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Alshdefat A, Nashwan AJ, Al Bibi H. A rare case of pycnodysostosis during pregnancy. Clin Case Rep 2022; 10:e6565. [PMCID: PMC9638073 DOI: 10.1002/ccr3.6565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/31/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
We describe a case in which a 41‐year‐old pregnant female with pycnodysostosis presented for elective cesarean section at week 37 + 5 of pregnancy. This is the first reported case of pycnodysostosis during pregnancy in Oman, to the author's best knowledge.
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Affiliation(s)
- Aisha Alshdefat
- Maternal and Child Health DepartmentCollege of Nursing, Sultan Qaboos UniversityMuscatOman
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Fang F, Ni Y, Yu H, Yin H, Yang F, Li C, Sun D, Pei T, Ma J, Deng L, Zhang H, Wang G, Li S, Shen Y, Liu X. Inflammatory endothelium-targeted and cathepsin responsive nanoparticles are effective against atherosclerosis. Am J Cancer Res 2022; 12:4200-4220. [PMID: 35673565 PMCID: PMC9169363 DOI: 10.7150/thno.70896] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Rationale: Atherosclerosis is characterized by lipid accumulation, plaque formation, and artery stenosis. The pharmacological treatment is a promising therapy for atherosclerosis, but this approach faces major challenges such as targeted drug delivery, controlled release, and non-specific clearance. Methods: Based on the finding that the cathepsin k (CTSK) enzyme is enriched in atherosclerotic lesions, we constructed an integrin αvβ3 targeted and CTSK-responsive nanoparticle to control the release of rapamycin (RAP) locally. The targeted and responsive nanoparticles (T/R NPs) were engineered by the self-assembly of a targeting polymer PLGA-PEG-c(RGDfC) and a CTSK-sensitive polymer PLGA-Pep-PEG. PLGA-Pep-PEG was also modified with a pair of FRET probe to monitor the hydrolysis events. Results: Our results indicated that RAP@T/R NPs accelerated the release of RAP in response to CTSK stimulation in vitro, which significantly inhibited the phagocytosis of OxLDL and the release of cytokines by inflammatory macrophages. Additionally, T/R NPs had prolonged blood retention time and increased accumulation in the early and late stage of atherosclerosis lesions. RAP@T/R NPs significantly blocked the development of atherosclerosis and suppressed the systemic and local inflammation in ApoE-/- mice. Conclusions: RAP@T/R NPs hold a great promise as a drug delivery system for safer and more efficient therapy of atherosclerosis.
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Affiliation(s)
- Fei Fang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China.,Department of Bioengineering and Department of Medicine, University of California, Los Angeles, Los Angeles 90001, USA
| | - Yinghao Ni
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Hongchi Yu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Hongmei Yin
- West China School of Pharmacy, Sichuan University, Chengdu 610041, China
| | - Fan Yang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Chunli Li
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Denglian Sun
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Tong Pei
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Jia Ma
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Li Deng
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Huaiyi Zhang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing 400030, China
| | - Song Li
- Department of Bioengineering and Department of Medicine, University of California, Los Angeles, Los Angeles 90001, USA
| | - Yang Shen
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Xiaoheng Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
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Yang YS, Xie J, Chaugule S, Wang D, Kim JM, Kim J, Tai PW, Seo SK, Gravallese E, Gao G, Shim JH. Bone-Targeting AAV-Mediated Gene Silencing in Osteoclasts for Osteoporosis Therapy. Mol Ther Methods Clin Dev 2020; 17:922-935. [PMID: 32405514 PMCID: PMC7210389 DOI: 10.1016/j.omtm.2020.04.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/13/2020] [Indexed: 12/26/2022]
Abstract
Improper activity of bone-resorbing osteoclasts results in low bone density and deterioration of bone structure, which increase the risk of fractures. Anti-resorptive therapies targeting osteoclasts have proven effective in preserving bone mass, but these therapeutic agents lead to defective new bone formation and numerous potential side effects. In this study, we demonstrate that recombinant adeno-associated virus, serotype 9 (rAAV9) can deliver to osteoclasts an artificial microRNA (amiR) that silences expression of key osteoclast regulators, RANK (receptor activator for nuclear factor κB) and cathepsin K (rAAV9.amiR-rank, rAAV9.amiR-ctsk), to prevent bone loss in osteoporosis. As rAAV9 is highly effective for the transduction of osteoclasts, systemic administration of rAAV9 carrying amiR-rank or amiR-ctsk results in a significant increase of bone mass in mice. Furthermore, the bone-targeting peptide motif (Asp)14 or (AspSerSer)6 was grafted onto the AAV9-VP2 capsid protein, resulting in significant reduction of transgene expression in non-bone peripheral organs. Finally, systemic delivery of bone-targeting rAAV9.amiR-ctsk counteracts bone loss and improves bone mechanical properties in mouse models of postmenopausal and senile osteoporosis. Collectively, inhibition of osteoclast-mediated bone resorption via bone-targeting rAAV9-mediated silencing of ctsk is a promising gene therapy that can preserve bone formation and mitigate osteoporosis, while limiting adverse off-target effects.
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Affiliation(s)
- Yeon-Suk Yang
- Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jun Xie
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA
- Viral Vector Core, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sachin Chaugule
- Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Dan Wang
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jung-Min Kim
- Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA, USA
| | - JiHea Kim
- Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Phillip W.L. Tai
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA
| | - Seok-kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ellen Gravallese
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA, USA
| | - Guangping Gao
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA
- Viral Vector Core, University of Massachusetts Medical School, Worcester, MA, USA
- Li Weibo Institute for Rare Diseases Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jae-Hyuck Shim
- Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA, USA
- Li Weibo Institute for Rare Diseases Research, University of Massachusetts Medical School, Worcester, MA, USA
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Abstract
RATIONALE Pycnodysostosis is a rare autosomal recessive skeletal dysplasia caused by a mutation in the cathepsin K encoded by cathepsin K gene (CTSK). Medullary thyroid carcinoma (MTC) is also a relatively rare type of primary thyroid carcinoma. PATIENT CONCERNS A 31-year-old woman presenting a short stature and a palpable nodule in the front of her neck that had gradually increased in size during the last 2 years was referred to our department. She has experienced multiple fractures at lower limbs in the last 2 decades. DIAGNOSES The patient's clinical examination revealed short stature, underweight, a prominent forehead, stubby fingers, and a fixed nodule in the right thyroid lobe. Intraoral examination revealed multiple clinically malposed and missing teeth, as well as chronic periodontitis with a narrow and grooved palate. Radiographic examination revealed typical widely separated cranial sutures and an open anterior/posterior fontanel with an obtuse gonial angle, acroosteolysis, and osteosclerosis with narrowed medullary cavities. Ultrasonography of the thyroid gland showed a marked hypoechoic solid nodule in the right lobe in which tumor cell clusters were confirmed by ultrasound-guided fine needle aspiration biopsy and was suspected to be MTC. Laboratory tests revealed dramatically elevated serum calcitonin >2000 pg/L (reference range: 0-5 pg/L) and carcinoembryonic antigen (CEA) 134.37 ng/mL (reference range: 0-5 ng/mL). Genotypic screening revealed compound heterozygous mutations in the CTSK gene (c.158delA, P.Asn53Thr/c.C830T, P.Ala277Val) but no mutation associated with the familial forms of MTC. INTERVENTIONS The patient underwent a total thyroidectomy with right-sided functional neck dissection. OUTCOMES CEA and serum calcitonin decreased significantly postthyroidectomy, and no further fracture has been reported by the patient so far. LESSONS The present study is the first to report a rare case of the coexistence of pycnodysostosis with a compound CTSK gene mutation and sporadic MTC. Radiological techniques and gene analysis play key roles in the definitive diagnosis.
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Affiliation(s)
- Xiulin Shi
- Department of Endocrinology and Diabetes
| | - Caoxin Huang
- Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | | | - Wei Liu
- Department of Endocrinology and Diabetes
| | | | - Xuejun Li
- Department of Endocrinology and Diabetes
- Xiamen Diabetes Institute, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
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Abstract
RATIONALE Pycnodysostosis is a rare autosomal recessive skeletal dysplasia characterized by short stature, craniofacial dysmorphism, acro-osteolysis, osteosclerosis, and brittle bone with poor healing. Pycnodysostosis results from the deficient activity of cathepsin K, a lysosomal cysteine protease that is encoded by CTSK. PATIENT CONCERNS We report a Korean adult patient with pycnodysostosis and atypical femur fracture whose diagnosis was confirmed by next-generation sequencing (NGS) of candidate genes. A 41-year-old female patient was presented with a left femur fracture after falling down. Underlying sclerotic bone disease was suspected as a radiographic skeletal survey showed thickened cortical bones, and the total body bone density was increased (T score was 5.3, and Z score was 4.9). DIAGNOSES We performed candidate gene sequencing of various sclerotic bone diseases for the differential molecular diagnosis of underlying sclerosing bone disease. Two heterozygous variants of CTSK were detected. One was a frameshift variant in exon 5, c.426delT (p.Phe142Leufs*19), which was previously reported, and the other was a novel missense variant in exon 6, c.755G>A (p.Ser252Asn). Sanger sequencing of CTSK confirmed the 2 heterozygous variants and thus the patient was diagnosed with pycnodysostosis. INTERVENTIONS The patient had emergency surgery for subtrochantic femoral fracture. OUTCOMES After 4 months of surgery, the patient had almost a full range of hip and knee movements and radiographs show the substantial bridging callus across the fracture. LESSONS Candidate gene sequencing could be a useful diagnostic tool for the genetically heterogeneous skeletal dysplasia group, especially in cases with a mild or atypical clinical phenotype.
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Affiliation(s)
| | | | - Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University Hospital, Ajou University School of Medicine, Suwon
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Herroon MK, Sharma R, Rajagurubandara E, Turro C, Kodanko JJ, Podgorski I. Photoactivated inhibition of cathepsin K in a 3D tumor model. Biol Chem 2016; 397:571-82. [PMID: 26901495 PMCID: PMC5901740 DOI: 10.1515/hsz-2015-0274] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/16/2016] [Indexed: 12/28/2022]
Abstract
Collagenolytic activity of cathepsin K is important for many physiological and pathological processes including osteoclast-mediated bone degradation, macrophage function and fibroblast-mediated matrix remodeling. Here, we report application of a light-activated inhibitor for controlling activity of cathepsin K in a 3D functional imaging assay. Using prostate carcinoma cell line engineered to overexpress cathepsin K, we demonstrate the utility of the proteolytic assay in living tumor spheroids for the evaluation and quantification of the inhibitor effects on cathepsin K-mediated collagen I degradation. Importantly, we also show that utilizing the ruthenium-caged version of a potent nitrile cathepsin K inhibitor (4), cis-[Ru(bpy)2(4)2](BF4)2 (5), offers significant advantage in terms of effective concentration of the inhibitor and especially its light-activated control in the 3D assay. Our results suggest that light activation provides a suitable, attractive approach for spatial and temporal control of proteolytic activity, which remains a critical, unmet need in treatment of human diseases, especially cancer.
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Affiliation(s)
- Mackenzie K. Herroon
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Rajgopal Sharma
- Department of Chemistry, Wayne State University, 5101 Cass Ave., Detroit, MI 48202, USA
| | - Erandi Rajagurubandara
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Claudia Turro
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, OH 43210, USA
| | - Jeremy J. Kodanko
- Department of Chemistry, Wayne State University, 5101 Cass Ave., Detroit, MI 48202, USA; and Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Izabela Podgorski
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48201, USA; and Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA
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Bone HG, Dempster DW, Eisman JA, Greenspan SL, McClung MR, Nakamura T, Papapoulos S, Shih WJ, Rybak-Feiglin A, Santora AC, Verbruggen N, Leung AT, Lombardi A. Odanacatib for the treatment of postmenopausal osteoporosis: development history and design and participant characteristics of LOFT, the Long-Term Odanacatib Fracture Trial. Osteoporos Int 2015; 26:699-712. [PMID: 25432773 PMCID: PMC4312384 DOI: 10.1007/s00198-014-2944-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 10/02/2014] [Indexed: 01/13/2023]
Abstract
SUMMARY Odanacatib is a cathepsin K inhibitor investigated for the treatment of postmenopausal osteoporosis. Phase 2 data indicate that 50 mg once weekly inhibits bone resorption and increases bone mineral density, with only a transient decrease in bone formation. We describe the background, design and participant characteristics for the phase 3 registration trial. INTRODUCTION Odanacatib (ODN) is a selective cathepsin K inhibitor being evaluated for the treatment of osteoporosis. In a phase 2 trial, ODN 50 mg once weekly reduced bone resorption while preserving bone formation and progressively increased BMD over 5 years. We describe the phase III Long-Term ODN Fracture Trial (LOFT), an event-driven, randomized, blinded placebo-controlled trial, with preplanned interim analyses to permit early termination if significant fracture risk reduction was demonstrated. An extension was planned, with participants remaining on their randomized treatment for up to 5 years, then transitioning to open-label ODN. METHODS The three primary outcomes were radiologically determined vertebral, hip, and clinical non-vertebral fractures. Secondary end points included clinical vertebral fractures, BMD, bone turnover markers, and safety and tolerability, including bone histology. Participants were women, 65 years or older, with a BMD T-score≤-2.5 at the total hip (TH) or femoral neck (FN) or with a prior radiographic vertebral fracture and a T-score≤-1.5 at the TH or FN. They were randomized to ODN or placebo tablets. All received weekly vitamin D3 (5600 international units (IU)) and daily calcium supplements as needed to ensure a daily intake of approximately 1200 mg. RESULTS Altogether, 16,713 participants were randomized at 387 centers. After a planned interim analysis, an independent data monitoring committee recommended that the study be stopped early due to robust efficacy and a favorable benefit/risk profile. Following the base study closeout, 8256 participants entered the study extension. CONCLUSIONS This report details the background and study design of this fracture end point trial and describes the baseline characteristics of its participants.
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Affiliation(s)
- H G Bone
- Michigan Bone & Mineral Clinic, Detroit, MI, USA,
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Affiliation(s)
- Sung-eun E. Kyung
- Department of Ophthalmology, School of Medicine, University of Dankook at Cheonan, South Korea
| | - Jonathan C. Horton
- Departments of Ophthalmology, Neurology and Physiology, University of California, San Francisco, San Francisco, California, USA
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Refaey ME, Zhong Q, Ding KH, Shi XM, Xu J, Bollag WB, Hill WD, Chutkan N, Robbins R, Nadeau H, Johnson M, Hamrick MW, Isales CM. Impact of dietary aromatic amino acids on osteoclastic activity. Calcif Tissue Int 2014; 95:174-82. [PMID: 25000990 PMCID: PMC4104004 DOI: 10.1007/s00223-014-9878-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/20/2014] [Indexed: 01/28/2023]
Abstract
We had shown that aromatic amino acid (phenylalanine, tyrosine, and tryptophan) supplementation prevented bone loss in an aging C57BL/6 mice model. In vivo results from the markers of bone breakdown suggested an inhibition of osteoclastic activity or differentiation. To assess osteoclastic differentiation, we examined the effects of aromatic amino acids on early /structural markers as vitronectin receptor, calcitonin receptor, and carbonic anhydrase II as well as, late/functional differentiation markers; cathepsin K and matrix metalloproteinase 9 (MMP-9). Our data demonstrate that the aromatic amino acids down-regulated early and late osteoclastic differentiation markers as measured by real time PCR. Our data also suggest a link between the vitronectin receptor and the secreted cathepsin K that both showed consistent effects to the aromatic amino acid treatment. However, the non-attachment related proteins, calcitonin receptor, and carbonic anhydrase II, demonstrated less consistent effects in response to treatment. Our data are consistent with aromatic amino acids down-regulating osteoclastic differentiation by suppressing remodeling gene expression thus contributing initially to the net increase in bone mass seen in vivo.
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Affiliation(s)
- Mona El Refaey
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Qing Zhong
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Ke-Hong Ding
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Xing-ming Shi
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Pathology, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Jianrui Xu
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Wendy B. Bollag
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Physiology, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Charlie Norwood VA Medical Center, Augusta, GA 30912 USA
| | - William D. Hill
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Department of Orthopaedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Charlie Norwood VA Medical Center, Augusta, GA 30912 USA
| | - Norman Chutkan
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Department of Orthopaedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Richard Robbins
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Hugh Nadeau
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Maribeth Johnson
- Departments of Biostatistics, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Mark W. Hamrick
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Department of Orthopaedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
| | - Carlos M. Isales
- Institute for Regenerative and Reparative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Department of Orthopaedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
- Departments of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912 USA
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Jensen PR, Andersen TL, Pennypacker BL, Duong LT, Delaissé JM. The bone resorption inhibitors odanacatib and alendronate affect post-osteoclastic events differently in ovariectomized rabbits. Calcif Tissue Int 2014; 94:212-22. [PMID: 24085265 PMCID: PMC3899456 DOI: 10.1007/s00223-013-9800-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/04/2013] [Indexed: 12/22/2022]
Abstract
Odanacatib (ODN) is a bone resorption inhibitor which differs from standard antiresorptives by its ability to reduce bone resorption without decreasing bone formation. What is the reason for this difference? In contrast with other antiresorptives, such as alendronate (ALN), ODN targets only the very last step of the resorption process. We hypothesize that ODN may therefore modify the remodeling events immediately following osteoclastic resorption. These events belong to the reversal phase and include recruitment of osteoblasts, which is critical for connecting bone resorption to formation. We performed a histomorphometric study of trabecular remodeling in vertebrae of estrogen-deficient rabbits treated or not with ODN or ALN, a model where ODN, but not ALN, was previously shown to preserve bone formation. In line with our hypothesis, we found that ODN treatment compared to ALN results in a shorter reversal phase, faster initiation of osteoid deposition on the eroded surfaces, and higher osteoblast recruitment. The latter is reflected by higher densities of mature bone forming osteoblasts and an increased subpopulation of cuboidal osteoblasts. Furthermore, we found an increase in the interface between osteoclasts and surrounding osteoblast-lineage cells. This increase is expected to favor the osteoclast-osteoblast interactions required for bone formation. Regarding bone resorption itself, we show that ODN, but not ALN, treatment results in shallower resorption lacunae, a geometry favoring bone stiffness. We conclude that, compared to standard antiresorptives, ODN shows distinctive effects on resorption geometry and on reversal phase activities which positively affect osteoblast recruitment and may therefore favor bone formation.
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Affiliation(s)
- Pia Rosgaard Jensen
- Clinical Cell Biology, Institute of Regional Health Research, University of Southern Denmark, Vejle/Lillebaelt Hospital, Vejle, Denmark
- Clinical Cell Biology, Vejle Hospital, Kabbeltoft 25, 7100 Vejle, Denmark
| | - Thomas Levin Andersen
- Clinical Cell Biology, Institute of Regional Health Research, University of Southern Denmark, Vejle/Lillebaelt Hospital, Vejle, Denmark
| | | | - Le T. Duong
- Bone Biology Group, Merck Research Laboratories, West Point, PA USA
| | - Jean-Marie Delaissé
- Clinical Cell Biology, Institute of Regional Health Research, University of Southern Denmark, Vejle/Lillebaelt Hospital, Vejle, Denmark
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Abstract
Cathepsin K is a highly potent collagenase and the predominant papain-like cysteine protease expressed in osteoclasts. Cathepsin K deficiencies in humans and mice have underlined the central role of this protease in bone resorption and, thus, have rendered the enzyme as an attractive target for anti-resorptive osteoporosis therapy. In the past decade, a lot of efforts have been made in developing highly potent, selective and orally applicable cathepsin K inhibitors. Some of these inhibitors have passed preclinical studies and are presently in clinical trials at different stages of advancement. The development of the inhibitors and preliminary results of the clinical trials revealed problems and lessons concerning the in situ specificity of the compounds and their tissue targeting. In this review, we briefly summarize the history of cathepsin K research and discuss the current development of cathepsin K inhibitors as novel anti-resorptives for the treatment of osteoporosis. We also discuss potential off-target effects of cathepsin K inhibition and alternative applications of cathepsin K inhibitors in arthritis, atherosclerosis, blood pressure regulation, obesity and cancer.
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Affiliation(s)
- Dieter Brömme
- University of British Columbia, Department of Oral Biological and Medical Sciences, Vancouver, BC V6T1Z3, Canada.
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12
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Boskey AL, Gelb BD, Pourmand E, Kudrashov V, Doty SB, Spevak L, Schaffler MB. Ablation of cathepsin k activity in the young mouse causes hypermineralization of long bone and growth plates. Calcif Tissue Int 2009; 84:229-39. [PMID: 19172215 PMCID: PMC2680183 DOI: 10.1007/s00223-008-9214-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 12/26/2008] [Indexed: 11/24/2022]
Abstract
Cathepsin K deficiency in humans causes pycnodysostosis, which is characterized by dwarfism and osteosclerosis. Earlier studies of 10-week-old male cathepsin K-deficient (knockout, KO) mice showed their bones were mechanically more brittle, while histomorphometry showed that both osteoclasts and osteoblasts had impaired activity relative to the wild type (WT). Here, we report detailed mineral and matrix analyses of the tibia of these animals based on Fourier transform infrared microspectroscopy and imaging. At 10 weeks, there was significant hypercalcification of the calcified cartilage and cortices in the KO. Carbonate content was elevated in the KO calcified cartilage as well as cortical and cancellous bone areas. These data suggest that cathepsin K does not affect mineral deposition but has a significant effect on mineralized tissue remodeling. Since growth plate abnormalities were extensive despite reported low levels of cathepsin K expression in the calcified cartilage, we used a differentiating chick limb-bud mesenchymal cell system that mimics endochondral ossification but does not contain osteoclasts, to show that cathepsin K inhibition during initial stages of mineral deposition retards the mineralization process while general inhibition of cathepsins can increase mineralization. These data suggest that the hypercalcification of the cathepsin K-deficient growth plate is due to persistence of calcified cartilage and point to a role of cathepsin K in bone tissue development as well as skeletal remodeling.
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Affiliation(s)
- Adele L Boskey
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY 10021, USA.
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Kozloff KM, Quinti L, Patntirapong S, Hauschka PV, Tung CH, Weissleder R, Mahmood U. Non-invasive optical detection of cathepsin K-mediated fluorescence reveals osteoclast activity in vitro and in vivo. Bone 2009; 44:190-8. [PMID: 19007918 PMCID: PMC2656637 DOI: 10.1016/j.bone.2008.10.036] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 09/22/2008] [Accepted: 10/01/2008] [Indexed: 11/24/2022]
Abstract
Osteoclasts degrade bone matrix by demineralization followed by degradation of type I collagen through secretion of the cysteine protease, cathepsin K. Current imaging modalities are insufficient for sensitive observation of osteoclast activity, and in vivo live imaging of osteoclast resorption of bone has yet to be demonstrated. Here, we describe a near-infrared fluorescence reporter probe whose activation by cathepsin K is shown in live osteoclast cells and in mouse models of development and osteoclast upregulation. Cathepsin K probe activity was monitored in live osteoclast cultures and correlates with cathepsin K gene expression. In ovariectomized mice, cathepsin K probe upregulation precedes detection of bone loss by micro-computed tomography. These results are the first to demonstrate non-invasive visualization of bone degrading enzymes in models of accelerated bone loss, and may provide a means for early diagnosis of upregulated resorption and rapid feedback on efficacy of treatment protocols prior to significant loss of bone in the patient.
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Affiliation(s)
- Kenneth M. Kozloff
- Center for Molecular Imaging Research, Harvard Medical School, Massachusetts General Hospital; 149 13th Street, Room 5406, Charlestown MA 02129-2060
| | - Luisa Quinti
- Center for Molecular Imaging Research, Harvard Medical School, Massachusetts General Hospital; 149 13th Street, Room 5406, Charlestown MA 02129-2060
| | - Somying Patntirapong
- Children’s Hospital Boston, Department of Orthopaedic Surgery, 300 Longwood Avenue, Enders 1007, Boston MA 02215
| | - Peter V. Hauschka
- Children’s Hospital Boston, Department of Orthopaedic Surgery, 300 Longwood Avenue, Enders 1007, Boston MA 02215
| | - Ching-Hsuan Tung
- Center for Molecular Imaging Research, Harvard Medical School, Massachusetts General Hospital; 149 13th Street, Room 5406, Charlestown MA 02129-2060
| | - Ralph Weissleder
- Center for Molecular Imaging Research, Harvard Medical School, Massachusetts General Hospital; 149 13th Street, Room 5406, Charlestown MA 02129-2060
| | - Umar Mahmood
- Center for Molecular Imaging Research, Harvard Medical School, Massachusetts General Hospital; 149 13th Street, Room 5406, Charlestown MA 02129-2060
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Punturieri A, Filippov S, Allen E, Caras I, Murray R, Reddy V, Weiss SJ. Regulation of elastinolytic cysteine proteinase activity in normal and cathepsin K-deficient human macrophages. J Exp Med 2000; 192:789-99. [PMID: 10993910 PMCID: PMC2193285 DOI: 10.1084/jem.192.6.789] [Citation(s) in RCA: 170] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Human macrophages mediate the dissolution of elastic lamina by mobilizing tissue-destructive cysteine proteinases. While macrophage-mediated elastin degradation has been linked to the expression of cathepsins L and S, these cells also express cathepsin K, a new member of the cysteine proteinase family whose elastinolytic potential exceeds that of all known elastases. To determine the relative role of cathepsin K in elastinolysis, monocytes were differentiated under conditions in which they recapitulated a gene expression profile similar to that observed at sites of tissue damage in vivo. After a 12-d culture period, monocyte-derived macrophages (MDMs) expressed cathepsin K in tandem with cathepsins L and S. Though cysteine proteinases are acidophilic and normally confined to the lysosomal network, MDMs secreted cathepsin K extracellularly in concert with cathepsins L and S. Simultaneously, MDMs increased the expression of vacuolar-type H(+)-ATPase components, acidified the pericellular milieu, and maintained extracellular cathepsin K in an active form. MDMs from a cathepsin K-deficient individual, however, retained the ability to express, process, and secrete cathepsins L and S, and displayed normal elastin-degrading activity. Thus, matrix-destructive MDMs exteriorize a complex mix of proteolytic cysteine proteinases, but maintain full elastinolytic potential in the absence of cathepsin K by mobilizing cathepsins L and S.
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Affiliation(s)
- Antonello Punturieri
- Department of Internal Medicine and the University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109
| | - Sergey Filippov
- Department of Internal Medicine and the University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109
| | - Edward Allen
- Department of Internal Medicine and the University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109
| | - Ingrid Caras
- Eos Biotechnology, Incorporated, South San Francisco, California 94080
| | - Richard Murray
- Eos Biotechnology, Incorporated, South San Francisco, California 94080
| | - Vivek Reddy
- Department of Internal Medicine and the University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109
| | - Stephen J. Weiss
- Department of Internal Medicine and the University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109
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