the specific AC isoforms present in these cells might also contribute to this effect (43, 44). In this context, the prolonged effect of forskolin observed in this study is intriguing. Forskolin is a plant-derived diterpene that directly binds to and potently activates nearly all the known mammalian AC isoforms (reviewed in Ref. 45). The increase in intracellular cAMP that is induced by forskolin is in most cases rapid and reversible in nature, although both the efficacy and the kinetics vary among different tissues or cell types (45). If both forskolin and CT/CTR cause similar persistent AC activation, it might be attributed to the intrinsic nature of the particular AC isoform(s) activated by CT/CTR rather than specific CT-induced signals that act on AC and stabilize its activated state. Alternatively, forskolin, like CT, might elicit signaling events in addition to the direct activation of AC (46) that could result in the stabilization of active AC or induce the suppression of CTR gene expression by other as yet unknown mechanisms. Further studies on the kinetics of activation of different AC isoforms by CT and forskolin in osteoclasts and other cell types will be necessary to fully elucidate the mechanisms of persistent suppression of CTR expression.

The main objective of our study was to determine whether the regulation of CTR mRNA expression by CT occurs at the transcriptional level. As a surrogate for the classical nuclear run-on assay, we examined the level of CTR hnRNA to measure the transcriptional rate. We demonstrated that treatment with CT caused a prompt and clear-cut reduction in the CTR hnRNA level, strongly suggesting the involvement of a transcriptional mechanism. A recent report by Wada et al. (22) concluded, however, that CT had no significant effect on the CTR transcriptional rate measured by nuclear run-on assay. Although these results seem contradictory, there may be an explanation for this discrepancy; CT may not affect initiation of transcription but, instead, block elongation of the CTR transcript and cause transcriptional arrest. Indeed, several genes, including c-myc (47), c-fos (48), and c-myb (49), are known to be subject to such a regulatory mechanism at the level of transcriptional elongation. In that case, CT effects may have been masked if the full-length CTR cDNA was used to detect the run-on transcripts synthesized in vitro (22). It is also possible that CTR mRNA expression is regulated by a combination of transcriptional and posttranscriptional mechanisms, the latter making a greater contribution to the late phase of the prolonged effect of CT. Further extensive studies will be necessary to elucidate the mechanism by which CT down-regulates the level of CTR hnRNA expression.

In summary, we have demonstrated that in cells of the osteoclast lineage, expression of the C1a-CTR isoform mRNA, which accounts for more than 99% of the total CTR RNA in these cells, is rapidly and persistently down-regulated by the receptor’s cognate ligand. The fact that CT treatment causes an approximately 10-fold reduction in the steady state level of CTR-hnRNA in 1 h suggests the involvement of transcriptional inhibition. This down-regulation is independent of de novo protein synthesis and is thus most likely mediated by posttranslational modifications of a preexisting factor(s) by a mechanism that involves the cAMP/protein kinase A pathway.


    Footnotes
 
1 This work was supported by NIH Grants DK-46773 (to S.R.G.), AR-03564 (to S.R.G.), and DE-04724 (to R.B.) and a postdoctoral fellowship from the Patrick and Catherine Weldon Donaghue Medical Research Foundation (to D.I.). Back

2 Present address: First Department of Internal Medicine, University of Tokushima School of Medicine, 3–18-15 Kuramoto-cho Tokushima-shi, Tokushima 770-8503, Japan. Back

Received May 20, 1998.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Copp DH 1969 Calcitonin and parathyroid hormone. Annu Rev Pharmacol 9:327–344[Medline]
  2. Nicholson GC, Moseley JM, Sexton PM, Mendelsohn FAO, Martin TJ 1986 Abundant calcitonin receptors in isolated rat osteoclasts: biochemical and autoradiographic characterization. J Clin Invest 78:355–360
  3. Azria M, Copp DH, Zanelli JM 1995 25 years of salmon calcitonin: from synthesis to therapeutic use. Calcif Tissue Int 57:405–408[CrossRef][Medline]
  4. Wener JA, Gorton SJ, Raisz LG 1972 Escape from inhibition of resorption in cultures of fetal bone treated with calcitonin and parathyroid hromone. Endocrinology 90:752–759[Medline]
  5. Silva OL, Becker KL 1973 Salmon calcitonin in the treatment of hypercalcemia. Arch Intern Med 132:337–339[CrossRef][Medline]
  6. Binstock ML, Mundy GR 1980 Effect of calcitonin and glutocorticoids in combination on the hypercalcemia of malignancy. Ann Intern Med 93:269–272
  7. Lin HY, Harris TL, Flannery MS, Aruffo A, Kaji EH, Gorn A, Kolakowski LF, Lodish HF, Goldring SR 1991 Expression cloning of an adenylate cyclase-coupled calcitonin receptor. Science 254:1022–1024[Abstract/Free Full Text]
  8. Gorn AH, Lin HY, Yamin M, Auron PE, Flannery MR, Tapp DR, Manning CA, Lodish HF, Krane SM, Goldring SR 1992 Cloning, characterization, and expression of a human calcitonin receptor from an ovarian carcinoma cell line. J Clin Invest 90:1726–1735
  9. Sexton PM, Houssami S, Hilton JM, O’Keeffe LM, Center RJ, Gillespie MT, Darcy P, Findlay DM 1993 Identification of brain isoforms of the rat calcitonin receptor. Mol Endocrinol 7:815–821[Abstract/Free Full Text]
  10. Yamin M, Gorn AH, Flannery MR, Jenkins NA, Gilbert DJ, Copeland NG, Tapp DR, Krane SM, Goldring SR 1994 Cloning and characterization of a mouse brain calcitonin receptor complementary deoxyribonucleic acid and mapping of the calcitonin receptor gene. Endocrinology 135:2635–2643[Abstract]
  11. Shyu JF, Inoue D, Baron R, Horne WC 1996 The deletion of 14 amino acids in the seventh transmembrane domain of a naturally occurring calcitonin receptor isoform alters ligand binding and selectively abolishes coupling to phospholipase C. J Biol Chem 271:31127–31134[Abstract/Free Full Text]
  12. Sarkar A, Dickerson IM 1997 Cloning, characterization, and expression of a calcitonin receptor from guinea pig brain. J Neurochem 69:455–464[Medline]
  13. Segre GV, Goldring SR 1993 Receptors for secretin, calcitonin, parathyroid hormone (PTH)/PTH-related peptide, vasoactive intestinal peptide, glucagonlike peptide 1, growth hormone-releaing hormone, and glucagon belong to a newly discovered G-protein-linked receptor family. Trends Endocrinol Metab 4:309–314[Medline]
  14. Kuestner RE, Elrod RD, Grant FJ, Hagen FS, Kuijper JL, Matthewes SL, O’Hara PJ, Sheppard PO, Stroop SD, Thompson DL, Whitmore TE, Findlay DM, Houssami S, Sexton PM, Moore EE 1994 Cloning and characterization of an abundant subtype of the human calcitonin receptor. Mol Pharmacol 46:246–255[Abstract]
  15. Albrandt K, Brady EMG, Moore CX, Mull E, Sierzega ME, Beaumont K 1995 Molecular cloning and functional expression of a third isoform of the human calcitonin receptor and partial characterization of the calcitonin receptor gene. Endocrinology 136:5377–5384[Abstract]
  16. Zolnierowicz S, Cron P, Solinas-Toldo S, Friess R, Lin HY, Hemmings BA 1994 Isolation, characterization, and chromosomal localization of the porcine calcitonin receptor gene. Identification of two variants of the receptor generated by alternative splicing. J Biol Chem 269:19530–19538[Abstract/Free Full Text]
  17. Ikegame M, Rakopoulos M, Zhou H, Houssami S, Martin TJ, Moseley JM, Findlay DM 1995 Calcitonin receptor isoforms in mouse and rat osteoclasts. J Bone Miner Res 10:59–65[Medline]
  18. Takahashi S, Goldring S, Katz M, Hilsenbeck S, Williams R, Roodman GD 1995 Downregulation of calcitonin receptor mRNA expression by calcitonin during human osteoclast-like cell differentiation. J Clin Invest 95:167–171
  19. Rakopoulos M, Ikegame M, Findlay DM, Martin TJ, Moseley JM 1995 Short treatment of osteoclasts in bone marrow culture with calcitonin causes prolonged suppression of calcitonin receptor mRNA. Bone 17:447–453[Medline]
  20. Lee SK, Goldring SR, Lorenzo JA 1995 Expression of the calcitonin receptor in bone marrow cell cultures and in bone: a specific marker of the differentiated osteoclast that is regulated by calcitonin. Endocrinology 136:4572–4581[Abstract]
  21. Wada S, Udagawa N, Nagata N, Martin TJ, Findlay DM 1996 Calcitonin receptor down-regulation relates to calcitonin resistance in mature mouse osteoclasts. Endocrinology 137:1042–1048[Abstract]
  22. Wada S, Udagawa N, Akatsu T, Nagata N, Martin TJ, Findlay DM 1997 Regulation by calcitonin and glucocorticoids of calcitonin receptor gene expression in mouse osteoclasts. Endocrinology 138:521–529[Abstract/Free Full Text]
  23. Ikegame M, Rakopoulos M, Martin TJ, Moseley JM, Findlay DM 1996 Effects of continuous calcitonin treatment on osteoclast-like cell development and calcitonin receptor expression in mouse bone marrow cultures. J Bone Miner Res 11:456–465[Medline]
  24. Miyoshi I, Kubonishi I, Yoshimoto S, Akagi T, Ohtsuki Y, Shiraishi Y, Nagata K, Hinuma Y 1981 Type C virus particles in a cord T-cell line derived by co-cultivating normal human cord leukocytes and human leukaemic T cells. Nature 294:770–771[CrossRef][Medline]
  25. Ruddle NH, Li C-B, Horne WC, Santiago P, Troiano N, Jay G, Horowitz M, Baron R 1993 Mice transgenic for HTLV-I LTR-tax exhibit tax expression in bone, skeletal alterations, and high bone turnover. Virology 197:196–204[CrossRef][Medline]
  26. Takahashi N, Akatsu T, Udagawa N, Sasaki T, Yamaguchi A, Moseley JM, Martin TJ, Suda T 1988 Osteoblastic cells are involved in osteoclast formation. Endocrinology 123:2600–2602[Abstract]
  27. Akatsu T, Tamura T, Takahashi N, Udagawa N, Tanaka S, Sasaki T, Yamaguchi A, Nagata N, Suda T 1992 Preparation and characterization of a mouse osteoclast-like multinucleated cell population. J Bone Miner Res 7:1297–1306[Medline]
  28. Chomczynski P, Sacchi N 1987 Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem 162:156–159[Medline]
  29. Nicholson GC, Moseley JM, Yates AJP, Martin TJ 1987 Control of cyclic adenosine 3',5'-monophosphate production in osteoclasts: calcitonin-induced persistent activation and homologous desensitization of adenylate cyclase. Endocrinology 120:1902–1908[Abstract]
  30. Houssami S, Findlay DM, Brady CL, Myers DE, Martin TJ, Sexton PM 1994 Isoforms of the rat calcitonin receptor: consequences for ligand binding and signal transduction. Endocrinology 135:183–190[Abstract]
  31. Chabre O, Conklin BR, Lin HY, Lodish HF, Wilson E, Ives HE, Catanzariti L, Hemmings BA, Bourne HR 1992 A recombinant calcitonin receptor independently stimulates 3',5'-cyclic adenosine monophosphate and Ca2+/inositol phosphate signaling pathways. Mol Endocrinol 6:551–556[Abstract]
  32. Chen Y, Shyu J-F, Santhanagopal A, Inoue D, David J-P, Dixon SJ, Horne WC, Baron R 1998 The calcitonin receptor stimulates Shc tyrosine phosphorylation and Erk1/2 activation. Involvement of Gi, protein kinase C, and calcium. J Biol Chem 273:19809–19816[Abstract/Free Full Text]
  33. Wada S, Udagawa N, Nagata N, Martin TJ, Findlay DM 1996 Physiological levels of calcitonin regulate the mouse osteoclast calcitonin receptor by a protein kinase A-mediated mechanism. Endocrinology 137:312–320[Abstract]
  34. Azria M 1989 The Calcitonins: Physiology, and Pharmacology, Karger, Basel, pp 1–152
  35. Wada S, Martin TJ, Findlay DM 1995 Homologous regulation of the calcitonin receptor in mouse osteoclast-like cells and human breast cancer T47D cells. Endocrinology 136:2611–2621[Abstract]
  36. McCarthy JEG, Kollmus H 1995 Cytoplasmic mRNA-protein interactions in eukaryotic gene expression. Trends Biochem Sci 20:191–197[CrossRef][Medline]
  37. Yang M, Kurkinen M 1994 Different mechanisms of regulation of the human stromelysin and collagenase genes. Analysis by a reverse-transcription-coupled-PCR assay. Eur J Biochem 222:651–658[Medline]
  38. Elferink CJ, Reiners JJ,Jr 1996 Quantitative RT-PCR on CYP1A1 heterogeneous nuclear RNA: a surrogate for the in vitro transcription run-on assay. BioTechniques 20:470–477[Medline]
  39. Gabbitas B, Pash JM, Delany AM, Canalis E 1996 Cortisol inhibits the synthesis of insulin-like growth factor-binding protein-5 in bone cell cultures by transcriptional mechanisms. J Biol Chem 271:9033–9038[Abstract/Free Full Text]
  40. Franchimont N, Rydziel S, Delany AM, Canalis E 1997 Interleukin-6 and its soluble receptor cause a marked induction of collagenase 3 expression in rat osteoblast cultures. J Biol Chem 272:12144–12150[Abstract/Free Full Text]
  41. Sexton PM, Hilton JM 1992 Biologically active salmon calcitonin-like peptide is present in rat brain. Brain Res 596:279–284[CrossRef][Medline]
  42. Lamp SJ, Findlay DM, Moseley JM, Martin TJ 1981 Calcitonin induction of a persistent activated state of adenylate cyclase in human breast cancer cells (T47D). J Biol Chem 256:12269–12274[Free Full Text]
  43. Sunahara RK, Dessauer CW, Gilman AG 1996 Complexity and diversity of mammalian adenylyl cyclases. Annu Rev Pharmacol Toxicol 36:461–480[CrossRef][Medline]
  44. Iyengar R 1993 Molecular and functional diversity of mammalian Gs-stimulated adenylyl cyclases. FASEB J 7:768–775[Abstract]
  45. Seamon KB, Daly JW 1986 Forskolin: its biological and chemical properties. Adv Cyclic Nucleotide Protein Phosphorylation Res 20:1–150[Medline]
  46. Laurenza A, Sutkowski EM, Seamon KB 1989 Forskolin: a specific stimulator of adenylyl cyclase or a diterpene with multiple sites of action? Trends Pharmacol Sci 10:442–447[CrossRef][Medline]
  47. Bentley DL, Groudine M 1986 A block to elongation is largely responsible for decreased transcription of c-myc in differentiated HL60 cells. Nature 321:702–706[CrossRef][Medline]
  48. Plet A, Eick D, Blanchard JM 1995 Elongation and premature termination of transcripts initiated from c-fos and c-myc promoters show dissimilar patterns. Oncogene 10:319–328[Medline]
  49. Bender TP, Thompson CB, Kuehl WM 1987 Differential expression of c-myb mRNA in murine B lymphomas by a block to transcription elongation. Science 237:1473–1476[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
J EndocrinolHome page
N. Schwarz, D. Renshaw, S. Kapas, and J. P Hinson
Adrenomedullin increases the expression of calcitonin-like receptor and receptor activity modifying protein 2 mRNA in human microvascular endothelial cells.
J. Endocrinol., August 1, 2006; 190(2): 505 - 514.
[Abstract] [Full Text] [PDF]


Home page
J Mol EndocrinolHome page
M Nakamura, S Morimoto, Q Yang, T Hisamatsu, N Hanai, Y Nakamura, I Mori, and K Kakudo
Osteoclast-like cells express receptor activity modifying protein 2: application of laser capture microdissection
J. Mol. Endocrinol., February 1, 2005; 34(1): 257 - 261.
[Abstract] [Full Text] [PDF]


Home page
EndocrinologyHome page
S. Yasuda, S. Wada, Y. Arao, M. Kogawa, F. Kayama, and S. Katayama
Interaction between 3' Untranslated Region of Calcitonin Receptor Messenger Ribonucleic Acid (RNA) and Adenylate/Uridylate (AU)-Rich Element Binding Proteins (AU-Rich RNA-Binding Factor 1 and Hu Antigen R)
Endocrinology, April 1, 2004; 145(4): 1730 - 1738.
[Abstract] [Full Text] [PDF]


Home page
EndocrinologyHome page
S. Wada, S. Yasuda, T. Nagai, T. Maeda, S. Kitahama, S. Suda, D. M. Findlay, M. Iitaka, and S. Katayama
Regulation of Calcitonin Receptor by Glucocorticoid in Human Osteoclast-Like Cells Prepared in Vitro Using Receptor Activator of Nuclear Factor-{{kappa}}B Ligand and Macrophage Colony-Stimulating Factor
Endocrinology, April 1, 2001; 142(4): 1471 - 1478.
[Abstract] [Full Text]


Home page
EndocrinologyHome page
A. Samura, S. Wada, S. Suda, M. Iitaka, and S. Katayama
Calcitonin Receptor Regulation and Responsiveness to Calcitonin in Human Osteoclast-Like Cells Prepared in Vitro using Receptor Activator of Nuclear Factor-{kappa}B Ligand and Macrophage Colony-Stimulating Factor
Endocrinology, October 1, 2000; 141(10): 3774 - 3782.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
K. Horie and P. A. Insel
Retrovirally Mediated Transfer of a G Protein-coupled Receptor Kinase (GRK) Dominant-negative Mutant Enhances Endogenous Calcitonin Receptor Signaling in Chinese Hamster Ovary Cells. GRK INHIBITION ENHANCES EXPRESSION OF RECEPTORS AND RECEPTOR mRNA
J. Biol. Chem., September 15, 2000; 275(38): 29433 - 29440.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
O. Anusaksathien, C. Laplace, X. Li, Y. Ren, L. Peng, S. R. Goldring, and D. L. Galson
Tissue-specific and Ubiquitous Promoters Direct the Expression of Alternatively Spliced Transcripts from the Calcitonin Receptor Gene
J. Biol. Chem., June 15, 2001; 276(25): 22663 - 22674.
[Abstract] [Full Text] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Inoue, D.
Right arrow Articles by Baron, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Inoue, D.
Right arrow Articles by Baron, R.


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals