Perspective: genetic and hormonal roles in bone disorders: insights of an updated bone physiology

In 1997 Professor J. Gorski suggested endocrinology needed new paradigms (Endocrine News 1997; 22:4,12). 'Connecting the dots' between diverse facts and ideas drawn from many lines of inquiry, plus accumulating evidence and increasing inadequacies of earlier ideas and terminology, led to an updated bone physiology called the 'Utah paradigm' that reveals new genetic and hormonal potential roles in bone physiology and disorders. One way to find a bone disorder's cause(s) and treatment( s) could depend on understanding the underlying physiology well enough to design effective drugs for it. In early views cell-level effects on osteoblasts and osteoclasts could explain most endocrine and genetic roles in bone disorders. The updated bone physiology supplements those views with roles of bone's tissue-level 'nephron-equivalent' mechanisms (NEMs) and their functions (NEFs), including some roles of biomechanics, whole-bone strength and muscle strength. That updated physiology reveals at least 42 nexuses above the cell level, some of them extraosseous, where genetic and/or hormonal effects might cause or help to treat varied bone problems. That multifactorial physiology also suggests that in vivo skeletal phenomena usually depend on many interlocking, laddered and nested feedback systems. Due to lack of study, how genes and hormones affect those nexuses and feedback systems still remains nearly unknown. Because studies of bone physiology in in vitro systems seldom if ever correctly predicted the in vivo effects, further live-animal research should seek the in vivo effects. This article suggests why more of that kind of research is needed, and some directions it could take.     

Bone and the kidney: a systems biology approach to the molecular mechanisms of renal osteodystrophy

Despite its apparent static condition, the skeleton undergoes a permanent process of remodeling mediated by osteoblasts and osteoclasts. The activity of these cells is regulated by a plethora of factors, ranging from mechanical stress to the effects of hormones to the immune system. One well-studied regulatory system involves the maintenance of calcium homeostasis through a network whose main regulatory components include ionized calcium, phosphate, parathyroid hormone and active vitamin D. This system establishes the link between bone and kidney, as one of the kidney's endocrine functions is the activation of vitamin D, while electrolyte homeostasis is one of its excretory functions. Impaired renal function leads to disturbances in this regulatory system, resulting in the complex syndrome of renal osteodystrophy that affects the majority of patients with chronic renal failure. This review summarizes the current understanding of bone physiology on a molecular level, examines some of the pathological pathways related to renal disease, and concludes with an outlook on how the emerging field of systems biology may contribute to a more dynamic and quantitative understanding of the physiology and pathophysiology of renal bone disease.     

Short-range intercellular calcium signaling in bone

The regulation of bone turnover is a complex and finely tuned process. Many factors regulate bone remodeling, including hormones, growth factors, cytokines etc. However, little is known about the signals coupling bone formation to bone resorption, and how mechanical forces are translated into biological effects in bone. Intercellular calcium waves are increases in intracellular calcium concentration in single cells, subsequently propagating to adjacent cells, and can be a possible mechanism for the coupling of bone formation to bone resorption. The aim of the present studies was to investigate whether bone cells are capable of communicating via intercellular calcium signals, and determine by which mechanisms the cells propagate the signals. First, we found that osteoblastic cells can propagate intercellular calcium transients upon mechanical stimulation, and that there are two principally different mechanisms for this propagation. One mechanism involves the secretion of a nucleotide, possibly ATP, acting in an autocrine action to purinergic P2Y2 receptors on the neighboring cells, leading to intracellular IP3 generation and subsequent release of calcium from intracellular stores. The other mechanism involves the passage of a small messenger through gap junctions to the cytoplasm of the neighboring cells, inducing depolarization of the plasma membrane with subsequent opening of membrane bound voltage-operated calcium channels. Next, we found that osteoblasts can propagate these signals to osteoclasts as well. We demonstrated that paracrine action of ATP was responsible for the wave propagation, but now the purinergic P2X7 receptor was involved. Thus, the studies demonstrate that calcium signals can be propagated not only among osteoblasts, but also between osteoblasts and osteoclasts in response to mechanical stimulation. Thus, intercellular calcium signaling can be a mechanism by which mechanical stimuli on bone are translated into biological signals in bone cells, and propagated through the network of cells in bone. Further, the observations offer new pharmacological targets for the modulation of bone turnover, and perhaps even for the treatment of bone metabolic disorders.     

BMPs in bone regeneration: Less is more effective,a paradigm-shift

Worldwide, the clinical application of BMP2 (bone morphogenetic protein 2) has helped an increasing number of patients achieve bone regeneration in a clinical area lacking simple solutions for difficult bone healing situations. In this review, the historical aspects and current critical clinical issues are summarized and positioned against new research findings on efficacy and function of BMP2. Knowledge concerning how the dose of this growth factor as well as its interaction with mechanical loading influences the efficacy of bone regeneration, might open possible future strategies in cases where bony bridging is unachievable so far. In conclusion, it is apparent that there is a substantial need for continued basic research to unravel the details of its function and the underlying signaling pathways involved, to make BMP2 even more relevant and safe in daily clinical use, even though this growth factor has been known for more than 125 years.     

How shall we proceed?

As we all know, the 2017 Nobel Prize in Physiology or Medicine was awarded in the field of Chronobiology. This was received with great excitement by all those who study different aspects of Biological Rhythms. In this brief essay, I would like to address the question, how shall we proceed after such great accomplishment from our esteemed colleagues? The short answer is, of course, keep up with the good work! There are plenty of unsolved questions beyond unravelling the molecular circadian clock. My choice of imperative topic is to teach circadian physiology at medical schools. Here, I suggest the term Chronostasis, to refer to the concept of timing physiological processes. The use of such concept will help medical students to understand physiology and medicine in circadian perspective to foster translational chronobiology in the short term.     

Imaging for lung physiology: what do we wish we could measure?

The role of imaging as a tool for investigating lung physiology is growing at an accelerating pace. Looking forward, we wished to identify unresolved issues in lung physiology that might realistically be addressed by imaging methods in development or imaging approaches that could be considered. The role of imaging is framed in terms of the importance of good spatial and temporal resolution and the types of questions that could be addressed as these technical capabilities improve. Recognizing that physiology is fundamentally a quantitative science, a recurring emphasis is on the need for imaging methods that provide reliable measurements of specific physiological parameters. The topics included necessarily reflect our perspective on what are interesting questions and are not meant to be a comprehensive review. Nevertheless, we hope that this essay will be a spur to physiologists to think about how imaging could usefully be applied in their research and to physical scientists developing new imaging methods to attack challenging questions imaging could potentially answer.     

Role of angiogenesis on bone formation

Angiogenesis and bone formation are coupled during skeletal development and fracture healing. This relationship, although known for some time, has not been properly explored. Advances in the discovery of how angiogenesis is regulated in physiological processes like embryogenesis, endometrial regeneration and wound healing or in pathologies such as cancer have provided a deeper understanding of how angiogenic factors may interact with bone cells to improve bone formation and bone regeneration. The lack of oxygen (hypoxia) and the subsequent generation of angiogenic factors have been shown to be critical in the development of a regular skeleton and achieving successful bone regeneration and fracture healing. Given that vascular status is important for a proper bone homeostasis, defining the roles of osteoblasts, osteoclasts, endothelial cells and angiogenic factors and their interactions in bone is a key issue for the development of new strategies to manage bone pathologies and nonfused fractures.     

A coupled mechano-biochemical model for bone adaptation

Bone remodelling is a fundamental biological process that controls bone microrepair, adaptation to environmental loads and calcium regulation among other important processes. It is not surprising that bone remodelling has been subject of intensive both experimental and theoretical research. In particular, many mathematical models have been developed in the last decades focusing in particular aspects of this complicated phenomenon where mechanics, biochemistry and cell processes strongly interact. In this paper, we present a new model that combines most of these essential aspects in bone remodelling with especial focus on the effect of the mechanical environment into the biochemical control of bone adaptation mainly associated to the well known RANKL-RANK-OPG pathway. The predicted results show a good correspondence with experimental and clinical findings. For example, our results indicate that trabecular bone is more severely affected both in disuse and disease than cortical bone what has been observed in osteoporotic bones. In future, the methodology proposed would help to new therapeutic strategies following the evolution of bone tissue distribution in osteoporotic patients.     

"Culture shock" from the bone cell's perspective: emulating physiological conditions for mechanobiological investigations

Bone physiology can be examined on multiple length scales. Results of cell-level studies, typically carried out in vitro, are often extrapolated to attempt to understand tissue and organ physiology. Results of organ- or organism-level studies are often analyzed to deduce the state(s) of the cells within the larger system(s). Although phenomena on all of these scales—cell, tissue, organ, system, organism—are interlinked and contribute to the overall health and function of bone tissue, it is difficult to relate research among these scales. For example, groups of cells in an exogenous, in vitro environment that is well defined by the researcher would not be expected to function similarly to those in a dynamic, endogenous environment, dictated by systemic as well as organismal physiology. This review of the literature on bone cell culture describes potential causes and components of cell "culture shock," i.e., behavioral variations associated with the transition from in vivo to in vitro environment, focusing on investigations of mechanotransduction and experimental approaches to mimic aspects of bone tissue on a macroscopic scale. The state of the art is reviewed, and new paradigms are suggested to begin bridging the gap between two-dimensional cell cultures in petri dishes and the three-dimensional environment of living bone tissue. osteoblast; osteocyte; tissue engineering; mechanobiology; mechanochemical transduction; fluid flow     

Optimal compressive force induces bone formation via increasing bone sialoprotein and prostaglandin E(2) production appropriately

Although orthodontic tooth movement can promote bone formation, the molecular mechanism that underlies this phenomenon is not fully understood. The purposes of this study were to determine how mechanical stress affects the osteogenic response of human osteoblastic cells (Saos-2), and also examine the optimal compression for osteogenesis in vitro. Saos-2 cells cultured with or without continuously compressive force (0.5 approximately 3.0 g/cm(2)). The expression of bone sialoprotein (BSP), osteopontin, and cyclooxygenase-2 (COX-2) were measured using real-time PCR, Western blot analysis and immunoassay. The calcium content in the mineralized nodules was determined using Calcium C-Test kit. Only one loading with 1.0 g/cm(2) of compressive force significantly increased the expression of BSP mRNA and protein, COX-2 mRNA expression and PGE(2) synthesis. Indomethacin, an inhibitor of PGE(2) synthesis, inhibited the compression-induced above phenomenon. Moreover, the conditioned medium from 1.0 g/cm(2) of compressive force apparently stimulated calcium content in mineralized nodules. This study demonstrates that an optimal compressive force stimulates in vitro mineralization by BSP synthesis through the autocrin action of PGE(2) production.     

Osteoimmunology: shared mechanisms and crosstalk between the immune and bone systems

Osteoimmunology is an interdisciplinary research field focused on the molecular understanding of the interplay between the immune and skeletal systems. Although osteoimmunology started with the study of the immune regulation of osteoclasts, its scope has been extended to encompass a wide range of molecular and cellular interactions, including those between osteoblasts and osteoclasts, lymphocytes and osteoclasts, and osteoblasts and haematopoietic cells. Therefore, the two systems should be understood to be integrated and operating in the context of the 'osteoimmune' system, a heuristic concept that provides not only a framework for obtaining new insights by basic research, but also a scientific basis for the discovery of novel treatments for diseases related to both systems.     

Electrical effects in bone

This paper presents a review of the work carried out on the electromechanical properties of bone over the the past three decades. Research in this field has established the piezoelectric nature of bone and identified collagen as the generating source in dry bone. Some of the characteristics of the strain generated potential (SGP) signal from dry and hydrated bone were found to be unaccountable in terms of a classical piezoelectric theory. Modifications of the theory were suggested and in the case of fully hydrated bone, a new mechanism (streaming potential) has emerged. The paper also reports on recent developments in the field and presents results from microstructural (osteonic) studies and from fluid-filled bone. The review indicates the need for actual in vivo work because most of the reported data were obtained, in the last decade, from in vitro work and were considered valid in vivo. Modelling of the mechanism which produces the SGP has been considered to explain the characteristics of these potentials. A representative model recently developed by the present authors and co-workers is reported. This model relates the generated potential to reorientation of spontaneous dipoles and differentiates between the generated and recorded signal, thus identifying effects from the measuring circuitry. The clinical aspects of electricity of bone in assisting fracture healing and the different techniques employed are mentioned briefly. Emphasis on new techniques of piezoelectric implants and their future development is also reported.     

Ion channels: from conductance to structure

In this perspective I tell the story (albeit a clearly abridged version) of how our knowledge of ion conduction through ion channels has evolved from a purely electrical concept to a structural dynamics view of ions interacting with a membrane protein. Our progress in this field has shown steady growth over the years but has also been interspersed with sudden jumps of discovery. These leaps have normally been associated with the introduction of a new technical advance or the development of a new biological preparation; therefore, it is quite certain that we have not seen them all.     

Isoprene research – 60 years later,the biology is still enigmatic

Isoprene emission is a major component of biosphere–atmosphere interactions. It is the single largest source of non‐methane hydrocarbon in the atmosphere. The first report of isoprene emission from plants was published in 1957 by Professor Guivi Sanadze. While humans have smelled the monoterpene hydrocarbons made by coniferous trees since their earliest migrations, only in 1957 did the world became aware that other trees make a type of hydrocarbon in even greater amounts but one to which the human nose is much less sensitive. For this 60th anniversary of the first report of isoprene emission from leaves, we trace the discovery and development of the research field, highlighting some of the most seminal observations and theoretical interpretations. This is not an exhaustive review, and many important papers are not cited, but we hope it will be of general interest to read how research in this field developed, how new observations forced us to reevaluate our theories about the significance of isoprene biosynthesis to plant physiology and adaptation and how scientific serendipity can sometimes drive a topic forward.     

Bone endocrine regulation of energy metabolism and male reproduction

Usually vertebrate physiology is studied within the confined limits of a given organ, if not cell type. This approach has progressively changed with the emergence of mouse genetics that has rejuvenated the concept of a whole body study of physiology. A vivid example of how mouse genetics has profoundly affected our understanding of physiology is skeleton physiology. A genetic approach to bone physiology revealed that bone via osteocalcin, an osteoblast-secreted molecule, is a true endocrine organ regulating energy metabolism and male reproduction. This ongoing body of work that takes bone out of its traditional roles is connecting it to a growing number of peripheral organs. These novel important hormonal connections between bone, energy metabolism and reproduction underscore the concept of functional dependence in physiology and the importance of genetic approaches to identify novel endocrine regulations.     

Calcitonin, an enigmatic hormone: does it have a function?

This editorial presents our view of the status of thyroidal calcitonin (TCT) in mammalian physiology. The discovery of calcitonin (CT) enabled the development of a valuable therapeutic agent but the early experiments most likely misled us with regard to its physiological significance. These early purported roles for TCT, first as an agent important in blood calcium regulation and later as an agent to prevent hypercalcemia, are no longer considered as physiological functions. While large supraphysiological doses of CT have an effect on the morphology and function of osteoclasts, it is unlikely that these effects of CT are important in the normal physiology of osteoclasts or bone remodeling. It is surprising that 38 years after the discovery of TCT there is no consensus as to its role in normal mammalian physiology. This editorial concerns three possibilities with respect to TCT: 1) the hormone is vestigial; 2) the hormone plays a role in water metabolism, ionic concentrations, and/or acid-base balance, actions that may not involve calcium metabolism at all; and 3) TCT acts to store phosphate postprandially on bone surfaces as a labile calcium-phosphate colloid, an action that may provide calcium needed for use in non-feeding periods or to reduce postprandial loss of phosphate when dietary phosphate is limited. Also discussed are recent publications indicating that CT synthesized in non-thyroidal tissues (NTCT) may have paracrine actions.     

The response of bone to mechanical loading and disuse: fundamental principles and influences on osteoblast/osteocyte homeostasis

Bone’s response to increased or reduced loading/disuse is a feature of many clinical circumstances, and our daily life, as habitual activities change. However, there are several misconceptions regarding what constitutes loading or disuse and why the skeleton gains or loses bone. The main purpose of this article is to discuss the fundamentals of the need for bone to experience the effects of loading and disuse, why bone loss due to disuse occurs, and how it is the target of skeletal physiology which drives pathological bone loss in conditions that may not be seen as being primarily due to disuse. Fundamentally, if we accept that hypertrophy of bone in response to increased loading is a desirable occurrence, then disuse is not a pathological process, but simply the corollary of adaptation to increased loads. If adaptive processes occur to increase bone mass in response to increased load, then the loss of bone in disuse is the only way that adaptation can fully tune the skeleton to prevailing functional demands when loading is reduced. The mechanisms by which loading and disuse cause bone formation or resorption are the same, although the direction of any changes is different. The osteocyte and osteoblast are the key cells involved in sensing and communicating the need for changes in mass or architecture as a result of changes in experienced loading. However, as those cells are affected by numerous other influences, the responses of bone to loading or disuse are not simple, and alter under different circumstances. Understanding the principles of disuse and loading and the mechanisms underlying them therefore represents an important feature of bone physiology and the search for targets for anabolic therapies for skeletal pathology.     

Physiological and regulatory convergence between osmotic and nutrient stress responses in microbes

Bacterial cells are regularly confronted with simultaneous changes in environmental nutrient supply and osmolarity. Despite the importance of osmolarity and osmoregulation in bacterial physiology, the relationship between the cellular response to osmotic perturbations and other stresses has remained largely unexplored. Bacteria cultured in hyperosmotic conditions and bacteria experiencing nutrient stress exhibit similar physiological changes, including metabolic shutdown, increased protein instability, dehydration, and condensation of chromosomal DNA. In this review, we highlight overlapping molecular players between osmotic and nutrient stresses. These connections between two seemingly disparate stress response pathways reinforce the importance of central carbon metabolism as a control point for diverse aspects of homeostatic regulation. We identify important open questions for future research, emphasizing the pressing need to develop and exploit new methods for probing how osmolarity affects phylogenetically diverse species.     

Understanding the local actions of lipids in bone physiology

The adult skeleton is a metabolically active organ system that undergoes continuous remodeling to remove old and/or stressed bone (resorption) and replace it with new bone (formation) in order to maintain a constant bone mass and preserve bone strength from micro-damage accumulation. In that remodeling process, cellular balances – adipocytogenesis/osteoblastogenesis and osteoblastogenesis/osteoclastogenesis – are critical and tightly controlled by many factors, including lipids as discussed in the present review.Interest in the bone lipid area has increased as a result of in vivo evidences indicating a reciprocal relationship between bone mass and marrow adiposity. Lipids in bones are usually assumed to be present only in the bone marrow. However, the mineralized bone tissue itself also contains small amounts of lipids which might play an important role in bone physiology. Fatty acids, cholesterol, phospholipids and several endogenous metabolites (i.e., prostaglandins, oxysterols) have been purported to act on bone cell survival and functions, the bone mineralization process, and critical signaling pathways. Thus, they can be regarded as regulatory molecules important in bone health. Recently, several specific lipids derived from membrane phospholipids (i.e., sphingosine-1-phosphate, lysophosphatidic acid and different fatty acid amides) have emerged as important mediators in bone physiology and the number of such molecules will probably increase in the near future. The present paper reviews the current knowledge about: (1°) bone lipid composition in both bone marrow and mineralized tissue compartments, and (2°) local actions of lipids on bone physiology in relation to their metabolism. Understanding the roles of lipids in bone is essential to knowing how an imbalance in their signaling pathways might contribute to bone pathologies, such as osteoporosis.     

The continuing quest to comprehend genomic imprinting

The discovery of the phenomenon of genomic imprinting in mammals showed that the parental genomes are functionally non-equivalent. Considerable advances have occurred in the field over the past 20 years, which has resulted in the identification and functional analysis of a number of imprinted genes the expression of which is determined by their parental origin. These genes belong to many diverse categories and they have been shown to regulate growth, complex aspects of mammalian physiology and behavior. Many aspects of the mechanism of imprinting have also been elucidated. However, the reasons for the evolution of genomic imprinting remain enigmatic. Further research is needed to determine if there is any relationship between the apparently diverse functions of imprinted genes in mammals, and their role in human diseases. It also remains to be seen what common features exist amongst the diverse imprinting control elements. The mechanisms involved in the erasure and re-establishment of imprints should provide deeper insights into epigenetic mechanisms of wide general interest.