Associations among circulating colony-stimulating factor-1, estrogen, and bone mineral density in postmenopausal women: results from a randomized placebo-controlled trial

Elevated circulating levels of IL-34 are strongly associated with osteoporosis

In this cross-sectional study, we observed a strong, age-independent association of circulating interleukin-34 (IL-34) levels with osteoporosis.

PURPOSE

The reported capacity of IL-34 to induce and enhance osteoclastogenesis suggests its potential involvement in the pathogenesis of osteoporosis. Our study aimed to evaluate whether there is an association between IL-34 expression and osteoporosis.

METHODS

We enrolled 30 women with osteoporosis and 230 age-matched non-osteoporotic women as a control group. Osteoporosis diagnosis was based on dual-energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck. Body composition parameters were assessed by the bioimpedance method. Plasma IL-34 levels were measured by ELISA.

RESULTS

In comparison with the control group, the mean plasma IL-34 levels were significantly higher in osteoporotic women (164.61 ± 36.40 pg/ml vs. 665.43 ± 253.67 pg/ml, p = 0.0002), whereas basal metabolic rate (BMR) was significantly lower (1422.03 ± 6.80 kcal vs. 1339.39 ± 17.52 kcal, p = 0.00007). Both variables remained statistically significant after adjustment for age (p < 0.001). We did not observe correlations between plasma IL-34 levels and body composition parameters in osteoporotic and control groups. Multiple logistic regression analysis with osteoporosis status as a dependent variable clearly showed that age, BMR and IL-34 levels were independently and significantly associated with osteoporosis. The calculated odds ratios (OR) were 1.66 (95% CI = 1.16-2.38) for IL-34 levels and 0.22 (95% CI = 0.07-0.65) for BMR.

CONCLUSION

The significant (fourfold) elevation of IL-34 plasma levels in osteoporosis patients suggests that circulating IL-34 could be used as a biomarker for osteoporosis.

Selective deletion of the receptor for CSF1, c-fms, in osteoclasts results in a high bone mass phenotype, smaller osteoclasts in vivo and an impaired response to an anabolic PTH regimen

The receptor for Colony Stimulating Factor 1 (CSF1), c-fms, is highly expressed on mature osteoclasts suggesting a role for this cytokine in regulating the function of these cells. Consistent with this idea, in vitro studies have documented a variety of effects of CSF1 in mature osteoclasts. To better define the role of CSF1 in these cells, we conditionally deleted c-fms in osteoclasts (c-fms-OC^-/-) by crossing c-fms^flox/flox mice with mice expressing Cre under the control of the cathepsin K promoter. The c-fms-OC^-/- mice were of normal weight and had normal tooth eruption. However, when quantified by DXA, bone mass was significantly higher in the spine and femur of female knock out mice and in the femurs of male knock out mice. MicroCT analyses of femurs showed that female c-fms-OC^-/- mice had significantly increased trabecular bone mass with a similar trend in males and both sexes demonstrated significantly increased trabecular number and reduced trabecular spacing. Histomorphometric analysis of the femoral trabecular bone compartment demonstrated a trend towards increased numbers of osteoclasts, +26% in Noc/BPm and +22% in OcS/BS in the k/o animals but this change was not significant. However, when the cellular volume of osteoclasts was quantified, the c-fms-OC^-/- cells were found to be significantly smaller than controls. Mature osteoclasts show a marked spreading response when exposed to CSF1 in a non-gradient fashion. However, osteoclasts freshly isolated from c-fms-OC^-/- mice had a near complete abrogation of this response. C-fms-OC^-/- mice treated with (1–34)hPTH 80 ng/kg/d in single daily subcutaneous doses for 29 days showed an attenuated anabolic response in trabecular bone compared to wild-type animals. Taken together, these data indicate an important non-redundant role for c-fms in regulating mature osteoclast function in vivo.