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PTH-CALCITONIN-VITAMIN D-BONE |
Department of Pathology (S.L.A., K.W., N.G.-C.), University of Texas Health Science Center and the South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, Texas 78284; and Skeletech Inc. (C.L., V.S.), Bothell, Washington 98021
Address all correspondence and requests for reprints to: Sherry L. Abboud, M.D., Department of Pathology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, Texas 78284. E-mail: . abbouds{at}uthscsa.edu
| Abstract |
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wk, op/opT mice showed normal growth and tooth eruption. Femurs removed at 5 and 14 wk were analyzed by peripheral quantitative computed tomography and histomorphometry. The abnormal bone mineral density, cancellous bone volume, and growth plate width observed in op/op mice was completely reversed in op/opT mice by 5 wk, and this effect persisted at 14 wk, with measurements comparable with wt/wt mice at each time point. Correction of the skeletal abnormalities in the 5-wk-old op/opT mice correlated with a marked increase in the total osteoclast number, and their number per millimeter of bone surface compared with that of op/op mutants. Osteoclast number was maintained at 14 wk in op/opT mice and morphologically resembled wt/wt osteoclasts. These results indicate that sCSF-1 is sufficient to drive normal osteoclast development and that the osteocalcin promoter provides an efficient tool for delivery of exogenous genes to the bone. Moreover, targeting sCSF-1 to osteoblasts in the bone microenvironment may be a potentially useful therapeutic modality for treating bone disorders. | Introduction |
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The importance of CSF-1 in osteoclast development has been demonstrated in studies using the osteopetrotic (op/op) mouse model. In the op/op mutant, a thymidine insertion in the coding sequence of the CSF-1 gene results in CSF-1 deficiency that, in turn, leads to decreased macrophage and osteoclast production (12, 13, 14). By 10 d of age, op/op mice develop an osteopetrotic phenotype characterized by stunted growth, absence of tooth eruption, and a domed skull. Failure of bone marrow transplantation to rescue the osteopetrotic phenotype and the inability of op/op osteoblasts to support osteoclast formation in vitro indicate that the primary defect in these mice is caused by a lack of osteoblast-derived CSF-1 (15, 16). The potential of sCSF-1 to cure the osteopetrotic defect has been controversial (17, 18, 19, 20). Sundquist et al. (20) showed that restoration of physiological concentrations of circulating CSF-1 in op/op mice, from 1 d after birth, for 4 wk, only partially rescued the osteopetrosis, with persistent metaphyseal sclerosis possibly attributable to inadequate delivery of recombinant human CSF-1 to this site or to a lack of membrane bound CSF-1. Alternatively, the discrepancy between this and other studies may be attributable to differences in the dose or duration of CSF-1 administration. When Wiktor-Jedrzejczak et al. (19) administered high concentrations of recombinant human CSF-1 to 6-d-old op/op mice for 2 months, circulating CSF-1 was restored to normal levels, body weight was partially corrected, and osteopetrosis was resolved. However, osteopetrosis relapsed 1 month after cessation of CSF-1 therapy, and it could not be reversed in mice treated after 7 d of age, suggesting that early and sustained postnatal CSF-1 protein expression in the bone microenvironment is required for complete remission of the osteopetrotic defect.
Osteoblasts play a key role in modulating osteoclast function via the release of cytokines and through cell-cell interaction (21, 22). Therefore, they provide a useful in vivo target for delivering exogenous genes that regulate osteoclastogenesis. In the present study, we took advantage of the tissue specificity of the osteocalcin promoter to selectively target sCSF-1 to osteoblasts in the bone microenvironment (23, 24). Osteocalcin is an abundant bone matrix protein expressed by mature osteoblasts but not by osteoprogenitor cells. To determine whether sCSF-1 can rescue the osteopetrotic defect, op/op mice carrying an osteocalcin promoter-driven human sCSF-1 transgene (op/opT) were generated. At 5 and 14 wk, resolution of osteopetrosis was assessed using peripheral quantitative computed tomography (pQCT) scanning, tartrate resistant acid phosphatase (TRAP) staining of osteoclasts on histologic preparations, and histomorphometric analysis.
| Materials and Methods |
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Generation of op/op mice expressing sCSF-1
The transgene consists of the osteocalcin promoter linked to the sCSF-1 cDNA. The 1.8-kb 5'-flanking sequence of the rat osteocalcin promoter in sp64 (Genentech, Inc., San Francisco, CA) was digested with SmaI-HindIII, subcloned into the HincII site of pUC7, and then inserted into the BAMHI site of the pBSpKCR3 vector (24). The 1.8-kb CSF-1 cDNA that encodes the full-length human sCSF-1 was excised from p3ACSF-RI (Genetics Institute, Cambridge, MA) with XhoI-EcoRI, subcloned into the HincII site of pUC7 and then inserted into the EcoRI-digested pBSpKCR3 (obtained from Dr. Windle, University of Texas Health Science Center, San Antonio, TX) (25). In this vector, the sCSF-1 cDNA is inserted into a fragment of the rabbit ß-globin gene that provides an intron and polyadenylation signal required for efficient expression of the transgene. Transgenic mice were generated, according to standard methods, at the San Antonio Cancer Institute Transgenic Facility, University of Texas Health Science Center, San Antonio (26). The ClaI-NotI-digested fragment was microinjected into fertilized eggs derived from the mating of B6C3 mice and implanted into the oviducts of pseudopregnant CD-1 foster females. Offspring were screened for the transgene by Southern blot hybridization of tail DNA with the osteocalcin-CSF-1 injection fragment. Three founders were identified with 45 copies of the transgene per haploid genome. Transgenic lines were established by breeding founders to B6C3 mice. One line, showing the highest CSF-1 protein levels in bone lysates, was selected for breeding with heterozygous op/wt mice to generate CSF-1 transgenic op/wt (op/wtT) mice. These mice were then interbred to establish op/op mice expressing the transgene (op/opT). At 5 and 14 wk, op/opT mice were killed and weighed, and bone and plasma CSF-1 protein levels were determined. Age-matched wt/wt and op/op littermates served as normal and mutant controls, respectively. Femurs and tibias were excised, and a portion was frozen in liquid nitrogen for CSF-1 protein analysis. The remaining bones were fixed in 10% formalin for 2 d before pQCT, histologic, and histomorphometric analysis. Four to five femurs were analyzed at each time point, and results are expressed as mean ± SE
Analysis of transgene expression
Human CSF-1 protein levels were measured in plasma, bone, and tissue extracts. Two tibias were rapidly dissected and frozen in liquid nitrogen before being crushed and homogenized in TENES V buffer [50 mM Tris-HCl (pH 7.4), 1% NP-40, 2 mM EDTA, 100 mM NaCl, 10 mM sodium oxyvanadate] containing proteinase inhibitors (1 mM phenylmethylsulfonylfluoride, 10 µg/ml leupeptin, 20 µg/ml aprotinin). Tissues harvested from mice were frozen and then homogenized in the same buffer. After centrifugation, bone, tissue, and plasma samples were diluted 1:21:6 and assayed using the human Quantikine enzyme-linked immunoassay kit (R&D Systems, Minneapolis, MN) according to the manufacturers instructions. CSF-1 concentrations were calculated from a standard curve (31.22000 pg/ml) using log-log linear regression. This assay specifically detects human CSF-1 and shows negligible species cross-reactivity. The sensitivity of the test is less than 9 pg/ml.
PCR detection of op genotype
The op allele was identified using PCR to amplify the segment containing the op mutation on chromosome 3, as previously described (27). Genomic DNA from tails was extracted using the QIAmp Tissue Kit (QIAGEN, Chatsworth, CA). Two primers (5'-TG TGTCCCTTCCTCAGATTACA-3' and 5'-GGTCTCATCTATTATGTCTTGTACCAGCCAAAA-3'), designed to generate PCR products of 195 bp (wt allele) or 196 bp (op allele), were used. A 2-bp mismatch in the 3'-antisense primer (underlined) introduced a second BglI site into the PCR product spanning the extra base of the op mutation that was absent from the PCR product from the wild-type template. Conditions for PCR reactions were 3 min at 94 C; 1 min at 94 C, 2 min at 62 C, and 2 min at 72 C for 40 cycles; and 10 min at 72 C. Twenty microliters of PCR product was then digested with 1 µl BglI for 2 h. The fragments were separated by electrophoresis in a 4% Metaphor agarose gel and visualized by ethidium bromide staining.
Bone mineral density (BMD) measurement
BMD of the femurs was measured by pQCT (RM 3000 pQCT, Norland Medical Systems, Inc., Fort Atkinson, WI). Quantitative readings were obtained at the metaphysis (12% from the distal end) and diaphysis (50% from the distal end). At each site, a 0.5-mm segment was scanned, and the BMD was calculated using small-animal software.
Histology and histomorphometric measurements
The distal half of each femur was decalcified in 10% sodium EDTA in 0.1 M phosphate buffer (pH 7.0) at 4 C for 4 d. The samples were dehydrated through standard graded alcohol solutions and embedded in glycol methacrylate using a JB-4 embedding kit (Polysciences, Inc., Warrington, PA). Tissues were sectioned longitudinally, at 4 mm, using a Jung Ultracut microtome (Reichert-Jung, Heidelberg, Germany), and the sections were stained for tartrate-resistant acid phosphatase activity followed by thionin green counterstaining (28). Static parameters were measured in a 2-mm square, 1 mm distal to the lowest point of the growth plate in the secondary spongiosa. Bone and osteoclast surfaces were traced; and cancellous bone volume (BV/TV), trabecular measurements, osteoclast numbers, and surfaces were calculated using Osteomeasure software (Osteometrics, Atlanta, GA), as we have previously described (29). The growth plate width was the average of the measurements at four equal distances along the growth plate.
| Results |
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These CSF-1T mice were then used to generate op/opT mice, and the op/op genotype was confirmed by PCR analysis as shown in Fig. 1
(left panel). An ethidium bromide-stained 4% agarose gel of BglI-digested PCR products shows a 96-bp fragment in all cases and fragments diagnostic of either the op allele (70 and 30 bp) or wt allele (99 bp). DNA isolated from transgenic mice in lanes 1 and 2 shows the wt/wt genotype, whereas DNA in lanes 7 and 8 shows the op/op genotype. DNA from op/wt mice in lanes 36 shows the expected 99- and 96-bp fragments, along with the 70- and 30-bp fragments, which stain less intensely than those observed in op/op mice because of the presence of only a single op allele. Ten days after birth, op/opT mice began to show tooth eruption; and, by 2
wk, eruption of the upper and lower incisors was comparable with wt/wt littermates, whereas op/op mice remained toothless (Fig. 1
, right panel).
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Radiographic and BMD measurements in op/opT mice
Skeletal growth and development in op/opT mice were significantly improved, compared with op/op mice. As shown in Fig. 2
, x-rays of op/op mice at 5 and 14 wk show marked skeletal sclerosis, with short and thickened long bones. There is dense, radiopaque bone in the iliac crest, and in the tibial and femoral metaphysis, with obliteration of marrow spaces that normally appear radiolucent. The caudal vertebrae of the tail also appear sclerotic. In contrast, op/opT mice show resolution of metaphyseal sclerosis by 5 wk and radiolucent marrow spaces in the iliac crest, caudal vertebrae, tibial, and femoral metaphyses comparable with wt/wt controls at 5 and 14 wk.
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| Discussion |
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Analysis of CSF-1T mice before cross-breeding confirmed selective targeting of the transgene to the bone, with little or no expression of human sCSF-1 in other tissues. Circulating levels of human sCSF-1 protein were also detectable. CSF-1T mice were established on the same genetic background as op/op mice, to minimize any effect of strain variation on transgene expression. Similar levels of human sCSF-1 in bone of CSF-1T mice used for cross-breeding and in op/opT mice indicated that the transgene was efficiently transferred to op/op mice. Because op/wtT mice were interbred to generate op/opT mice, some mice would be expected to be homozygous or heterozygous for the transgene. The levels of transgene expression and resolution of the osteopetrotic defect in op/opT mice were remarkably similar among the animals examined. Successful targeting of sCSF-1 to bone in op/op T mice was evident by 2
wk, when eruption of upper and lower incisors was comparable with wt/wt littermates. At 5 wk, high levels of sCSF were detected in bone extracts of op/opT but not wt/wt controls. Human sCSF-1 levels in bone remained elevated at 14 wk, whereas plasma levels declined. This decrease may have resulted from enhanced CSF-1 receptor-mediated internalization and intracellular metabolism (30). Adequate transgene expression in op/op mice was manifested by normalization of growth and body weight. Tooth eruption in op/opT mice occurred at 2
wk, earlier than would be expected if it were attributable to spontaneous resolution (5 wk).
The radiographic changes in op/opT mice were dramatic, compared with op/op mice at 5 wk, with complete loss of metaphyseal sclerosis and radiolucent marrow spaces throughout the axial skeleton. pQCT images of femurs from 5- and 14-wk-old op/opT mice confirmed the presence of normal cancellous bone in the metaphysis and bone of normal thickness in the diaphysis, with an expanded marrow cavity comparable with wt/wt mice. These results correlated with histologic analysis of op/opT femurs that showed normalization of the growth plate width, numerous TRAP-positive osteoclasts along thin bony trabeculae in the metaphysis, and a well-developed marrow cavity. Histomorphometric analysis confirmed that the abnormal BV/TV and growth plate width observed in op/op mice was completely reversed in op/opT mice by 5 wk and persisted at 14 wk. These findings, to our knowledge, provide the most detailed analysis of the effect of sCSF-1 on op/op skeletal tissues. The lack of excessive osteoclastogenesis and osteoporosis, despite the high levels of sCSF-1, is intriguing and suggests that sCSF-1 is required for restoration of normal osteoclastogenesis but may not be a critical factor that results in excessive osteoclastogenesis and bone resorption.
Under normal physiological conditions, local production of CSF-1 by osteoblasts and their cell-to-cell interaction with osteoclast progenitors are critical for osteoclast development (21, 22, 31). Systemically administered sCSF-1 may have numerous effects on multiple organs, and it is unclear from previous studies whether the effect of sCSF-1 on bone is direct or mediated indirectly via the release of other growth factors. Our findings support a direct effect of sCSF-1 on osteoclastogenesis, with a sustained cure achieved by restoring sCSF-1 levels in the osteoblasts of op/op mice throughout murine development. To date, relapse of osteopetrosis has not been observed in op/opT mice up to 1 yr. The remarkable concordance between the op/opT and wild-type animals is intriguing. Our previous in vitro data predicted that sCSF-1 would only partially cure osteopetrosis. In coculture experiments, retrovirally transduced op/op stromal cells producing normal levels of sCSF-1 protein supported fewer numbers of osteoclasts, compared with normal stroma (32). However, in vitro studies may not mimic in vivo physiological conditions. It is likely that selective expression of sCSF-1 in op/op osteoblasts, rather than in whole-bone marrow stroma, during development provided a more physiologic milieu and restored osteoclastogenesis and corrected the skeletal abnormalities.
Similar to that in rodents, osteopetrosis in humans is a heterogenous group of skeletal disorders characterized by reduced bone resorption caused by inactive osteoclasts (33). Although a few studies have identified mutations in the gene encoding the vacuolar proton pump as a cause of certain forms of osteopetrosis, the genetic defect(s) underlying most cases of osteopetrosis remains to be determined (34, 35). Rescue of op/op mice with sCSF-1 raises the possibility that a similar CSF-1-deficiency disease may also exist among the heterogeneous forms of human osteopetrosis. The use of promoters with tissue specificity has potential therapeutic application in bone disorders (36, 37). The rat osteocalcin promoter has been shown to direct osteoblast-specific expression of GH and TGF-ß2 in transgenic mice (23, 24). It has also been used for in vivo targeting to metastatic pulmonary osteosarcoma (38). Administration iv of an adenoviral vector containing an osteocalcin-thymidine kinase construct was shown to localize to tumor cells and inhibit their growth when mice were treated with ancyclovir. More recently, mice transplanted with bone marrow-derived adherent cells containing the osteocalcin promoter showed reporter gene expression in the engrafted osteoblast cells (39). This suggests that exogenous genes could be delivered to the bone using ex vivo techniques, whereby autologous bone marrow adherent cells are expanded in culture, transduced with an osteocalcin-containing vector, and infused into the recipient. Alternatively, mature osteoblasts in the bone could be directly targeted in vivo using adenoviral-based gene therapy. Thus, targeting sCSF-1 or other exogenous genes to osteoblasts may provide a useful therapeutic approach for regulating osteoclast development and function in a variety of bone disorders, including osteopetrosis, osteoporosis, and bone metastasis.
| Acknowledgments |
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| Footnotes |
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This work was supported, in part, by funding from the NIH (AR-42306, to S.L.A.), Veterans Administration Merit Award (to S.L.A.), and Department of Defense (DAMD17-99-1-9400, to N.G.-C).
Abbreviations: BMD, Bone mineral density; BV/TV, cancellous bone volume; pQCT, peripheral quantitative computed tomography; TRAP, tartrate resistant acid phosphatase; sCSF-1, soluble colony-stimulating factor-1.
Received August 30, 2001.
Accepted for publication January 15, 2002.
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