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Integrative Analysis of Exosomal miR-452 and miR-4713 Downregulating NPY1R for the Prevention of Childhood Obesity. DISEASE MARKERS 2022; 2022:2843353. [PMID: 35401881 PMCID: PMC8986441 DOI: 10.1155/2022/2843353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 12/25/2022]
Abstract
Neuropeptides are associated with childhood obesity and exploring their regulatory mechanisms may reveal new insights for novel treatments. Childhood obesity data were downloaded from the GEO database and were used to screen for differentially expressed neuropeptides in patients with obesity. NPY1R expression was significantly upregulated in children with obesity compared to children without obesity (p < 0.05). The GEO database was used to filter differentially expressed miRNAs in patients with obesity. And hsa-mir-4713 and hsa-mir-452 were found significantly downregulated in adipose tissue. The GEO, TRRUST, and TFacts databases were used to screen all transcription factors for differentially expressed genes (DEGs). The potential regulatory networks between the differentially expressed miRNAs, TFs, and neuropeptides were mapped. In the constructed NPY1R regulatory network, the transcription factors TCF4, HEY1, and GATA3 are significantly associated with NPY1R. TCF4 and HEY1 were positively correlated with NPY1R, while GATA3 was negatively correlated with NPY1R. In the clinical peripheral blood samples, NPY1R, TCF4, and HEY1 were significantly more expressed in the obesity and the obesity with fracture group compared to the control group, while there was no statistically significant difference between the obesity group and the obesity with fracture group in terms of expression. The expression of GATA3, miR-452, and miR-4713 was also significantly lower in the obesity and the obesity with fracture groups when compared to the NC group. Therefore, NPY1R, TCF4, HEY1, GATA3, miR-452, and miR-4713 may be risk factors for fracture in obese children. The potential NPY1R regulatory function was exerted by two pathways: positive regulation caused by TCF4 and HEY1 acting on miR-4713 and negative regulation via GATA3 acting on miR-452. Potential NPY1R-related targets for the treatment of childhood obesity were provided in this study.
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Chen R, Hao Z, Chen X, Fu Q, Ma Y. Neuropeptide Y enhances proliferation and chondrogenic differentiation of ATDC5 cells. Neuropeptides 2020; 80:102022. [PMID: 31987472 DOI: 10.1016/j.npep.2020.102022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/19/2020] [Accepted: 01/19/2020] [Indexed: 12/19/2022]
Abstract
In recent years, emerging evidence has illustrated the indispensable role of sympathetic neurotransmitters and their receptors in cartilage mediation. The presence of neuropeptide Y (NPY)-positive sympathetic nerve fibres in cartilage and NPY-secretion function in chondrocytes raises the possibility of NPY directly regulating the function of chondrocytes. Therefore, this study intended to evaluate the effect of NPY and its receptors on the proliferation and chondrogenic differentiation of ATDC5 cells. Results showed NPY, especially at a concentration of 10-10 M, to significantly enhance proliferation of ATDC5 cells. Moreover, NPY effectively facilitated early chondrogenesis and late hypertrophy/mineralisation of ATDC5 cells via Y1 receptor signalling, rather than via Y2 receptor signalling. Taken together, the results help us to understand how NPY and its receptors affect the function of chondrocytes.
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Affiliation(s)
- Ruixin Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Zhichao Hao
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Xiaodan Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Qiang Fu
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
| | - Yuanyuan Ma
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
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Hamaya E, Fujisawa T, Tamura M. Osteoadherin serves roles in the regulation of apoptosis and growth in MC3T3‑E1 osteoblast cells. Int J Mol Med 2019; 44:2336-2344. [PMID: 31638177 DOI: 10.3892/ijmm.2019.4376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/19/2019] [Indexed: 11/05/2022] Open
Abstract
Small leucine‑rich proteoglycans (SLRPs) are a class of proteoglycans that are characterized by small protein cores and structures of leucine‑rich repeats. SLRPs are expressed in most extracellular matrices and share numerous biological functions that are associated with binding of collagens and cell surface receptors. Osteoadherin (also termed osteomodulin) is encoded by the Omd gene and is a keratan sulfate proteoglycan of the class II subfamily of SLRPs. Osteoadherin is highly expressed in mineralized tissues, including bone and dentin; however, it's precise roles remain unknown. The present study determined the Omd expression levels and investigated the effects of over‑ and under‑expression of osteoadherin in osteoblastic cells. Omd mRNA expression increased with osteoblast differentiation in MC3T3‑E1 cells. In C2C12 cells, Omd mRNA expression was induced by bone morphogenetic protein (BMP)2. Reporter assays similarly demonstrated activation of the Omd gene promoter following co‑transfection with Smad1 and Smad4, which are intracellular signaling molecules of the BMP2 signaling pathway. Overexpression of Omd increased the viability and decreased caspase 3/7 activity in MC3T3‑E1 cells. By contrast, following transfection with small interfering RNA for Omd, viable cell numbers were decreased and caspase 3/7 activity was increased. Furthermore, overexpression of Omd reduced the expression of CCN family 2 in these cells. These results demonstrate that Omd expression is regulated during osteoblast differentiation, and that the protein product osteoadherin serves roles in the apoptosis and growth of osteoblast cells.
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Affiliation(s)
- Eri Hamaya
- Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
| | - Toshiaki Fujisawa
- Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
| | - Masato Tamura
- Department of Biochemistry and Molecular Biology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
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刘 松, 吴 建, 胡 稷, 王 簕, 王 钊, 孟 欢, 卓 灵, 郑 健. [Neuropeptide Y Y1 receptor antagonist PD160170 promotes osteogenic differentiation of rat bone marrow mesenchymal stem cells in vitro and femoral defect repair in rats]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:669-676. [PMID: 29997088 PMCID: PMC6765719 DOI: 10.3969/j.issn.1673-4254.2018.06.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the effects of neuropeptide Y (NPY) Y1 receptor antagonist PD160170 in promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and accelerating healing of femoral defect in rats. METHODS The third generation of rat BMSCs were treated with PBS (control) or 10-6, 10-7, or 10-8 mol/L NPY Y1 receptor antagonist PD160170. After 7 and 14 days of treatment, the cells were examined for osteogenic differentiation with alkaline phosphatase (ALP) and alizarin red staining. At 7 and 21 days of treatment, the mRNA and protein expressions of collagen type I (COLI), osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) in the cells were detected using q-PCR and Westem Blotting. In a male SD rat model (body weight 300∓20 g) of bilateral femoral condyle defects (2.5 mm in diameter), the effect of daily local injection of 0.2 mL PD160170 (10-6 and 10-8 mol/L, for 28 consecutive days) in promoting bone defect repair was evaluated with micro-CT scans. RESULTS ALP and alizarin red staining showed that the BMSCs treated with PD160170, at the optimal concentration of 10-8 mol/L, contained more intracellular cytoplasmic brown particles and mineralized nodules in extracellular matrix than PBS-treated cells. PD160170 (10-8 mol/L) significantly up-regulated the mRNA and protein expressions of COLI at day 7 and those of OCN and Runx2 at day 21 (P<0.05). In the rat models of femoral bone defect, the volume/tissue volume ratio, bone mineral density and the number of bone trabeculae were significantly greater in 10-6 mol/L PD160170 group than in the control group (P<0.05), but the bone trabecular thickness (P=0.07) and bone volume (P=0.35) were similar between the two groups. CONCLUSION NPY Y1 receptor antagonist PD160170 can promote osteogenic differentiation of BMSCs and healing of femoral defects in rats, suggesting the potential of therapeutic strategies targeting NPY Y1 receptor signaling in the prevention and treatment of bone fracture and osteoporosis.
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Affiliation(s)
- 松 刘
- 广州医科大学附属第三医院骨科二区,广东 广州 510150Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - 建群 吴
- 广州市花都区人民医院骨科,广东 广州 510800Department of Orthopedics, Huadu District People's Hospital, Guangzhou 510800, China
- 南方医院医科大学南方医院创伤骨科,广东 广州 510515Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 稷杰 胡
- 南方医院医科大学南方医院创伤骨科,广东 广州 510515Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 簕 王
- 广州医科大学附属第三医院骨科二区,广东 广州 510150Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - 钊 王
- 广州医科大学附属第三医院骨科二区,广东 广州 510150Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - 欢 孟
- 南方医院医科大学南方医院创伤骨科,广东 广州 510515Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 灵剑 卓
- 南方医院医科大学南方医院创伤骨科,广东 广州 510515Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 健雄 郑
- 南方医院医科大学南方医院创伤骨科,广东 广州 510515Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Yahara M, Tei K, Tamura M. Inhibition of neuropeptide Y Y1 receptor induces osteoblast differentiation in MC3T3‑E1 cells. Mol Med Rep 2017; 16:2779-2784. [PMID: 28656295 DOI: 10.3892/mmr.2017.6866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/03/2017] [Indexed: 01/07/2023] Open
Abstract
Neuropeptide Y (NPY) is a major neural signaling molecule. NPY is produced by peripheral tissues, such as osteoblasts, and binds to the corresponding Y1 receptor that belongs to the G‑protein‑coupled receptor family. Osteoblast‑specific Y1 receptor knockout mice exhibit high bone mass, indicating a role of the NPY‑Y1 receptor axis in the regulation of bone homeostasis. In the bone microenvironment, peripheral nerve fibers and osteoblasts produce NPY. However, the effects of the Y1 receptor on osteoblasts remain unexplored. In the present study, an RNA interference approach was employed to target the Y1 receptor, in order to determine whether it may function to regulate the growth, differentiation and viability of osteoblasts. Knockdown of the Y1 receptor by small interfering RNA (siRNA) lead to induction of alkaline phosphatase (ALP) activity and mineralization in mouse MC3T3‑E1 osteoblast cells. In addition, the mRNA expression levels of ALP, osteocalcin, collagen (I) α1, and bone sialoprotein were significantly increased following transfection of a Y1 receptor siRNA. Furthermore, the mRNA expression levels of Runx2 and osterix were significantly increased; however, no significant alterations in cell proliferation and caspase‑3/7 activity were observed in Y1 receptor siRNA‑transfected cells when compared with non‑targeting controls. The results demonstrate that Y1 receptor inhibition may increase osteoblastic differentiation, which indicates a role of the Y1 receptor in the regulation of osteoblastic differentiation.
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Affiliation(s)
- Motoki Yahara
- Department of Biochemistry and Molecular Biology, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
| | - Kanchu Tei
- Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
| | - Masato Tamura
- Department of Biochemistry and Molecular Biology, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8586, Japan
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Wang FS, Lian WS, Weng WT, Sun YC, Ke HJ, Chen YS, Ko JY. Neuropeptide Y mediates glucocorticoid-induced osteoporosis and marrow adiposity in mice. Osteoporos Int 2016; 27:2777-2789. [PMID: 27080706 DOI: 10.1007/s00198-016-3598-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 04/08/2016] [Indexed: 12/15/2022]
Abstract
UNLABELLED Increased neuropeptide Y (NPY) expression occurred in the glucocorticoid-induced osteoporotic skeleton. NPY knockout mice exhibited a minor response to the glucocorticoid-mediated exacerbation of bone accretion and fatty marrow pathogenesis. NPY deletion restored SITR1 signaling and enhanced PPARγ ubiquitination of bone tissue, an alternative strategy for ameliorating glucocorticoid-induced skeletal deterioration. INTRODUCTION Glucocorticoid excess is observed to worsen the pathogenesis of osteoporosis and fatty marrow. This study was undertaken to investigate the contribution of neuropeptide Y (NPY) to glucocorticoid-induced bone loss and marrow adiposity. METHODS NPY knockout and wild-type mice were administered methylprednisolone for four consecutive weeks. Bone mineral density, microarchitecture, and calcein-labeled mineral acquisition were quantified by μCT, dual energy X-ray absorptiometry, and histomorphometry. Expression of osteogenic and adipogenic markers and acetylation states of PPARγ were detected by RT-quantitative PCR, immunoprecipitation, and immunoblotting. RESULTS High NPY levels were associated with glucocorticoid-induced trabecular bone deterioration and marrow fat accumulation. Mice lacking NPY had high bone mass concomitant with spacious trabecular and cortical bone microstructure. NPY deletion shielded skeletal tissues from the glucocorticoid-induced impediment of bone mass, trabecular morphometric characteristics, mineral accretion activity, and fatty marrow development. Ex vivo, NPY deficiency sustained osteogenic differentiation capacity and curtailed the glucocorticoid-mediated escalation of adipocyte formation reactions of primary bone-marrow mesenchymal cells. NPY deletion appeared to modulate Y1 and Y2 receptors, sirtuin 1, ERK, and p38 signaling pathways, an effect that facilitated hypoacetylation and ubiquitination of adipogenic transcription factor PPARγ in the skeletal tissues exposed to glucocorticoid stress. CONCLUSIONS NPY mediates the glucocorticoid-induced disturbance of mineral accretion and marrow adipogenesis through post-translational modification of PPARγ. This study brings a new molecular insight into the disintegration of adipogenic and osteogenic activities within glucocorticoid-mediated osteoporotic skeletons. Control of NPY is an alternative strategy to ameliorate glucocorticoid-induced bone destruction and fatty marrow.
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Affiliation(s)
- F-S Wang
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - W-S Lian
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - W-T Weng
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Y-C Sun
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - H-J Ke
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Y-S Chen
- Department of Medical Research, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Core Laboratory for Phenomics and Diagnostics, Kaohisung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - J-Y Ko
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung District, Kaohsiung, 83303, Taiwan.
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Fernando HA, Zibellini J, Hsu MS, Seimon RV, Nguyen AD, Sainsbury A. The neuropeptide Y-ergic system: potential therapeutic target against bone loss with obesity treatments. Expert Rev Endocrinol Metab 2015; 10:177-191. [PMID: 30293515 DOI: 10.1586/17446651.2015.1001741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Obesity is no longer considered to provide protection against osteoporosis. Moreover, treatments for obesity are now suspected of reducing bone mass. With the escalating incidence of obesity, combined with increases in the frequency, duration and intensity of interventions used to combat it, we face a potential increase in health burden due to osteoporotic fractures. The neuropeptide Y-ergic system offers a potential target for the prevention and anabolic treatment of bone loss in obesity, due to its dual role in the regulation of energy homeostasis and bone mass. Although the strongest stimulation of bone mass by this system appears to occur via indirect hypothalamic pathways involving Y2 receptors (one of the five types of receptors for neuropeptide Y), Y1 receptors on osteoblasts (bone-forming cells) induce direct effects to enhance bone mass. This latter pathway may offer a suitable target for anti-osteoporotic treatment while also minimizing the risk of adverse side effects.
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Affiliation(s)
- Hamish A Fernando
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Jessica Zibellini
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Michelle Sh Hsu
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Radhika V Seimon
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Amy D Nguyen
- b 2 Neuroscience Program, Garvan Institute of Medical Research, University of New South Wales, Darlinghurst, Australia
| | - Amanda Sainsbury
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
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Ma WH, Liu YJ, Wang W, Zhang YZ. Neuropeptide Y, substance P, and human bone morphogenetic protein 2 stimulate human osteoblast osteogenic activity by enhancing gap junction intercellular communication. ACTA ACUST UNITED AC 2015; 48:299-307. [PMID: 25714881 PMCID: PMC4418359 DOI: 10.1590/1414-431x20144226] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 11/13/2014] [Indexed: 01/05/2023]
Abstract
Bone homeostasis seems to be controlled by delicate and subtle “cross talk” between
the nervous system and “osteo-neuromediators” that control bone remodeling. The
purpose of this study was to evaluate the effect of interactions between
neuropeptides and human bone morphogenetic protein 2 (hBMP2) on human osteoblasts. We
also investigated the effects of neuropeptides and hBMP2 on gap junction
intercellular communication (GJIC). Osteoblasts were treated with neuropeptide Y
(NPY), substance P (SP), or hBMP2 at three concentrations. At various intervals after
treatment, cell viability was measured by the MTT assay. In addition, cellular
alkaline phosphatase (ALP) activity and osteocalcin were determined by colorimetric
assay and radioimmunoassay, respectively. The effects of NPY, SP and hBMP on GJIC
were determined by laser scanning confocal microscopy. The viability of cells treated
with neuropeptides and hBMP2 increased significantly in a time-dependent manner, but
was inversely associated with the concentration of the treatments. ALP activity and
osteocalcin were both reduced in osteoblasts exposed to the combination of
neuropeptides and hBMP2. The GJIC of osteoblasts was significantly increased by the
neuropeptides and hBMP2. These results suggest that osteoblast activity is increased
by neuropeptides and hBMP2 through increased GJIC. Identification of the
GJIC-mediated signal transduction capable of modulating the cellular activities of
bone cells represents a novel approach to studying the biology of skeletal
innervation.
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Affiliation(s)
- W H Ma
- The Third Hospital of Hebei Medical University, The Provincial Key Laboratory for Orthopedic Biomechanics of Hebei, Shijiazhuang, Hebei Province, China
| | - Y J Liu
- The Third Hospital of Hebei Medical University, The Provincial Key Laboratory for Orthopedic Biomechanics of Hebei, Shijiazhuang, Hebei Province, China
| | - W Wang
- The Third Hospital of Hebei Medical University, The Provincial Key Laboratory for Orthopedic Biomechanics of Hebei, Shijiazhuang, Hebei Province, China
| | - Y Z Zhang
- The Third Hospital of Hebei Medical University, The Provincial Key Laboratory for Orthopedic Biomechanics of Hebei, Shijiazhuang, Hebei Province, China
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