Tests of linkage and/or association of TGF-beta1 and COL1A1 genes with bone mass

Association of collagen type I alpha 1 +1245G/T polymorphism and osteoporosis risk in post-menopausal women: a meta-analysis

AIM

To fully understand the association between collagen type I alpha 1 (COL1A1) +1245G/T polymorphism and osteoporosis risk in post-menopausal women.

METHODS

We searched the electronic databases including PubMed, Embase and Cochrane library updated to January 2016, as well as printed articles. Studies were screened according to the predefined inclusion and exclusion criteria, and the included studies were further assessed by Clark scores system. Furthermore, the association between COL1A1 +1245G/T polymorphism and osteoporosis risk was assessed using odds ratios (ORs) and their 95% confidence intervals (95% CIs). Additionally, the meta-analysis was carried out using Review Manger 5.1 software (Cochrane Collaboration, Oxford, UK) and Stata 11.0 software (StataCorp, College Station, TX, USA).

RESULTS

A total of five studies, which contained 1557 subjects (including 458 osteoporosis patients, 269 osteopenic patients and 830 normal controls), were included. Further, the included studies achieved Clark scores no less than 5, indicating a moderate or high quality. The pooled effect size indicated that there was a significant association between COL1A1 +1245G/T polymorphism and osteoporosis risk only under a co-dominant model (GG vs. TT, OR = 2.45, 95% CI = 1.11-5.44, P = 0.03). Moreover, there was no significant correlation between COL1A1 +1245G/T polymorphism and osteopenic risk under each model (P > 0.05).

CONCLUSION

There might be a certain relationship between GG genotype of COL1A1 +1245G/T polymorphism and osteoporosis risk in post-menopausal women.

Effects of COLIA1 polymorphisms and haplotypes on perimenopausal bone mass, postmenopausal bone loss and fracture risk

One thousand seven hundred seventeen perimenopausal women from the Danish Osteoporosis Prevention Study were genotyped for the -1997G/T, -1663indelT and +1245G/T polymorphisms in the COLIA1 gen. We found that the -1997T allele and a haplotype containing it were associated with reduced bone mineral density (BMD) and increased bone turnover at menopause and after 10 years of follow-up.

INTRODUCTION

We wanted to investigate whether the -1997G/T, -1663indelT and +1245G/T polymorphisms in the COLIA1 gene are associated with perimenopausal bone mass, early postmenopausal bone loss and interact with hormone treatment.

METHODS

One thousand seven hundred seventeen perimenopausal women from the Danish Osteoporosis Prevention Study were genotyped, and haplotypes were determined. BMD was examined by dual X-ray absorptiometry.

RESULTS

Women carrying the -1997T variant had lower BMD at all measured sites: lumbar spine BMD 1.030 ± 0.137 g/cm(2), 1.016 ± 0.147 g/cm(2) and 0.988 ± 0.124 g/cm(2) in women with the GG, GT and TT genotypes, respectively (p < 0.05) and total hip BMD 0.921 ± 0.116 g/cm(2), 0.904 ± 0.123 g/cm(2) and 0.887 ± 0.109 g/cm(2) in women with the GG, GT and TT genotypes, respectively (p = 0.01). The effect remained after 10 years although statistical significance was lost. Haplotype 3 (-1997T-1663ins + 1245G) was associated with lower bone mass and higher levels of bone turnover. Compared with haplotype 1, haplotype 3 carriers had lower BMD at the lumbar spine, femoral neck and total hip by 0.016 ± 0.007 g/cm(2), 0.015 ± 0.006 g/cm(2) and 0.017 ± 0.006 g/cm(2), respectively (p < 0.05-0.005). No association with postmenopausal changes in bone mass and fracture risk and no overall interaction with the effects of hormone therapy could be demonstrated for any of the polymorphisms in COLIA1.

CONCLUSIONS

The -1997G/T polymorphism and haplotype 3 are significantly associated with perimenopausal bone mass, and these effects were sustained up to 10 years after menopause. No association between the -1663indelT or +1245G/T polymorphisms and peri- or postmenopausal bone mass could be demonstrated.

Promoter and intron 1 polymorphisms of COL1A1 interact to regulate transcription and susceptibility to osteoporosis

Three polymorphisms (-1997G/T; -1663IndelT and +1245G/T) have been identified in the 5' flank of COL1A1 gene that are associated with osteoporosis but the underlying mechanism is unclear. Here we investigated the functional effects of these variants on COL1A1 transcription. Transcription was 2-fold higher with the osteoporosis-associated G-del-T haplotype compared with the common G-Ins-G haplotype. Gel shift assays showed that the region surrounding the -1663IndelT polymorphism recognized a complex of proteins essential for osteoblast differentiation and function including Nmp4 and Osterix, and the osteoporosis-associated -1663delT allele had increased binding affinity for this complex. Chromatin immunoprecipitation assays confirmed that the region flanking -1663insdelT bound a complex of proteins including Osterix and Nmp4 and also showed evidence of recruitment of Nmp4 to the Sp1 binding site in intron 1. Further studies showed that haplotype G-del-T had higher binding affinity for RNA polymerase II, consistent with increased transcription of the G-del-T allele and there was a significant inverse association between carriage of G-del-T and bone mineral density (BMD) in a cohort of 3270 Caucasian women. We conclude that common polymorphic variants in the 5' flank of COLIA1 regulate transcription by affecting DNA-protein interactions and that increased levels of transcription correlate with reduced BMD values in vivo. This is consistent with a model whereby increased COL1A1 transcription predisposes to osteoporosis, probably by increasing production of the alpha 1 chain and disrupting the normal ratio of collagen type 1 alpha 1 and alpha 2 chains.

A bivariate whole genome linkage study identified genomic regions influencing both BMD and bone structure

Areal BMD (aBMD) and areal bone size (ABS) are biologically correlated traits and are each important determinants of bone strength and risk of fractures. Studies showed that aBMD and ABS are genetically correlated, indicating that they may share some common genetic factors, which, however, are largely unknown. To study the genetic factors influencing both aBMD and ABS, bivariate whole genome linkage analyses were conducted for aBMD-ABS at the femoral neck (FN), lumbar spine (LS), and ultradistal (UD)-forearm in a large sample of 451 white pedigrees made up of 4498 individuals. We detected significant linkage on chromosome Xq27 (LOD = 4.89) for LS aBMD-ABS. In addition, we detected suggestive linkages at 20q11 (LOD = 3.65) and Xp11 (LOD = 2.96) for FN aBMD-ABS; at 12p11 (LOD = 3.39) and 17q21 (LOD = 2.94) for LS aBMD-ABS; and at 5q23 (LOD = 3.54), 7p15 (LOD = 3.45), Xq27 (LOD = 2.93), and 12p11 (LOD = 2.92) for UD-forearm aBMD-ABS. Subsequent discrimination analyses indicated that quantitative trait loci (QTLs) at 12p11 and 17q21 may have pleiotropic effects on aBMD and ABS. This study identified several genomic regions that may contain QTLs important for both aBMD and ABS. Further endeavors are necessary to follow these regions to eventually pinpoint the genetic variants affecting bone strength and risk of fractures.

Molecular genetic studies of gene identification for osteoporosis

This review comprehensively summarizes the most important and representative molecular genetics studies of gene identification for osteoporosis published up to the end of September 2007. It is intended to constitute a sequential update of our previously published reviews covering the available data up to the end of 2004. Evidence from candidate gene-association studies, genome-wide linkage and association studies, as well as functional genomic studies (including gene-expression microarray and proteomics) on osteogenesis and osteoporosis, are reviewed separately. Studies of transgenic and knockout mice models relevant to osteoporosis are summarized. The major results of all studies are tabulated for comparison and ease of reference. Comments are made on the most notable findings and representative studies for their potential influence and implications on our present understanding of genetics of osteoporosis. The format adopted by this review should be ideal for accommodating future new advances and studies.

Vertebral body integrity: a review of various anatomical factors involved in the lumbar region

The body of the vertebra can be affected in the majority of the conditions involving the lumbar spine. Multiple references, both books and periodicals, have been reviewed, and the anatomical factors responsible for the vertebral body integrity in the lumbar spine have been included under the following important areas, namely, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, and biomechanics.

INTRODUCTION

The anatomy provides a three-dimensional frame work to support the interaction between the physiological and pathological alterations. The body of the vertebra can be affected in a majority of acute or chronic conditions involving the lumbar spine. The etiology of these conditions is multifactorial, which has been dealt with in previous studies sporadically. This study aims to review and incorporate the important anatomical factors which can influence the integrity of vertebral bodies in the lumbar region and manifest as low back pain.

METHODS

Multiple references, both books and periodicals, have been reviewed for the literature. Electronic databases, including Medline and PubMed, were used to collect the latest information. They were finally arranged in an anatomical framework for the article. An attempt has been made to cover these relevant issues in an integrated way in the article and have been structured into introduction, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, biomechanics, and conclusion. The aforementioned anatomical aspects, some of which have received less attention in the literature, may be helpful to clinicians for restoring the mobility, stability, and load bearing capacity of the lumbar spine as well as planning better management strategies, especially for the chronic low back pain.

RESULTS

In our article all the anatomical factors affecting the integrity of vertebral body, including the morphology, development, genetics, growth and ossification, blood supply, specifically in the lumbar region, have been described, which were not covered earlier. The limitations of this review is its wide dimensions; hence, there are fair scopes of missing many relevant facts, as all of them cannot be compiled in a single article. We have attempted to confine our views to different anatomical domains only, this is our second limitation. Additional studies are required to incorporate and discuss the uncovered relevant scientific details.

CONCLUSIONS

The integrity of the body of the lumbar vertebra is multifactorial (Fig. 8). The vast spectrum of the anatomical domain influencing it has been summarized. The evolution of erect posture is a landmark in the morphology of human beings and the lumbar lordosis, which has also contributed to the gross design of the vertebral body, is one of the most important adaptations for axial loading and bipedal movements. The role of metamerism in the evolution of vertebrate morphology is repeated in the development of spine. The body of the vertebra is intersegmental in origin, which results in dual vascular and nerve supply, both from superior and inferior aspects of the body of the lumbar vertebrae. The vertebral body ossifies from three primary centers, one for centrum, which will form the major portion of body, and the other two for neural arches. The cartilaginous growth plate is mainly responsible for the longitudinal vertebral growth. Regional differentiation of the vertebral column, and the definite pattern of the structure of the different vertebra, is regulated by a large number of genetic factors, including the Hox genes. The vertebral body design therefore provides the requirements for optimal load transfer by maximal strength with minimal weight. Bone mineral density (BMD), bone quality, microarchitecture, and material properties are the important factors that contribute to bone strength. BMD is highly heritable; bone mineral distribution and architecture are also shown to be under strong genetic influence. All the aforementioned factors finally integrate to ensure mainly the mobility, stability, and load bearing capacity of the lumbar spine.

Molecular genetic studies of gene identification for osteoporosis: a 2004 update

This review summarizes comprehensively the most important and representative molecular genetics studies of gene identification for osteoporosis published up to the end of December 2004. It is intended to constitute a sequential update of our previously published review covering the available data up to the end of 2002. Evidence from candidate gene association studies and genome-wide linkage studies in humans, as well as quantitative trait locus mapping animal models are reviewed separately. Studies of transgenic and knockout mice models relevant to osteoporosis are summarized. An important extension of this update is incorporation of functional genomic studies (including DNA microarrays and proteomics) on osteogenesis and osteoporosis, in light of the rapid advances and the promising prospects of the field. Comments are made on the most notable findings and representative studies for their potential influence and implications on our present understanding of genetics of osteoporosis. The format adopted by this review should be ideal for accommodating future new advances and studies.

Gene polymorphisms involved in the regulation of bone quality

Osteoporotic fractures in subjects at advanced age constitute a tremendous and growing problem. Established lifestyle risk factors can explain only a modest proportion of the liability to osteoporotic fractures. Bone mineral density (BMD) is considered the best established risk factor for osteoporotic fractures. The importance of genetic factors in the quality of bone is substantial, but no consensus exists yet on the genes that are involved. However, concomitant diseases, balance disorders and lifestyle habits are more important for fractures in elderly subjects. The abundance of common sequence variations, so-called polymorphisms, in the human genome and their high frequency in the population have made them targets to explain variation in the risk. Some genes have been identified that appear to be involved in the regulation of bone mass and in the pathogenesis of osteoporosis. Among these are those coding for the two estrogen receptors (ERalpha and ERbeta), the androgen receptor (AR) and the vitamin D receptor (VDR). In addition, enzymes involved in the biogenesis of estrone and estradiol have attracted attention as well as polymorphisms in the regulatory region of the type I collagen gene, COLIA1, affecting the binding site for the transcription factor Specificity protein 1 (Sp1). Although evidence suggests that the quality of bone is determined to a large extent by genetic factors, research so far has not been able to unequivocally identify genes involved in this matter. Over the last years a large number of studies have pointed to the variability in many genes and their relation with BMD, bone-related symptoms or specific therapies. The findings emphasize the complexity of the genetics of bone mass and bone loss.

Transforming growth factor-beta1 to the bone

TGF-beta1 is a ubiquitous growth factor that is implicated in the control of proliferation, migration, differentiation, and survival of many different cell types. It influences such diverse processes as embryogenesis, angiogenesis, inflammation, and wound healing. In skeletal tissue, TGF-beta1 plays a major role in development and maintenance, affecting both cartilage and bone metabolism, the latter being the subject of this review. Because it affects both cells of the osteoblast and osteoclast lineage, TGF-beta1 is one of the most important factors in the bone environment, helping to retain the balance between the dynamic processes of bone resorption and bone formation. Many seemingly contradictory reports have been published on the exact functioning of TGF-beta1 in the bone milieu. This review provides an overall picture of the bone-specific actions of TGF-beta1 and reconciles experimental discrepancies that have been reported for this multifunctional cytokine.