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Yang Z, Wu Y, Neo SH, Yang D, Jeon H, Tee CA, Denslin V, Lin DJ, Lee EH, Boyer LA, Han J. Size-Based Microfluidic-Enriched Mesenchymal Stem Cell Subpopulations Enhance Articular Cartilage Repair. Am J Sports Med 2024; 52:503-515. [PMID: 38186352 DOI: 10.1177/03635465231214431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND The functional heterogeneity of culture-expanded mesenchymal stem cells (MSCs) has hindered the clinical application of MSCs. Previous studies have shown that MSC subpopulations with superior chondrogenic capacity can be isolated using a spiral microfluidic device based on the principle of inertial cell focusing. HYPOTHESIS The delivery of microfluidic-enriched chondrogenic MSCs that are consistent in size and function will overcome the challenge of the functional heterogeneity of expanded MSCs and will significantly improve MSC-based cartilage repair. STUDY DESIGN Controlled laboratory study. METHODS A next-generation, fully automated multidimensional double spiral microfluidic device was designed to provide more refined and efficient isolation of MSC subpopulations based on size. Analysis of in vitro chondrogenic potential and RNA sequencing was performed on size-sorted MSC subpopulations. In vivo cartilage repair efficacy was demonstrated in an osteochondral injury model in 12-week-old rats. Defects were implanted with MSC subpopulations (n = 6 per group) and compared with those implanted with unsegregated MSCs (n = 6). Osteochondral repair was assessed at 6 and 12 weeks after surgery by histological, micro-computed tomography, and mechanical analysis. RESULTS A chondrogenic MSC subpopulation was efficiently isolated using the multidimensional double spiral device. RNA sequencing revealed distinct transcriptomic profiles and identified differential gene expression between subpopulations. The delivery of a chondrogenic MSC subpopulation resulted in improved cartilage repair, as indicated by histological scoring, the compression modulus, and micro-computed tomography of the subchondral bone. CONCLUSION We have established a rapid, label-free, and reliable microfluidic protocol for more efficient size-based enrichment of a chondrogenic MSC subpopulation. Our proof-of-concept in vivo study demonstrates the enhanced cartilage repair efficacy of these enriched chondrogenic MSCs. CLINICAL RELEVANCE The delivery of microfluidic-enriched chondrogenic MSCs that are consistent in size and function can overcome the challenge of the functional heterogeneity of expanded MSCs, resulting in significant improvement in MSC-based cartilage repair. The availability of such rapid, label-free enriched chondrogenic MSCs can enable better cell therapy products for cartilage repair with improved treatment outcomes.
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Affiliation(s)
- Zheng Yang
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Department of Orthopaedic Surgery, National University of Singapore, Singapore, Singapore
- NUS Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Yingnan Wu
- Department of Orthopaedic Surgery, National University of Singapore, Singapore, Singapore
- NUS Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Shu Hui Neo
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
| | - Dahou Yang
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
| | - Hyungkook Jeon
- Department of Manufacturing Systems and Design Engineering, Seoul National University of Science and Technology, Seoul, Republic of Korea
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Ching Ann Tee
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
| | - Vinitha Denslin
- NUS Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Daryl Jimian Lin
- Department of Orthopaedic Surgery, National University of Singapore, Singapore, Singapore
- NUS Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Eng Hin Lee
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Department of Orthopaedic Surgery, National University of Singapore, Singapore, Singapore
- NUS Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Laurie A Boyer
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Jongyoon Han
- Critical Analytics for Manufacturing Personalized-Medicine Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore, Singapore
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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Roles of miR-196a and miR-196b in Zebrafish Motor Function. Biomolecules 2023; 13:biom13030554. [PMID: 36979489 PMCID: PMC10046552 DOI: 10.3390/biom13030554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
Background: The exertion of motor function depends on various tissues, such as bones and muscles. miR-196 has been widely studied in cancer and other fields, but its effect on bone and skeletal muscle is rarely reported. In order to explore the role of miR-196 family in bone and skeletal muscle, we used the previously successfully constructed miR-196a-1 and miR-196b gene knockout zebrafish animal models for research. Methods: The behavioral trajectories of zebrafish from 4 days post-fertilization (dpf) to 7 dpf were detected to analyze the effect of miR-196a-1 and miR-196b on motor ability. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were used to detect the dorsal muscle tissue of zebrafish. The bone tissue of zebrafish was detected by microcomputed tomography (micro-CT). Real-time PCR was used to detect the expression levels of related genes, including vcp, dpm1, acta1b, mylpfb, col1a1a, bmp8a, gdf6a, and fgfr3. Results: The behavioral test showed that the total behavioral trajectory, movement time, and movement speed of zebrafish larvae were decreased in the miR-196a-1 and miR-196b gene knockout lines. Muscle tissue analysis showed that the structure of muscle fibers in the zebrafish lacking miR-196a-1 and miR-196b was abnormal and was characterized by vacuolar degeneration of muscle fibers, intranuclear migration, melanin deposition, and inflammatory cell infiltration. Bone CT examination revealed decreased bone mineral density and trabecular bone number. The real-time PCR results showed that the expression levels of vcp, dpm1, gdf6a, fgfr3, and col1a1a were decreased in the miR-196b gene knockout group. The expression levels of dpm1, acta1b, mylpfb, gdf6a, and col1a1a were decreased, and the expression level of fgfr3 was increased in the miR-196b gene knockout group compared with the wild-type group. Conclusions: miR-196a-1 and miR-196b play an important role in muscle fiber structure, bone mineral density, and bone trabecular quantity by affecting the expression of vcp, dpm1, acta1b, mylpfb, gdf6a, fgfr3, and col1a1a and then affect the function of the motor system
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Neurosurgical Treatment and Outcome of Pediatric Skull Base Lesions: A Case Series and Review of the Literature. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020216. [PMID: 36832345 PMCID: PMC9954611 DOI: 10.3390/children10020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Pediatric skull base lesions occur rarely and are of various etiologies. Traditionally, open craniotomy has been the treatment of choice; however, nowadays, endoscopic approaches are increasingly applied. In this retrospective case series, we describe our experience in treating pediatric skull base lesions and provide a systematic overview of the literature on the treatment and outcome of pediatric skull base lesions. METHODS We conducted a retrospective data collection of all pediatric patients (<18 years) treated for a skull base lesion at the Division of Pediatric Neurosurgery, University Children's Hospital Basel, Switzerland, between 2015 and 2021. Descriptive statistics and a systematic review of the available literature were additionally conducted. RESULTS We included 17 patients with a mean age of 8.92 (±5.76) years and nine males (52.9%). The most common entity was sellar pathologies (n = 8 47.1%), with craniopharyngioma being the most common pathology (n = 4, 23.5%). Endoscopic approaches, either endonasal transsphenoidal or transventricular, were used in nine (52.9%) cases. Six patients (35.3%) suffered from transient postoperative complications, while in none of the patients these were permanent. Of the nine (52.9%) patients with preoperative deficits, two (11.8%) showed complete recovery and one (5.9%) partial recovery after surgery. After screening 363 articles, we included 16 studies with a total of 807 patients for the systematic review. The most common pathology reported in the literature confirmed our finding of craniopharyngioma (n = 142, 18.0%). The mean PFS amongst all the studies included was 37.73 (95% CI [36.2, 39.2]) months, and the overall weighted complication rate was 40% (95% CI [0.28 to 0.53] with a permanent complication rate of 15% (95% CI [0.08 to 0.27]. Only one study reported an overall survival of their cohort of 68% at five years. CONCLUSION This study highlights the rarity and heterogeneity of skull base lesions in the pediatric population. While these pathologies are often benign, achieving GTR is challenging due to the deep localization of the lesions and eloquent adjacent structures, leading to high complication rates. Therefore, skull base lesions in children require an experienced multidisciplinary team to provide optimal care.
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Shoaib Z, Fan TM, Irudayaraj J. Osteosarcoma mechanobiology and therapeutic targets. Br J Pharmacol 2021; 179:201-217. [PMID: 34679192 PMCID: PMC9305477 DOI: 10.1111/bph.15713] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022] Open
Abstract
Osteosarcoma (OS) is the one of the most common primary tumors of bone with less than a 20% 5-year survival rate after the development of metastases. OS is highly predisposed in Paget's disease (PD) of bone, and both have common characteristic skeletal features due to rapid bone remodeling. OS prognosis is location dependent which further emphasizes the likely contribution of the bone microenvironment in its pathogenesis. Mechanobiology is the phenomenon when mechanical cues from the changing physical microenvironment of bone are transduced to biological pathways through mechanosensitive cellular components. Mechanobiology-driven therapies have been used for curbing tumor progression by direct alteration of the physical microenvironment or inhibition of metastasis-associated mechanosensitive proteins. This review emphasizes the contribution of mechanobiology to OS progression, and sheds light on current mechanobiology-based therapies and potential new targets for improving disease management. Additionally, the variety of 3D models currently used to study OS mechanobiology are summarized.
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Affiliation(s)
- Zunaira Shoaib
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Timothy M Fan
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Joseph Irudayaraj
- Department of Bioengineering, Nick Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, IL, USA.,Biomedical Research Center, Carle Foundation Hospital, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL, USA
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İşeri Nepesov M, Kıral E, Bozan G, Kılıç Ö, Çarman KB, Yarar C, Şaylısoy S, Dinleyici EÇ. Brain Abscess in a Patient with Osteopetrosis: A Rare Complication. J Clin Res Pediatr Endocrinol 2021; 13:358-361. [PMID: 32840095 PMCID: PMC8388059 DOI: 10.4274/jcrpe.galenos.2020.2020.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Brain abscess formation is extremely rare in patients with osteopetrosis. Herein, we report a case of viridans streptococci brain abscess in an immunocompromised child diagnosed with osteopetrosis. The patient presented with a sudden change in mental status and convulsions. Radiological evaluation revealed a temporal lobe brain abscess, and intravenous antibiotherapy was started immediately. The patient underwent abscess drainage, and laboratory investigation of pus material revealed viridans streptococci.
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Affiliation(s)
- Merve İşeri Nepesov
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Eskişehir, Turkey
| | - Eylem Kıral
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
| | - Gürkan Bozan
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
| | - Ömer Kılıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Eskişehir, Turkey,* Address for Correspondence: Division of Pediatric Infectious Diseases, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey Phone: +90 222 239 29 79 E-mail:
| | - Kürşat Bora Çarman
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Neurology, Eskişehir, Turkey
| | - Coşkun Yarar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Neurology, Eskişehir, Turkey
| | - Suzan Şaylısoy
- Eskişehir Osmangazi University Faculty of Medicine, Department of Radiology, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
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Computed Tomography Diagnostic of Uncommon Case of Osteopetrosis in 80-Year-Old Man-Case Report. MEDICINA-LITHUANIA 2020; 56:medicina56100518. [PMID: 33023136 PMCID: PMC7601162 DOI: 10.3390/medicina56100518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: During osteopetrosis course, impaired bone remodeling induces skeletal osteosclerosis and abnormally dense bones, which, however, are brittle and susceptible to low-energy fractures. In this study, radiological evaluation and densitometric measurements of several bones of the skeleton in one of the oldest patients in the world suffering from osteopetrosis was presented. Materials and Methods: Volumetric bone mineral density measurements of the examined bones in an 80-year-old man were performed using two different quantitative computed tomography techniques. Results: The obtained results show higher values of the volumetric bone mineral density of the trabecular bone in lumbar spine than in the cortical bone compartment. T-score and Z-score in this patient reached values of 27–28 and 31–32, respectively. Conclusions: The obtained densitometric data may serve for further diagnostic purposes of osteopetrosis. As documented, the severity of the osteosclerotic changes of bones were higher in this patient than in most other described cases. Moreover, radiological signs diagnosed in this patient were characteristic for all types of osteopetrosis making this case very uncommon.
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Quist EM, Doan R, Pool RR, Porter BF, Bannasch DL, Dindot SV. Identification of a Candidate Mutation in the COL1A2 Gene of a Chow Chow With Osteogenesis Imperfecta. J Hered 2019; 109:308-314. [PMID: 29036614 DOI: 10.1093/jhered/esx074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/18/2017] [Indexed: 01/08/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a genetic disease that occurs in humans and animals. Individuals with OI exhibit signs of extreme bone fragility and osteopenia with frequent fractures and perinatal lethality in severe cases. In this study, we report the clinical diagnosis of OI in a dog and the use of targeted next-generation sequencing to identify a candidate autosomal dominant mutation in the COL1A2 gene. A 5-month-old male Chow Chow was examined with a fractured left humerus and resolving, bilateral femoral fractures. Radiographs revealed generalized osteopenia and bilateral humeral, radial, and femoral fractures. Targeted next-generation sequencing of genes associated with OI in humans (COL1A1, COL1A2, LEPRE1, SERPINH1, and CRTAP) revealed a G>A heterozygous mutation in the splice donor site of exon 18 of the COL1A2 gene (c.936 + 1G>A). The splice donor mutation was not detected among 91 control dogs representing 21 breeds. A comparative analysis of exon 18 and the exon-intron junction further showed that the mutated splice donor site is conserved among vertebrates. Altogether, these findings reveal a candidate autosomal splice donor site mutation causing OI in an individual Chow Chow.
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Affiliation(s)
- Erin M Quist
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Ryan Doan
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Roy R Pool
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Brian F Porter
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Danika L Bannasch
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA
| | - Scott V Dindot
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
- Department of Molecular and Cellular Medicine, College of Medicine, Texas A&M Health Science Center, College Station, TX
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Paccou J, Michou L, Kolta S, Debiais F, Cortet B, Guggenbuhl P. High bone mass in adults. Joint Bone Spine 2018; 85:693-699. [PMID: 29407041 DOI: 10.1016/j.jbspin.2018.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2017] [Indexed: 02/07/2023]
Abstract
A finding of high bone mineral density (BMD) from routine dual-energy X-ray absorptiometry (DXA) screening is not uncommon. No consensus exists about the definition of high BMD, and T-score and/or Z-score cutoffs of ≥+2.5 or ≥+4 have been suggested. The many disorders that can result in high BMD are usually classified based on whether the BMD changes are focal vs. generalized or acquired vs. constitutional. In over half the cases, careful interpretation of the DXA report and images identifies the cause as an artefact (e.g., degenerative spinal disease, vascular calcifications, or syndesmophytes) or focal lesion (e.g., sclerotic bone metastasis or Paget's disease). Generalized acquired high BMD may be secondary to a diverse range of disorders such as fluorosis, diffuse bone sclerosis related to renal osteodystrophy, hematological diseases, and hepatitis C. Identification of the cause may require additional investigations such as imaging studies, serum tryptase assay, or serological tests for the hepatitis C virus. Finally, high BMD is a feature of many genetic diseases, most notably osteopetrosis and the disorders caused by mutations in the sclerostin gene SOST (sclerosing bone dysplasia and van Buchem disease) or in the LRP5 gene encoding the low-density lipoprotein receptor-related protein 5 (which is the Wnt co-receptor).
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Affiliation(s)
- Julien Paccou
- Département de rhumatologie, université de Lille, 59000 Lille, France; PMOI, EA 4490, 59000 Lille, France.
| | - Laetitia Michou
- Division de rhumatologie, département de médecine, CHU de Québec, université Laval, Québec, G1V4G2 QC, Canada
| | - Sami Kolta
- Inserm, U 1153, département de rhumatologie, hôpital Cochin, Université Paris Descartes, 75014 Paris, France
| | - Françoise Debiais
- Service de rhumatologie, CHU de Poitiers, 2, rue de La-Milétrie, BP 577, 86021 Poitiers cedex, France
| | - Bernard Cortet
- Département de rhumatologie, université de Lille, 59000 Lille, France; PMOI, EA 4490, 59000 Lille, France
| | - Pascal Guggenbuhl
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; Inserm UMR 991, 35043 Rennes, France; Université Rennes 1, faculté de médecine, 35043 Rennes, France
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Santos MCD, Pires AF, Soares K, Barros L. Family experience with osteogenesis imperfecta type 1: the most distressing situations. Disabil Rehabil 2017; 40:2281-2287. [DOI: 10.1080/09638288.2017.1334236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Margarida Custódio dos Santos
- Faculdade de Psicologia, Universidade de Lisboa, Lisbao, Portugal
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbao, Portugal
| | - Ana Filipa Pires
- Faculdade de Psicologia, Universidade de Lisboa, Lisbao, Portugal
| | - Kelly Soares
- Faculdade de Psicologia, Universidade de Lisboa, Lisbao, Portugal
| | - Luísa Barros
- Faculdade de Psicologia, Universidade de Lisboa, Lisbao, Portugal
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Loss of stat3 function leads to spine malformation and immune disorder in zebrafish. Sci Bull (Beijing) 2017; 62:185-196. [PMID: 36659403 DOI: 10.1016/j.scib.2017.01.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 11/22/2016] [Accepted: 12/08/2016] [Indexed: 01/21/2023]
Abstract
STAT (Signal Transducers and Activators of Transcription) gene family members have been revealed to be involved in cell growth and differentiation in vertebrates. Despite their physiological importance, their functions are poorly studied at organ and systemic levels. In this study, we performed a genome-wide analysis using data from invertebrates to vertebrates to identify STAT genes and analyze their evolutionary history. Interestingly, the STAT gene family undergoes genome duplications during the evolutionary history with STAT3 homologues firstly appearing in the basal extant vertebrate, sea lamprey, suggesting its possible roles in spine formation. To investigate the functions of stat3 in fish species, TALEN technology was performed to generate mutant zebrafish lines. Stat3 mutant zebrafish showed no obvious defects at early developmental stage but displayed severe lateral and vertical curvature of the spine (scoliosis), spine fracture and the incomplete bone joints with narrower junction between vertebrae at early juvenile stage, as indicated by Alizarin red and Alcian blue staining, radiography and micro-computed tomography (MicroCT) analysis. Transcriptome analysis reveals dramatic alterations in a number of genes involved in immune and infection response, skeletal development and somatic growth, especially downregulated expression of collagen gene family, in the juvenile stat3 mutant zebrafish. Moreover, most of the collagen genes were detected to have abnormal expression pattern during the formation of spine deformities in stat3 mutants. Our data reveal that stat3 is specially expressed in vertebrates and required for normal spine development and immune function in zebrafish.
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Lin WD, Wang CH, Wu KH, Chou IC, Tsai FJ. Identification and Characterization of Mutations in the CLCN7 Gene in a Taiwanese Patient with Infantile Malignant Osteopetrosis. Pediatr Neonatol 2016; 57:155-7. [PMID: 26365571 DOI: 10.1016/j.pedneo.2015.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/15/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Wei-De Lin
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chung-Hsing Wang
- Department of Genetics and Metabolism, Children's Hospital of China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Kang-His Wu
- Department of Hematology-Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - I-Ching Chou
- Department of Neurology, Children's Hospital of China Medical University, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Department of Genetics and Metabolism, Children's Hospital of China Medical University, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Medical Genetics, China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan.
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Mackenroth L, Fischer-Zirnsak B, Egerer J, Hecht J, Kallinich T, Stenzel W, Spors B, von Moers A, Mundlos S, Kornak U, Gerhold K, Horn D. An overlapping phenotype of Osteogenesis imperfecta and Ehlers-Danlos syndrome due to a heterozygous mutation in COL1A1
and biallelic missense variants in TNXB
identified by whole exome sequencing. Am J Med Genet A 2016; 170A:1080-5. [DOI: 10.1002/ajmg.a.37547] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 12/21/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Luisa Mackenroth
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
- Faculty of Medicine Carl Gustav Carus; Institute for Clinical Genetics; Dresden Germany
| | - Björn Fischer-Zirnsak
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
- Max-Planck-Institut für Molekulare Genetik; Berlin Germany
| | - Johannes Egerer
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Jochen Hecht
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Tilmann Kallinich
- Department of Pediatric Pneumology and Immunology; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Werner Stenzel
- Institute for Neuropathology; Charité; Universitätsmedizin Berlin; Berlin Germany
| | - Birgit Spors
- Department of Radiology; Charité; Universitätsmedizin Berlin; Berlin Germany
| | | | - Stefan Mundlos
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
- Max-Planck-Institut für Molekulare Genetik; Berlin Germany
| | - Uwe Kornak
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
- Max-Planck-Institut für Molekulare Genetik; Berlin Germany
| | - Kerstin Gerhold
- Department of Pediatric Pneumology and Immunology; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Denise Horn
- Institute of Medical and Human Genetics; Charité-Universitätsmedizin Berlin; Berlin Germany
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Tosi LL, Warman ML. Mechanistic and therapeutic insights gained from studying rare skeletal diseases. Bone 2015; 76:67-75. [PMID: 25819040 DOI: 10.1016/j.bone.2015.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 03/19/2015] [Indexed: 12/14/2022]
Abstract
Rare bone diseases account for 5% of all birth defects and can cause significant morbidity throughout patients' lives. Significant progress is being made to elucidate the pathophysiological mechanisms underlying these diseases. This paper summarizes presentation highlights of a workshop on Rare Skeletal Diseases convened to explore how the study of rare diseases has influenced the field's understanding of bone anabolism and catabolism and directed the search for new therapies benefiting patients with rare conditions as well as patients with common skeletal disorders.
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Affiliation(s)
- Laura L Tosi
- Division of Orthopaedics and Sports Medicine, Children's National Health System, 111 Michigan Avenue NW, Washington, DC 20010, USA.
| | - Matthew L Warman
- Orthopaedic Research Laboratories, Boston Children's Hospital, 320 Longwood Avenue, Room EN260.1, Boston, MA 02115, USA.
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Kulyapina A, Verdaguer Martin J, Navarro Cuellar C, Navarro Vila C. Long-Term Follow-Up of Bimaxillary Osteomyelitis Associated with Autosomal Dominant Osteopetrosis: A Case Report. J Maxillofac Oral Surg 2015; 15:121-6. [PMID: 26929564 DOI: 10.1007/s12663-015-0749-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 01/20/2015] [Indexed: 11/25/2022] Open
Abstract
Osteopetrosis (OP) is a rare metabolic bone disease characterized by a generalized increase in skeletal mass. The disease is characterized by increased susceptibility to develop osteomyelitis of the jaws. We report a case of clinical and radiological progression of bimaxillary osteomyelitis in a patient with autosomal dominant OP. The patient presented non simultaneous osteomyelitis in both upper and lower jaws with time interval of 10 years. The osteomyelitis of maxilla resulted in oroantral fistula formation and required surgical closure with Bichat fat pad flap. The mandibular osteomyelitis resulted in sequestra formation and pathological fracture and required multiple debridement procedures. Both maxillary and mandibular osteomyelitic foci were persistent and healing required more than 2 years. The case confirms the possibility of development of non simultaneous bimaxillary osteomyelitis in patients with OP. The case enhances the need of close follow- up and preventive measures in patients with OP.
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Affiliation(s)
- A Kulyapina
- Department of Maxillofacial Surgery, Gregorio Marañón General University Hospital, C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - J Verdaguer Martin
- Department of Maxillofacial Surgery, Gregorio Marañón General University Hospital, C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - C Navarro Cuellar
- Department of Maxillofacial Surgery, Gregorio Marañón General University Hospital, C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - C Navarro Vila
- Department of Maxillofacial Surgery, Gregorio Marañón General University Hospital, C/Doctor Esquerdo 46, 28007 Madrid, Spain
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15
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Cooley MA, Harikrishnan K, Oppel JA, Miler SF, Barth JL, Haycraft CJ, Reddy SV, Scott Argraves W. Fibulin-1 is required for bone formation and Bmp-2-mediated induction of Osterix. Bone 2014; 69:30-8. [PMID: 25201465 PMCID: PMC4385289 DOI: 10.1016/j.bone.2014.07.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 07/22/2014] [Accepted: 07/27/2014] [Indexed: 01/16/2023]
Abstract
The extracellular matrix protein Fibulin-1 (Fbln1) has been shown to be involved in numerous processes including cardiovascular and lung development. Here we have examined the role of Fbln1 in bone formation. Alizarin red staining of skulls from Fbln1-deficient mice showed reduced mineralization of both membranous and endochondral bones. MicroCT (μCT) analysis of the calvarial bones (i.e., frontal, parietal and interparietal bones collectively) indicated that bone volume in Fbln1 nulls at neonatal stage P0 were reduced by 22% (p=0.015). Similarly, Fbln1 null frontal bones showed a 16% (p=0.035) decrease in bone volume, with a reduction in the interfrontal bone, and a discontinuity in the leading edge of the frontal bone. To determine whether Fbln1 played a role in osteoblast differentiation during bone formation, qPCR was used to measure the effects of Fbln1 deficiency on the expression of Osterix (Osx), a transcription factor essential for osteoblast differentiation. This analysis demonstrated that Osx mRNA was significantly reduced in Fbln1-deficient calvarial bones at developmental stages E16.5 (p=0.049) and E17.5 (p=0.022). Furthermore, the ability of Bmp-2 to induce Osx expression was significantly diminished in Fbln1-deficient mouse embryo fibroblasts. Together, these findings indicate that Fbln1 is a new positive modulator of the formation of membranous bone and endochondral bone in the skull, acting as a positive regulator of Bmp signaling.
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Affiliation(s)
- Marion A Cooley
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Keerthi Harikrishnan
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - James A Oppel
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Sloan F Miler
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jeremy L Barth
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Courtney J Haycraft
- Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Sakamuri V Reddy
- Charles P. Darby Children's Research Institute, Medical University of South Carolina, Charleston, SC 29425, USA
| | - W Scott Argraves
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
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16
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Guay-Bélanger S, Picard S, Gagnon E, Morissette J, Siris ES, Orcel P, Brown JP, Michou L. Detection of SQSTM1/P392L post-zygotic mutations in Paget's disease of bone. Hum Genet 2014; 134:53-65. [PMID: 25241215 PMCID: PMC4282700 DOI: 10.1007/s00439-014-1488-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 09/10/2014] [Indexed: 01/30/2023]
Abstract
Paget’s disease of bone (PDB) is transmitted, in one-third of cases, in an autosomal dominant mode of inheritance with incomplete penetrance. The SQSTM1/P392L germinal mutation is the most common mutation associated with PDB. Given the focal nature of PDB, one team of investigators showed that SQSTM1/P392L somatic mutations could occur in pagetic bone lesions in the absence of germinal mutations detectable in the peripheral blood. The objectives of this study were to develop a reliable method to detect SQSTM1/P392L post-zygotic mutations, by optimizing a polymerase chain reaction (PCR)-clamping method reported to be effective in detecting post-zygotic mutations in peripheral blood from patients with fibrous dysplasia; and to evaluate the frequency of this post-zygotic mutation in PDB patients. We used a locked nucleic acid (LNA) specifically designed for the SQSTM1/P392L mutation, which blocks the wild-type allele amplification during the PCR. DNA from 376 pagetic patients and 297 controls, all without any SQSTM1/P392L germinal mutation, was analyzed. We found that 4.8 % of PDB patients and 1.4 % of controls were carriers of this post-zygotic mutation [p = 0.013, OR 3.68 (1.23; 11.00)]. PDB patient carriers of a post-zygotic mutation had a lower number of affected bones and Renier’s index than patients carrying a germinal mutation, suggesting a lower disease extension. We also demonstrated that this post-zygotic mutation was restricted to the monocytic lineage. These results confirmed that LNA PCR clamping is effective for the detection of SQSTM1/P392L post-zygotic mutations, which may occur in patients with PDB.
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Affiliation(s)
- Sabrina Guay-Bélanger
- CHU de Québec Research Centre, Rhumatologie-R4774, CHU de Québec, 2705 boulevard Laurier, Québec, QC, G1V 4G2, Canada
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17
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Imbert L, Aurégan JC, Pernelle K, Hoc T. Mechanical and mineral properties of osteogenesis imperfecta human bones at the tissue level. Bone 2014; 65:18-24. [PMID: 24803077 DOI: 10.1016/j.bone.2014.04.030] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/18/2014] [Accepted: 04/25/2014] [Indexed: 12/12/2022]
Abstract
Osteogenesis imperfecta (OI) is a genetic disorder characterized by an increase in bone fragility on the macroscopic scale, but few data are available to describe the mechanisms involved on the tissue scale and the possible correlations between these scales. To better understand the effects of OI on the properties of human bone, we studied the mechanical and chemical properties of eight bone samples from children suffering from OI and compared them to the properties of three controls. High-resolution computed tomography, nanoindentation and Raman microspectroscopy were used to assess those properties. A higher tissue mineral density was found for OI bone (1.131 gHA/cm3 vs. 1.032 gHA/cm3, p=0.032), along with a lower Young's modulus (17.6 GPa vs. 20.5 GPa, p=0.024). Obviously, the mutation-induced collagen defects alter the collagen matrix, thereby affecting the mineralization. Raman spectroscopy showed that the mineral-to-matrix ratio was higher in the OI samples, while the crystallinity was lower, suggesting that the mineral crystals were smaller but more abundant in the case of OI. This change in crystal size, distribution and composition contributes to the observed decrease in mechanical strength.
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Affiliation(s)
- Laurianne Imbert
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France
| | - Jean-Charles Aurégan
- Department of Pediatric Orthopedics, Necker - Enfants Malades Hospital, AP-HP, Paris Descartes University, 145 rue de Sèvres, 75014 Paris, France; B2OA UMR CNRS 7052, University Paris-Diderot, 10 avenue de Verdun, 75010 Paris, France
| | - Kélig Pernelle
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France
| | - Thierry Hoc
- LTDS UMR CNRS 5513, Ecole Centrale Lyon, 36 avenue Guy de Collongue, 69134 Ecully, France.
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18
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Jenkins PF, Prieto P, Tang RA, Yousefi S. Osteopetrosis. THE AMERICAN ORTHOPTIC JOURNAL 2013; 63:107-11. [PMID: 24141761 DOI: 10.3368/aoj.63.1.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Osteopetrosis is a rare disease that occurs when a child has an unequal balance between new bone growth and elimination of old bone. Children with this entity are able to make new bone tissue, but are not able to break down and eliminate old bones, which is essential for normal bone growth. These thickened and enlarged bones are very weak. These children can exhibit: failure to thrive, macrocephaly, anemia, deafness, and blindness. We will present a case of osteopetrosis, esotropia, and amblyopia of a 7-year-old boy and will discuss the pathophysiology and treatment.
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Affiliation(s)
- Patricia F Jenkins
- From Neuro-Ophthalmology of Texas, University of Houston, Houston, Texas
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19
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[Is orthognathic surgery an alternative for mandibular osteopetrosis?]. ACTA ACUST UNITED AC 2013; 114:43-5. [PMID: 23711216 DOI: 10.1016/j.revsto.2012.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 12/19/2011] [Accepted: 12/21/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Osteopetrosis is a metabolic bone disease that leads to bone malformation and bone healing disorders. We report the case of a patient who underwent orthognathic surgery to treat a class III skeletal malocclusion. OBSERVATION A 21-year-old patient had presented with osteopetrosis in his childhood, which had been treated by bone marrow transplantation. He presented with esthetic and functional sequels, a class III skeletal malocclusion, lateral mandibular deviation, and dental agenesis. This dysmorphism was corrected by bimaxillar osteotomy. The postoperative outcome was uneventful, with satisfactory and stable healing. DISCUSSION The patient's lesions where after-effects of his disease, but the bone structure is normal, because osteopetrosis regressed after bone marrow transplantation. There is no risk for the consolidation. Osteopetrosis, even when treated by bone marrow transplantation, is not a contraindication for maxillomandibular osteotomy.
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20
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Abstract
OBJECTIVE Fibrous dysplasia of bone and primary hyperparathyroidism (PHPT) may occur in patients with McCune-Albright Syndrome. A small number of cases with both diagnoses that are not associated with the above-mentioned genetic disorder have been published in the literature. It is uncertain if these disorders are linked in some way. In the present study, we aimed to further explore a potential relationship between PHPT and fibrous dysplasia of bone. METHODS We conducted a retrospective review of all cases seen at Mayo Clinic, Rochester, Minnesota, between 1976 and 2011 that were diagnosed with both PHPT and fibrous dysplasia of bone. RESULTS We identified 10 patients who were diagnosed with both PHPT and fibrous dysplasia of bone. Fibrous dysplasia was polyostotic in 7 (70%) cases. It affected the lower extremities in 6 (60%) patients, the skull or facial bones in 4 (40%), and was localized to one rib in 1 patient (10%). In 4 patients, fibrous dysplasia was diagnosed first, between 9 to 50 years before being diagnosed with PHPT. Two cases of fibrous dysplasia were recognized between 2 and 5 years after the diagnosis of PHPT. The remaining 4 patients were diagnosed with both conditions at approximately the same time. CONCLUSION It remains unclear if the association between fibrous dysplasia of bone and PHPT is more than coincidental, although the possibility of a rare familial genetic syndrome is not completely excluded.
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Affiliation(s)
- Adina F Turcu
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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21
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New insights into adhesion signaling in bone formation. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2013; 305:1-68. [PMID: 23890379 DOI: 10.1016/b978-0-12-407695-2.00001-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Mineralized tissues that are protective scaffolds in the most primitive species have evolved and acquired more specific functions in modern animals. These are as diverse as support in locomotion, ion homeostasis, and precise hormonal regulation. Bone formation is tightly controlled by a balance between anabolism, in which osteoblasts are the main players, and catabolism mediated by the osteoclasts. The bone matrix is deposited in a cyclic fashion during homeostasis and integrates several environmental cues. These include diffusible elements that would include estrogen or growth factors and physicochemical parameters such as bone matrix composition, stiffness, and mechanical stress. Therefore, the microenvironment is of paramount importance for controlling this delicate equilibrium. Here, we provide an overview of the most recent data highlighting the role of cell-adhesion molecules during bone formation. Due to the very large scope of the topic, we focus mainly on the role of the integrin receptor family during osteogenesis. Bone phenotypes of some deficient mice as well as diseases of human bones involving cell adhesion during this process are discussed in the context of bone physiology.
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22
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Giannini C, Siliqi D, Bunk O, Beraudi A, Ladisa M, Altamura D, Stea S, Baruffaldi F. Correlative light and scanning X-ray scattering microscopy of healthy and pathologic human bone sections. Sci Rep 2012; 2:435. [PMID: 22666538 PMCID: PMC3364490 DOI: 10.1038/srep00435] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 05/11/2012] [Indexed: 11/09/2022] Open
Abstract
Scanning small and wide angle X-ray scattering (scanning SWAXS) experiments were performed on healthy and pathologic human bone sections. Via crystallographic tools the data were transformed into quantitative images and as such compared with circularly polarized light (CPL) microscopy images. SWAXS and CPL images allowed extracting information of the mineral nanocrystalline phase embedded, with and without preferred orientation, in the collagen fibrils, mapping local changes at sub-osteon resolution. This favorable combination has been applied for the first time to biopsies of dwarfism syndrome and Paget's disease to shed light onto the cortical structure of natural bone in healthy and pathologic sections.
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Affiliation(s)
- C Giannini
- Istituto di Cristallografia-IC-CNR, via Amendola 122/O, I-70126 Bari, Italy.
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23
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Abstract
PURPOSE OF REVIEW The review summarizes the recent findings relevant to the clinical management, genetic predisposition, and molecular mechanisms implicated in Paget's disease of bone (PDB). RECENT FINDINGS PDB is characterized by focal regions of increased bone remodeling and abnormal bone architecture. PDB is treated effectively with amino-bisphosphonates, which can produce very prolonged disease remission. The disease has a strong genetic component and a large number of studies focus on the cellular mechanisms affected by mutations in the SQSTM1 (sequestosome 1) gene which are associated with PDB. Identifying other genes associated with PDB is an additional active research focus. SUMMARY In recent years, there has been a great progress in the understanding of the epidemiology, genetics and molecular biology of PDB. However, an integrative view of the disease cause is still missing and is likely to be attained only with further discoveries of genetic factors, environmental factors, and the interactions between them. Investigations of the cellular mechanisms that are disrupted in PDB contribute greatly to the understanding of normal bone remodeling.
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Affiliation(s)
- Dorit Naot
- Department of Medicine, University of Auckland, Auckland, New Zealand.
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