The turnover of mineralized growth plate cartilage into bone may be regulated by osteocytes

Agrin-deficient osteocytes disrupt bone tissue homeostasis in male mice

Osteocytes are terminally differentiated osteoblasts that secrete molecules that regulate bone-tissue homeostasis. Considering that the extracellular matrix protein agrin (AGRN) is secreted by osteoblasts and modulates their differentiation, we hypothesized that AGRN is also expressed by osteocytes and plays a role in their function and therefore in bone remodeling. To test this hypothesis, we deleted agrin specifically in osteocytes using dentin matrix acidic phosphoprotein 1 (DMP1)-Cre mice (C57/BL6 background) and silenced agrin in vitro using clustered regularly interspaced short palindromic repeats/associated nuclease Cas-9 in the Ocy454 osteocyte cell line. We found that osteocytes express agrin and its receptors, low-density lipoprotein receptor-related protein 4, and α-dystroglycan, and that mice with agrin-deficient osteocytes exhibited lower bone mass and impaired mechanical and chemical properties of bone tissue. Agrin knockdown in Ocy454 cells disrupted osteocyte differentiation and function, which reduced osteoblast and increased osteoclast differentiation in a cell co-culture model. Our results showed that agrin is expressed by osteocytes, which are key regulators of bone mass and its mechanical and chemical properties. These findings indicate that agrin may be a therapeutic target because it is important to maintain the balance of the osteocyte-osteoblast-osteoclast circuit, and consequently, bone tissue homeostasis.

Mechanical factors explain development of cam-type deformity

OBJECTIVE

A cam-type deformity drastically increases the risk of hip osteoarthritis (OA). Since this type of skeletal anomaly is more prevalent among young active adults, it is hypothesized that the loading conditions experienced during certain types of vigorous physical activities stimulates formation of cam-type deformity. We further hypothesize that the growth plate shape modulates the influence of mechanical factors on the development of cam-type deformity.

DESIGN

We used finite element (FE) models of the proximal femur with an open growth plate to study whether mechanical factors could explain the development of cam-type deformity in adolescents. Four different loading conditions (representing different types of physical activities) and three different levels of growth plate extension towards the femoral neck were considered. Mechanical stimuli at the tissue level were calculated by means of the osteogenic index (OI) for all loading conditions and growth plate shape variations.

RESULTS

Loading conditions and growth plate shape influence the distribution of OI in hips with an open growth plate, thereby driving the development of cam-type deformity. In particular, specific types of loads experienced during physical activities and a larger growth plate extension towards the femoral neck increase the chance of cam-type deformity.

CONCLUSIONS

Specific loading patterns seem to stimulate the development of cam-type deformity by modifying the distribution of the mechanical stimulus. This is in line with recent clinical studies and reveals mechanobiological mechanisms that trigger the development of cam-type deformity. Avoiding these loading patterns during skeletal growth might be a potential preventative strategy for future hip OA.

Alterations to the subchondral bone architecture during osteoarthritis: bone adaptation vs endochondral bone formation

OBJECTIVE

Osteoarthritis (OA) is characterized by loss of cartilage and alterations in subchondral bone architecture. Changes in cartilage and bone tissue occur simultaneously and are spatially correlated, indicating that they are probably related. We investigated two hypotheses regarding this relationship. According to the first hypothesis, both wear and tear changes in cartilage, and remodeling changes in bone are a result of abnormal loading conditions. According to the second hypothesis, loss of cartilage and changes in bone architecture result from endochondral ossification.

DESIGN

With an established bone adaptation model, we simulated adaptation to high load and endochondral ossification, and investigated whether alterations in bone architecture between these conditions were different. In addition, we analyzed bone structure differences between human bone samples with increasing degrees of OA, and compared these data to the simulation results.

RESULTS

The simulation of endochondral ossification led to a more refined structure, with a higher number of trabeculae in agreement with the finding of a higher trabecular number in osteochondral plugs with severe OA. Furthermore, endochondral ossification could explain the presence of a "double subchondral plate" which we found in some human bone samples. However, endochondral ossification could not explain the increase in bone volume fraction that we observed, whereas adaptation to high loading could.

CONCLUSION

Based on the simulation and experimental data, we postulate that both endochondral ossification and adaptation to high load may contribute to OA bone structural changes, while both wear and tear and the replacement of mineralized cartilage with bone tissue may contribute cartilage thinning.

A sclerostin-based theory for strain-induced bone formation

Bone formation responds to mechanical loading, which is believed to be mediated by osteocytes. Previous theories assumed that loading stimulates osteocytes to secrete signals that stimulate bone formation. In computer simulations this 'stimulatory' theory successfully produced load-aligned trabecular structures. In recent years, however, it was discovered that osteocytes inhibit bone formation via the protein sclerostin. To reconcile this with strain-induced bone formation, one must assume that sclerostin secretion decreases with mechanical loading. This leads to a new 'inhibitory' theory in which loading inhibits osteocytes from inhibiting bone formation. Here we used computer simulations to show that a sclerostin-based model is able to produce a load-aligned trabecular architecture. An important difference appeared when we compared the response of the stimulatory and inhibitory models to loss of osteocytes, and found that the inhibitory pathway prevents the loss of trabeculae that is seen with the stimulatory model. Further, we demonstrated with combined stimulatory/inhibitory models that the two pathways can work side-by-side to achieve a load-adapted bone architecture.