Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Osteoporosis remain major clinical challenges. RNA interference (RNAi) provides a promising approach for promoting osteoblastic bone formation to settle the challenges. However, the major bottleneck for translating RNAi with efficacy and safety to clinical bone anabolic strategy is lack of osteoblast-specific delivery systems for osteogenic siRNAs. Previously, we developed a targeting system involving DOTAP-based cationic liposomes attached to oligopeptides (AspSerSer)6, (also known as (DSS)6), which had good affinity for bone formation surface. Using this system, osteogenic Pleckstrin Homology Domain Containing, Family O Member 1 (Plekho1) siRNA could be specifically delivered to bone formation surface at tissue level and promoted bone formation in osteopenic rodents. However, concerns still exist regarding indirect osteoblast-specific delivery, detrimental retention in hepatocytes, mononuclear phagocyte system (MPS)-induced dose reduction and inefficient nanoparticle extravasation. Aptamers, selected by cell-based Systematic evolution of ligands by exponential enrichment (cell-SELEX), are single-stranded DNA (ssDNA) or RNA which binds to target cells specifically by distinct tertiary structures. By performing positive selection with osteoblasts and negative selection with hepatocytes and peripheral blood mononuclear cells (PBMCs), we aimed to screen an aptamer that could achieve direct osteoblast-specific delivery and minimal hepatocyte and PBMCs accumulation of Plekho1 siRNAs. In addition, lipid nanoparticles (LNPs) have been widely used as nanomaterials encapsulating siRNA due to their small particle size below 90 nm. Polyethylene glycol¡(PEG) as the mostly used hydrophilic polymer, could efficiently prevent LNPs from MPS uptake. So, LNPs with PEG shielding could serve as siRNA carriers to realize efficient extravasation from fenestrated capillaries to osteoblasts and help reduce MPS uptake of the siRNAs. Recently, we screened an aptamer (CH6) by cell-SELEX specifically targeting both rat and human osteoblasts and developed the aptamer-functionalized LNPs encapsulating osteogenic Plekho1 siRNA, i.e., CH6-LNPs-siRNA. Our results demonstrated that CH6-LNPs-siRNA had an average particle size below 90 nm and no significant cytotoxicity in vitro. CH6 aptamer facilitated osteoblast-selective uptake of Plekho1 siRNA and gene silencing in vitro. In this study, we further found that CH6 aptamer facilitated the bone-specific distribution of siRNA by biophotonic imaging and quantitative analysis. Immunohistochemistry results showed that CH6 achieved in vivo osteoblast-specific delivery of Plekho1 siRNA. Dose-response experiment indicated that CH6-LNPs-siRNA achieved almost 80% gene knockdown at the siRNA dose of 1.0 mg/kg and maintained 12 days for over 50% gene silencing. microCT, bone histomorphometry and mechanical testing confirmed that CH6 facilitated bone formation, leading to improved bone micro-architecture, increased bone mass and enhanced mechanical properties in osteoporotic rodents. Furthermore, CH6-LNPs-siRNA achieved better bone anabolic action when compared to the previously developed (AspSerSer)6-liposome-siRNA. There was no obvious toxicity in rats injected with CH6-LNPs-siRNA. All these results indicated that osteoblast-specific aptamer-functionalized LNPs could act as a novel RNAi-based bone anabolic strategy and advance selectivity of targeted delivery for osteogenic siRNAs from tissue level toward cellular level. In addition, the generation of ssDNA from double-stranded PCR products is an essential step in selection of aptamers in SELEX. We found that the size separation derived from unequal primers with chemical modification could be a satisfactory alternative to the classic magnetic separation.

The highly optimized hierarchical structure of trabecular bone is a major contributor to its remarkable mechanical properties. At the micro-scale level, individual plate-like and rod-like trabeculae are interconnected, forming a complex trabecular architecture. It is widely believed that bone strength, an important mechanical characteristic that describes the capability of bone to resist fracture, is largely determined by the tissue-level material properties of these microscopic trabecular elements. However, due to the complicated microstructure and irregular morphology of trabecular bone, a link between the tissue-level and the apparent level mechanics in trabecular bone has never been established. Thus, the goal of this thesis is to examine the tissue-level material properties of trabecular bone and their contribution to apparent-level bone mechanics, and ultimately to improve our fundamental understanding and assessment of bone strength in diseased and healthy patients. At the micro-scale level, plate-like and rod-like trabeculae are distinctly aligned along different orientations on the anatomical axis of the skeleton. Also, the highly organized underlying ultrastructure of bone tissue suggests trabecular bone might possess an anisotropic tissue modulus, i.e. different modulus in the axial and lateral cross-section of a trabecula. In this thesis, we studied this tissue-level anisotropy by examining mechanical properties of individual trabecular plates and rods aligned longitudinally, obliquely, and transversely on the anatomical axis using micro-indentation. We discovered that, despite the different orientations of trabeculae, tissue moduli are higher in the axial direction than in the lateral direction for both plates and rods. We also discovered that plates have a higher tissue modulus than rods, suggesting different degrees of mineralization. Furthermore, the tissue mineral density correlated strongly but distinctly with tissue modulus in the axial and lateral directions, providing descriptions on how spatially heterogeneous mineralization at the tissue level affects the tissue modulus. After characterization of the anisotropic and heterogeneous modulus of trabecular bone at the tissue level, we then sought to investigate its contribution to apparent-level mechanical properties, including apparent Young’s modulus and yield strength. Non-linear FE voxel models incorporating experimentally determined anisotropy and heterogeneity were created from micro-computed tomography (µCT) images of healthy trabecular bone samples. Apparent Young's modulus and yield strength predicted by the models were compared to and correlated with gold standard mechanical testing measurements, as well as to the same FE models without incorporation of anisotropy and/or heterogeneity. We discovered that the anisotropic model prediction was highly correlated and indistinguishable from mechanical testing measurements. However, the prediction power of the model was not enhanced by incorporating anisotropy and heterogeneity (compared to a homogeneous and isotropic model), suggesting that variances in tissue-level material properties contribute minimally to the apparent level bone behaviors in healthy bone. However, the possibility remained that a more substantial contribution could arise in diseased bone, particularly diseases in which tissue-level properties are compromised. Therefore, we studied trabecular bone in two diseased conditions – subchondral bone in human knees affected by osteoarthritis and pelvic bone affected by adolescent idiopathic sclerosis – to see how disease can alter the tissue-level and, consequently, apparent-level bone mechanics. In OA bone, we found a significant decrease in tissue modulus in the subchondral bone under severely damaged cartilage compared to control, which provides an explanation for a minimal increase in apparent stiffness with an almost doubled bone volume fraction. In AIS bone, no differences were found in tissue-level or apparent level Young’s modulus compared to control. However, the mineral density was found to play a distinct role in the modulus of growing bone tissue compared to mature bone.

At its primary level (nm scale) bone is a nanocomposite consisting of a mineral (hydroxyapatite) phase which gives bone its strength and an organic (type I collagen) phase giving bone its fracture toughness. Hydroxyapatite, (HAP) Ca10(PO4)6(OH)2, is the most abundant mineral in the human body. Bone tissue has a complex hierarchical structure spanning multiple length scales (cm to nm). Characterization of mineral composition in biomineralized tissues such as bone at their primary level, is very challenging and requires instrumentation with nanometer-scale spatial resolution. Transmission electron microscopy (TEM) combines high spatial resolution with visual correlation of diffraction and elemental-composition data. Electron energy-loss spectroscopy (EELS) is a sensitive technique used to probe electronic structure at the molecular level. TEM-based EELS is the only available technique that can provide information about the chemical and coordination environment of minerals with nm scale spatial resolution. Prior studies in our group has developed a method to create biomimetic HAP using biomineralization routes inside the clay galleries of montmorillonite clay modified with amino acids (in-situ HAPclay). Incorporation of in-situ HAPclay into polymer scaffolds and seeding with human mesenchymal stem cells has enabled the cells towards differentiation into osteoblastic lineages without differentiating media. Because of the importance of these materials for bioengineering applications, TEM-EELS was used to evaluate differences and similarities among HAP, biomimetic in-situ HAPclay, modified MMT clay, and β-tricalcium phosphate. Osteogenesis imperfecta (OI), also known as brittle bone disease, is an inheritable disease characterized by increased bone fragility, low bone mass, and bone deformity caused primarily by mutation in collagen type I genes and is expressed as changes in structure and mechanics at the macrostructural level of bone. Therefore the mineralization of HAP in OI bone and the molecular basis of OI bone disease makes this an interesting system for molecular-level investigations. Small changes in the valence band and outer electronic structures of the diseased bone have been revealed through EELS. These small changes observed in the electron energy-loss spectra of the OI bone appear to play important biological roles towards development of the disease. / National Science Foundation under Grant Nos. 0619098, 0821655, 0923354, and 1229417

Background: Osteoblasts participating in the inflammation regulation gradually obtain concerns. However, its role in joint inflammation of rheumatoid arthritis (RA) is largely unknown. Here, we investigated the role of osteoblastic pleckstrin homology domain-containing family O member 1 (PLEKHO1), a negative regulator of osteogenic lineage activity, in regulating joint inflammation in RA. Methods: The level of osteoblastic PLEKHO1 in RA patients and collagen-induced arthritis (CIA) mice was examined. The role of osteoblastic PLEKHO1 in joint inflammation was evaluated by a CIA mice model which was induced in osteoblast-specific Plekho1 conditional knockout mice and mice expressing high Plekho1 exclusively in osteoblasts, respectively. The effect of osteoblastic PLEKHO1 inhibition was explored in a CIA mice model. The mechanism of osteoblastic PLEKHO1 in regulating joint inflammation was performed by a series of in vitro studies. Results: PLEKHO1 was highly expressed in osteoblasts from RA patients and CIA mice. Osteoblastic Plekho1 deletion ameliorated joint inflammation, whereas overexpressing Plekho1 only within osteoblasts exacerbated local inflammation in CIA mice. PLEKHO1 was required for TNF receptor-associated factor 2 (TRAF2)-mediated the ubiquitination of receptor-interacting serine/threonine-protein kinase 1 (RIP1) to activate nuclear factor kappa-light-chain-enhancer of activated B (NF-kB) pathway for inducing inflammatory cytokines production in osteoblasts. Moreover, osteoblastic PLEKHO1 inhibition improved joint inflammation and attenuated bone formation reduction in CIA mice. Conclusions: These data strongly suggest that highly expressed PLEKHO1 in osteoblasts mediates joint inflammation in RA. Targeting osteoblastic PLEKHO1 may exert dual therapeutic action of alleviating joint inflammation and promoting bone repair in RA.

Indiana University-Purdue University Indianapolis (IUPUI) / Heritable disorders of phosphate handling are the most common cause of hypophosphatemic rickets in developed countries. Isolated renal phosphate wasting and subsequent low serum phosphate concentrations may result from a number of genetic disorders that include: autosomal dominant hypophosphatemic rickets (ADHR), X-linked hypophosphatemic rickets (XLH), and autosomal recessive hypophosphatemic rickets (ARHR). Fibroblast growth factor-23 (FGF23), identified as the causative gene in ADHR, is produced in bone and plays a central role in kidney phosphate regulation. Increased serum concentrations of FGF23 lead to renal phosphate wasting through down regulation of renal sodium-phosphate co-transporters. However, the molecular mechanisms of FGF23 bioactivity in hormonal phosphate regulation are largely unknown. An experimental focus of this dissertation was to investigate the molecular mechanisms of FGF23-mediated phosphate regulation in the bone-kidney hormonal axis. To this end, the role of Dentin Matrix Protein 1 (DMP1), newly identified as the gene responsible for ARHR, was further defined by the identification of a novel large deletion as well as testing the molecular consequences of DMP1 mutations. FGF23 requires a signaling complex composed of Klotho and an FGFR for bioactivity, however, the location and composition of the signaling complex is unknown. Klotho localizes to the renal distal convoluted tubule, whereas the sodium phosphate co-transporters are expressed within the renal proximal tubules. The molecular mechanisms of FGF23 signaling were investigated by isolating a novel marker of FGF23 bioactivity using array technology, determining the location of initial FGF23 signaling in the kidney, and by identifying a novel mutation in a receptor upstream of FGF23 production. Taken together, these results increase the knowledge of the molecular mechanisms of phosphate homeostasis in relation to FGF23 bioactivity, leading to the identification of potentially novel therapeutic targets. / indefinitely

ENGLISH ABSTRACT: Background: The detection of bone infection can be very difficult especially in bone with altered structure due to prior trauma or surgical procedures. Complicated osteomyelitis (COM) is becoming a public health problem especially with the difficult choice between, high cost surgery and prolonged courses of intravenous or oral antibiotic therapy, as well as the social and psychological effect of longterm disease and disability of the patient. The correct localisation of especially bone infection is still a challenge for the clinician. The single photon emission computed tomography/low dose computed tomography (SPECT/CT), by fusing the functional information with the anatomical parts, is a wellestablished tool used in many nuclear medicine studies. This improves the overall quality of the study with more clear answers. The aim of the study was to determine the added value of SPECT/CT in the management of complicated osteomyelitis (COM) in patients with endo-prosthesis, post traumatic osteomyelitis with and without metal implants and diabetic foot. Methods: This was a prospective study, between February 2010 and February 2012. Patients with suspected COM who fulfilled the selection and inclusion criteria were included. All had abnormal three phase bone scan followed by infection imaging with 99mTc labelled white blood cells and 99mTc -colloid if the99mTc labelled white blood cell study was abnormal. 67Ga citrate was used in vertebral involvement. Planar and SPECT/CT images were reviewed for presence of abnormal uptake and for its localization in bone and soft tissue. Scan results were defined as positive or negative. Both planar and SPECT/CT images were compared regarding diagnosis and precise localization of infection. The final diagnosis was obtained from surgical specimen or microbiological culture as well as clinical follow-up of all patients. Results: There were 72 patients, 29 male and 43 female with mean age of 57 yrs [range 27-88].There were 24 patients with prosthesis, 16 with hip prosthesis (PH=16), and 8 with knee prosthesis (PK=8). There were 44 patients with post traumatic osteomyelitis, 26 with metal implants (TOM=26) and 18 without metal implants (TOWM= 18). Four patients had diabetic foot (DF= 4). Infection was diagnosed in 19/72 patients on planar images and in 21/72 on SPECT/CT. Infection was diagnosed in 4 patients with prosthesis, 16 patients with post traumatic injury and one diabetic foot patient. The four patients with prosthesis, SPECT /CT added diagnostic value by excluding osteomyelitis in 3 patients and by defining the exact extent and localizing soft tissue and bone infection (STI/OM) in one patient. In 16 patients with post traumatic OM on planar images, SPECT /CT added diagnostic value, by excluding OM in 4 patients and confirming only STI, better localisation of the uptake in bone and soft tissue in 5 patients, of them 2 patient was negative on planar, and in 7 patients, confirmed and defined the exact extent of both OM and STI. One diabetic foot was positive for STI on the planar, the SPECT/CT added diagnostic value by defining the extent of the infection. In summary the added value of SPECT/CT was: a. Overall infection: 1. Exclusion of osteomyelitis by confirming only soft tissue involvement: 7 patients (10%) 2. Better localization in bone and soft tissue: 6 patients (8%) 3. Better delineation of extent of infection: 9 patients (12%) 4. None: 50 patients (70%) b. In positive cases only: 1. Exclusion of osteomyelitis by confirming only soft tissue involvement: 7 patients (33%) 2. Better localization in bone and soft tissue: 5 patients (24%) 3. Better delineation of extent of infection: 9 patients (43%) 4. None: 0 patients The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy for infection, on planar was 90%, 100%, 100%, 97%, 97%, respectively and for SPECT/CT 100%, 100%, 100%, 100%, 100%. For OM on planar, the sensitivity, specificity , positive predictive value, negative predictive value and accuracy was 100%, 89%, 53%, 100%, 90%, respectively and for SPECT/CT 100%, 100%, 100%, 100%, 100%. Conclusion: In complicated osteomyelitis, SPECT/CT is useful in localizing, defining the exact extent of infection where the planar images are abnormal, with no added value if the planar images are negative. We recommend in clinical practice the routine use of hybrid SPECT/CT imaging in complicated osteomyelitis when planar images are abnormal. / AFRIKAANSE OPSOMMING: Agtergrond: Die opspoor van beeninfeksie is veral moeilik in been wat as gevolg van vorige trauma of chirurgiese prosedures misvorm is. Gekompliseerde osteomiëlitis word ‘n gesondheidsprobleem veral as gevolg van die moeilike keuse tussen hoë koste chirurgie en langdurige kursusse binneaarse of orale antibiotika, asook die sosiale en sielkundige gevolge van langstaande siekte en die gestremdheid van die pasiënt. Die korrekte lokalisering van veral beeninfeksie is steeds ‘n uitdaging vir die geneesheer. Enkel foton emissie rekenaartomografie / lae dosis rekenaartomografie (SPECT/CT), die kombinasie van funksionele en anatomiese inligting, is ‘n goed gevestigde metode in baie kerngeneeskunde ondersoeke. Dit verbeter die algemene kwaliteit van die studie met ‘n meer spesifieke antwoord. Die doel van hierdie studie was om die bykomende waarde van SPECT/CT in die hantering van gekompliseerde osteomiëlitis in pasiënte met endo-protese, post traumatise osteomiëlitis met en sonder metaal prosteses asook diabetiese voet te bepaal. Metode: ‘n Prospektiewe studie is tussen Februarie 2010 en Februarie 2012 gedoen. Pasiënte met vermoedelik gekompliseerde osteomiëlitis wat aan die keuse en insluitingskriteria voldoen het, is ingesluit. Almal het abnormale drie-fase beenflikkergramme gehad, gevolg deur infeksiebeelding met 99mTc gemerkte witselle en 99mTc kolloïed indien die 99mTc gemerkte witselstudie abnormaal was. 67Ga sitraat is gebruik wanneer daar werwelaantasting teenwoordig was. Die planare en SPECT/CT beelde is vergelyk ten opsigte van diagnose en presiese lokalisering van die infeksie. Die finale diagnose is met behulp van chirurgiese monsters en mikrobiologiese kweking asook die kliniese opvolg van alle pasiënte bepaal. Resultate: Die studie het 72 pasiënte, 29 mans en 43 vroue, met gemiddelde ouderdom van 57 jaar [27 – 88 ingesluit]. Daar was 24 pasiënte met prosteses, waarvan 16 met heupprosteses (PH= 16) en 8 met knieprosteses (PK= 8). Van die 44 pasiënte met post traumatiese osteomiëlitis, het 26 metaal prosteses (TOM= 26) en 18 geen metaalprosteses gehad nie (TOWM= 18). Vier pasiënte het diabetiese voet gehad (DF= 4). By 19/72 van die pasiënte is infeksie op die planare beelde gediagnoseer en in 21/72 op die SPECT/CT beelde. Die bykomende twee gevalle was 1 met TOM en 1 met TOWM. Infeksie is by 4 pasiënte met prosteses, 16 pasiënte met post traumatiese besering en 1 met diabetiese voet gediagnoseer. In die vier pasiënte met prosteses, het SPECT/CT ‘n diagnostiese bydrae gelewer om osteomiëlitis by 3 van die pasiënte uit te skakel en die presiese omvang en lokalisering van sagte weefsel en beeninfeksie (STI/OM) in een pasiënt te bepaal. In 16 pasiënte met post traumatise osteomiëlitis op die planare beelde, was SPECT/CT van diagnostiese waarde, waar osteomiëlitis in 4 pasiënte uitgesluit is, en slegs STI bevestig is. Beter lokalisering van die opname in been en sagte weefsel was in 5 pasiënte moontlik, van wie 2 op die planare beelde negatief was, en in 7 pasiënte bevestig en die presiese omvang met beide OM en STI gedefinieer is. Een diabetiese voet was positief vir STI op die planare beelde, maar die SPECT/CT het diagnostiese waarde verbeter deur die omvang van die infeksie beter te toon. Ter opsomming, was die waarde van die SPECT/CT: 1. Uitsluiting van osteomiëlitis deur slegs van sagte weefsel aantasting te bevestig: 7 pasiënte 10% 2. Beter lokalisering in been en sagte weefsel: 5 pasiënte 7% 3. Beter definisie van omvang van infeksie: 9 pasiënte 12% 4. Geen bykomende waarde: 51 pasiënte 71% Die algehele sensitiwiteit, spesifisiteit, positiewe voorspellingswaarde, negatiewe voorspellingswaarde en akkuraatheid vir die opspoor van infeksie vir die planare beelde was 90%, 100%, 100%, 97%, 97%, onderskeidelik en vir die SPECT/CT 100%, 100%, 100%, 100% en 100%. Vir osteomiëlitis was sensitiwiteit, spesifisiteit, positiewe voorspellingswaarde, negatiewe voorspellingswaarde en akkuraatheid van planare beelde 100%, 89%, 53%, 100%, 90%, onderskeidelik en die van SPECT/CT 100%, 100%, 100%, 100% , 100%. Gevolgtrekking: SPECT/CT is nuttig in die lokalisering en definiëring van die presiese omvang van die infeksie in gekompliseerde osteomiëlitis in gevalle waar die planare beelde abnormaal is, met geen bykomende waarde wanneer planare beelde negatief is nie. Ons beveel SPECT/CT beelding as roetine in kliniese praktyk aan wanneer planare beelde in gekompliseerde osteomiëlitis abnormaal is.

骺軟骨板是位於長骨骨骺的一個軟骨結構，其主要功用為使骨骼延伸生長。 若人類骺軟骨板基因出現障礙，骨骼生長往往會受到嚴重的影響，使骨骼變得短小、畸形，造成殘障。此外，一些後天的系統性失調也會損害骺軟骨板的正常運作，導致矮小症。現今常用來醫治骨骼生長障礙的包括重組的人類生長荷爾蒙。然而，它的功效並非顯著，亦帶來很多的副作用；因此，我們希望能尋求更好的醫治方法。 / 近有的研究結果顯示，很多的內分泌及分泌因子能夠刺激骺軟骨板進行軟骨增生。但是，研究者卻往往未能將這些因子轉化及運用作醫療用途，原因是它們通常都是局部性地於骺軟骨板產出及發生效用。倘若以上提及的生長因子能給骺軟骨板的靶子蛋白鏈準確地被帶往骺軟骨板，那麼這些因子便能有效地被利用作治療用途，而其效能亦會給大大提高，副作用也會被減低。因此，我們現在進行研究的首要目標為於採用噬菌體展示和酵母展示方法， 尋找那些能認辨出骺軟骨板的靶子蛋白鏈及單鏈抗體。 / 於噬菌體展示庫裡，我們找出了兩條能認辨出小鼠骨骼軟骨細胞的靶子蛋白鏈 － C1 (RLDPTSYLRTFW) 和 C19 (HDSQLEALIKFM)。然而於體外測試實驗中， 它們對軟骨細胞及細胞外基質只擁有中度的親近性和特異性。此後，於酵母展示庫裡，我們亦發現三條可認辨某骺軟骨板蛋白的單鏈抗體 － 它們的親近性甚高 (達至1 nM)，而其對軟骨組織的特異性也為良好 (它們只認辨軟骨組織，但卻沒能認辨出其他的軟組織，包括腦、心臟、肝臟、肺臟、腎臟、脾臟、小腸及肌肉)。 其後，於小鼠胚胎免疫染色測試實驗中，這些單鏈抗體只亦選擇地認辨軟骨組織。再者，當這些單鏈抗體被注射入小鼠的靜脈中，它們也會準確地停留在軟骨組織裡，顯示出其特異性於體內測試實驗中亦存在。 / 總括而言，利用噬菌體展示和酵母展示方法，我們發現了一些能認辨出骺軟骨板的靶子蛋白鏈及單鏈抗體。這些單鏈抗體擁有對軟骨組織非常高的親近性和特異性。我們預計，若然將這些單鏈抗體和內分泌及分泌因子連結在一起，它們或能成為醫治骨骼生長障礙的新方法。 / The growth plate is a specialized cartilage structure at the ends of long bones that is responsible for bone elongation. Many human genetic disorders of the growth plate impair skeletal growth, often resulting in bones that are severely short and malformed, causing serious disability. Many acquired systemic disorders also impair growth plate function, causing short stature. Currently, recombinant human growth hormone is used to treat growth disorders, but it has limited efficacy for severe diseases and causes significant adverse effects. / Recent studies have identified many endocrine and paracrine factors that are capable of promoting chondrogenesis at the growth plate. However, the development of these molecules into effective therapies has been hampered by their action mechanism; they are produced locally and act locally in the growth plate and thus fail to lend themselves to systemic therapeutic approaches. We envisioned that, if these growth factors could be linked to growth plate-targeting peptides or polypeptides and then administered systemically, these molecules might provide a better treatment strategy for growth disorders because targeting might augment the therapeutic effect on the growth plate but diminish undesirable effects on non-target tissues. Toward this goal, we sought to identify peptides and antibody fragments that bind to cartilage tissue using phage display and yeast display technologies. / We used a phage display library that expressed linear peptides of 12 random amino acids on the phage surface and then selected for binding to murine primary cultured chondrocytes. This approach successfully identified two peptides, namely C1 (RLDPTSYLRTFW) and C19 (HDSQLEALIKFM), which exhibited moderate binding affinity and specificity to chondrocytes and extracellular matrix in vitro. We also used a yeast display library to identify three single-chain variable(scFv) antibody fragments that bound strongly to a growth plate-specific protein(EC50 values less than 1 nM). These antibody fragments demonstrated specific binding in vitro to homogenates of cartilage tissues, but not homogenates of brain, heart, liver, lung, kidney, spleen, small intestine, or muscle. Moreover, they also exhibited tissue-specific binding to cartilage structures in sections of mouse embryos. When these purified antibody fragments were injected intravenously in mice, they localized to cartilage and were not detectable in other tissues, including brain, heart, liver, lung, kidney, spleen, small intestine, or muscle, indicating that the antibody fragments were capable of specifically targeting cartilage tissue in vivo. / In conclusion, we employed phage display and yeast display methods to identify peptides and antibody fragments that bind to cartilage tissues. The selected antibody fragments showed particularly high binding affinity and specificity to cartilage. Conjugating these antibody fragments to endocrine and paracrine signaling molecules has the potential to provide targeted therapy for growth plate disorders. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Cheung, Sao Fong. / Thesis (Ph.D.) Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 89-102). / Abstracts also in Chinese.

[Truncated abstract] Osteoclasts are multinucleated giant cells responsible for the resorption of the mineralized bone matrix during the process of bone remodelling. During activation towards bone resorption, polarization of the osteoclast results in the formation of a unique plasma membrane, the ruffled border, the actual resorptive organelle of the osteoclast. Through this domain protons are actively pumped into the resorption lacuna creating an acidic microenvironment that favours the dissolution of the mineralized bone matrix. The polarised secretion of protons is carried out by the action of the vacuolar-type (H+)-ATPase (V-ATPase), composed of functionally and structurally distinct subunits of the V1 and V0 domains. The general structure of the V-ATPase complex is highly conserved from yeast to mammals, however, multiple isoforms for specific V-ATPase subunits do exist exhibiting differential subcellular, cellular and tissue-specific localizations. This study focuses on the molecular identification and characterization of V-ATPase accessory subunit Ac45 and the d2 isoform of the V0 domain d subunit in osteoclasts. Using the techniques of cDNA Subtractive Hybridization and DNA Micro-Array analyses respectively, the accessory subunit Ac45 and the d2 isoform of the V0 domain d subunit were identified in RAW264.7-cells derived OcLs. ... Using web-based computational predictions, two possible transmembrane domains, an N-terminus 'signal anchor' sequence and a C-terminus dilysine- like endoplasmic reticulum (ER) retention signal were identified. By confocal microscopy, EYFP-tagged e was found to localize to the perinuclear region of transfected COS-7 cells in compartments representing the ER and Golgi apparatus with some localization in late endosomal/lysosomal-like vesicles. ER truncation of e did not alter its subcellular localization but exhibited significantly weaker association with Ac45 compared to the wild-type as depicted by BRET analyses. Association with the other V0 subunits remain unaffected. This may hint at a possibility that Ac45 may play a role in the masking of the ER signal of e following it's incorporation into the V0 domain. Although no solid evidence for a role in the assembly of the mammalian VATPase have been established, subunit e still represents a potential candidate whose role in the V-ATPase complex requires further investigation. Collectively, the data presented in this thesis has provided further insight into the composition of the osteoclast V-ATPase proton pump by: 1) identifying an accessory subunit, Ac45 which shows promise as a potential candidate for the regulation and/or targeting of the V-ATPase complex in osteoclasts and truncation of its targeting signal impairs osteoclastic bone resorption; 2) identification and preliminary characterization of the d2 isoform of the V0 domain d subunit whose exact role in the V-ATPase complex and in osteoclasts remains to be determined, although its has been implicated to be essential for osteoclastic function; and 3) Preliminary characterization of subunit-e, a potential assembly factor candidate for the mammalian V-ATPase V0 domain.