Altering tooth eruption by blocking bone resorption--the local delivery of bafilomycin A1

Degradation of hydroxyapatite in vivo and in vitro requires osteoclastic sodium-bicarbonate co-transporter NBCn1

Dissolution of the inorganic bone matrix releases not only calcium and phosphate ions, but also bicarbonate. Electroneutral sodium-bicarbonate co-transporter (NBCn1) is expressed in inactive osteoclasts, but its physiological role in bone resorption has remained unknown. We show here that NBCn1, encoded by the SLC4A7 gene, is directly involved in bone resorption. NBCn1 protein was specifically found at the bone-facing ruffled border areas, and metabolic acidosis increased NBCn1 expression in rats in vivo. In human hematopoietic stem cell cultures, NBCn1 mRNA expression was observed only after formation of resorbing osteoclasts. To further confirm the critical role of NBCn1 during bone resorption, human hematopoietic stem cells were transduced with SLC4A7 shRNA lentiviral particles. Downregulation of NBCn1 both on mRNA and protein level by lentiviral shRNAs significantly inhibited bone resorption and increased intracellular acidification in osteoclasts. The lentiviral particles did not impair osteoclast survival, or differentiation of the hematopoietic or mesenchymal precursor cells into osteoclasts or osteoblasts in vitro. Inhibition of NBCn1 activity may thus provide a new way to regulate osteoclast activity during pathological bone resorption.

Proton pump inhibitors control osteoclastic resorption of calcium phosphate implants and stimulate increased local reparative bone growth

Calcium phosphate (CAP) rods and pastes based on dicalcium and tetracalcium phosphate chemistry were modified with a specific osteoclast proton pump inhibitor, Bafilomycin A(1), and implanted in the distal femurs of young male Wistar rats for 7, 10, and 14 days. The extent of osteoclastic resorption of these materials and the amount of regenerative bone formed were qualitatively evaluated. Resorptive activity similar to the remodeling process of natural bone was observed in the controls. In contrast, the resorption of materials containing Bafilomycin A(1) was considerably lower, even though tartrate-resistant acid phosphatase-positive osteoclasts were present at the tissue/material interface. A greater amount of newly formed bone consistently surrounded the CAP rods and pastes containing Bafilomycin A(1) in comparison to the control specimens, which indicated that this reparative bone was not resorbed as quickly as the new bone surrounding the controls. Increased local bone mass around the Bafilomycin A(1)-modified materials resulted from the diffusion of the proton pump inhibitor into the biological tissue at the defect site. Thus, through inhibition of the osteoclast proton pump, Bafilomycin A(1) slowed down not only the resorption of the implant material but also the resorption of the newly formed reparative bone, which resulted in an increased local bone mass.

Bafilomycin A1 in bone resorption and tooth eruption in dogs

Tooth eruption depends on bone resorption to form an eruption pathway. We have previously shown that a 2-wk local infusion of bafilomycin A1, an inhibitor of vacuolar H(+)-ATPases in osteoclasts, into the crypts of erupting mandibular premolars in dogs blocks bone resorption during this period and eruption of these teeth is delayed for 8 wk. Here we report the limits of inhibition of resorption that still permit eruption of these teeth. In 3 dogs 10(-6) M bafilomycin was delivered by osmotic minipumps early (18 wk) in eruption to the fourth premolar for 1, 3 or 4 wk. Radiographs taken at weekly intervals thereafter showed that bafilomycin delivery for 1 wk delayed eruption for 3 wk, delivery for 3 wk delayed eruption 9 wk and delivery for 4 wk prevented eruption. These data show that tooth eruption is delayed in direct proportion to the time resorption is blocked, and that this process for dog premolars cannot be blocked for more than 3 wk with 10(-6) M bafilomycin without blocking eruption itself.