A osteogênese imperfeita (OI) é caracterizada como uma desordem genética na qual uma osteopenia generalizada leva a baixa estatura, fragilidade óssea excessiva e deformidades ósseas graves. As células mesenquimais estromais multipotentes (CTMs) são precursores presentes na medula óssea adulta capazes de se diferenciar em osteoblastos, adipócitos e mioblastos que passaram a ter grande importância como fonte terapia celular. O objetivo do presente estudo foi analisar o perfil de expressão gênica durante a diferenciação osteogênica a partir de células mesenquimais estromais multipotentes da medula óssea obtidas de pacientes diagnosticados com Osteogênese Imperfeita e de indivíduos controle. Foram coletadas amostras de três indivíduos normais e cinco amostras de pacientes portadores de Osteogênese Imperfeita. As células mononucleares (CMN) foram isoladas para a obtenção de células mesenquimais que foram expandidas até a terceira passagem quando iniciou-se o estímulo para diferenciação osteogênica. Também foram realizadas análises para contagem de CFU-F e para quatro das cinco amostras de pacientes portadores de OI, o número de CFU-F observado foi inferior ao geralmente encontrado para amostras de doadores normais. Foram coletadas células para análises de imunofenotipagem celular por citometria de fluxo e o RNA foi extraído originando a amostra denominada T0. As garrafas restantes tiveram suas células estimuladas para diferenciação osteogênica. Após um dia em cultura com estímulo, mais uma garrafa teve o RNA de suas células extraído (T1), e o mesmo procedimento foi realizado nos dias 2 (T2), 7 (T7), 12 (T12), 17 (T17) e 21 (T21). Todas as amostras demonstraram possuir potencial de diferenciação in vitro em osteoblastos e adipócitos. A imunofenotipagem de células mesenquimais foi realizada e as amostras de todos os pacientes apresentaram perfil imunofenotípico compatível com trabalhos anteriores. Foram identificadas mutações nos genes COL1A1 e/ou COL1A2 responsáveis pelo desenvolvimento da doença para quatro dos cinco pacientes avaliados. Para o paciente portador de Osteogênese Imperfeita e Síndrome de Bruck a região codificadora do gene PLOD2 também foi seqüenciada, porém não foram encontradas mutações. A análise da expressão gênica foi realizada pela técnica de microarranjos e foram identificados vários genes com expressão diferencial. Alguns genes com importância fundamental na diferenciação osteoblástica apresentaram menor expressão nas amostras dos pacientes portadores de OI, sugerindo um menor comprometimento das CTMs desses pacientes com a linhagem osteogênica. Outros genes também tiveram sua expressão diferencial confirmada por PCR em Tempo Real. Foi observado um aumento na expressão de genes relacionados a adipócitos, sugerindo um aumento da diferenciação adipogênica em detrimento à diferenciação osteogênica. A expressão das variantes do gene PLOD2 mostrou-se diferencial entre amostras normais, de OI e do paciente portador de Síndrome de Bruck. Também foi evidenciada uma expressão diferencial do microRNA 29b, um microRNA com papel estabelecido durante a diferenciação osteogênica, sugerindo um mecanismo de regulação dependente da quantidade de RNAm do seu gene alvo, o COL1A1. / Osteogenesis imperfecta (OI) is characterized as a genetic disorder in which a generalized osteopenia leads to short stature, bone fragility and serious skeletal deformities. Mesenchymal stem cells (MSCs) are precursors present in adult bone marrow that can differentiate into osteoblasts, adipocytes and myoblasts that have been given great importance as a source cell therapy. The aim of this study was to analyze the gene expression profile during osteogenic differentiation from mesenchymal stem cells from bone marrow taken from patients diagnosed with Osteogenesis Imperfecta and control subjects. Samples were collected from three normal individuals and five samples from patients with Osteogenesis Imperfecta. Mononuclear cells (MON) were isolated to obtain mesenchymal cells that were expanded until third passage when the stimulus for osteogenic differentiation was induced. Analyses were also conducted to count the CFU-F and for four of the five samples from patients with OI, the number of CFU-F observed was lower than generally found for normal samples. Cells were collected for analysis of cell immunophenotyping by flow cytometry and RNA was extracted from the resulting sample called T0. Remaining cells were stimulated for osteogenic differentiation. After a day in culture with stimulation, cells from another bottle had their RNA extracted (T1), and the same procedure was performed on days 2 (T2), 7 (T7), 12 (T12), 17 (T17) and 21 (T21). All samples have shown potential of in vitro differentiation into osteoblasts and adipocytes. Immunophenotyping of mesenchymal cells was performed and samples of all patients had immunophenotypic profile consistent with previous works. We identified mutations in COL1A1 and / or COL1A2 responsible for developing the disease for four of five patients. For the patient with Osteogenesis Imperfecta and Bruck Syndrome, coding region of the gene PLOD2 was also sequenced, but no mutations were found. The gene expression analysis was performed by microarray and identified several genes with differential expression. Some genes of fundamental importance in osteoblast differentiation showed lower expression in samples from patients with OI, suggesting a minor involvement of MSCs of patients with osteogenic lineage. Other genes also confirmed their differential expression by Real Time PCR. We observed an increased expression of genes related to adipocytes, suggesting an increased adipogenic differentiation at the expense of osteogenic differentiation. The expression of PLOD2 gene variants proved to be different between normal samples, OI and the patient with Bruck Syndrome. There was also evidence of differential expression of 29b microRNA, with established role during osteogenic differentiation, suggesting a mechanism dependent regulation of mRNA abundance of its gene target, COL1A1.

A osteogênese imperfeita (OI) é caracterizada como uma desordem genética na qual uma osteopenia generalizada leva a baixa estatura, fragilidade óssea excessiva e deformidades ósseas graves. As células mesenquimais estromais multipotentes (CTMs) são precursores presentes na medula óssea adulta capazes de se diferenciar em osteoblastos, adipócitos e mioblastos que passaram a ter grande importância como fonte terapia celular. O objetivo do presente estudo foi analisar o perfil de expressão gênica durante a diferenciação osteogênica a partir de células mesenquimais estromais multipotentes da medula óssea obtidas de pacientes diagnosticados com Osteogênese Imperfeita e de indivíduos controle. Foram coletadas amostras de três indivíduos normais e cinco amostras de pacientes portadores de Osteogênese Imperfeita. As células mononucleares (CMN) foram isoladas para a obtenção de células mesenquimais que foram expandidas até a terceira passagem quando iniciou-se o estímulo para diferenciação osteogênica. Também foram realizadas análises para contagem de CFU-F e para quatro das cinco amostras de pacientes portadores de OI, o número de CFU-F observado foi inferior ao geralmente encontrado para amostras de doadores normais. Foram coletadas células para análises de imunofenotipagem celular por citometria de fluxo e o RNA foi extraído originando a amostra denominada T0. As garrafas restantes tiveram suas células estimuladas para diferenciação osteogênica. Após um dia em cultura com estímulo, mais uma garrafa teve o RNA de suas células extraído (T1), e o mesmo procedimento foi realizado nos dias 2 (T2), 7 (T7), 12 (T12), 17 (T17) e 21 (T21). Todas as amostras demonstraram possuir potencial de diferenciação in vitro em osteoblastos e adipócitos. A imunofenotipagem de células mesenquimais foi realizada e as amostras de todos os pacientes apresentaram perfil imunofenotípico compatível com trabalhos anteriores. Foram identificadas mutações nos genes COL1A1 e/ou COL1A2 responsáveis pelo desenvolvimento da doença para quatro dos cinco pacientes avaliados. Para o paciente portador de Osteogênese Imperfeita e Síndrome de Bruck a região codificadora do gene PLOD2 também foi seqüenciada, porém não foram encontradas mutações. A análise da expressão gênica foi realizada pela técnica de microarranjos e foram identificados vários genes com expressão diferencial. Alguns genes com importância fundamental na diferenciação osteoblástica apresentaram menor expressão nas amostras dos pacientes portadores de OI, sugerindo um menor comprometimento das CTMs desses pacientes com a linhagem osteogênica. Outros genes também tiveram sua expressão diferencial confirmada por PCR em Tempo Real. Foi observado um aumento na expressão de genes relacionados a adipócitos, sugerindo um aumento da diferenciação adipogênica em detrimento à diferenciação osteogênica. A expressão das variantes do gene PLOD2 mostrou-se diferencial entre amostras normais, de OI e do paciente portador de Síndrome de Bruck. Também foi evidenciada uma expressão diferencial do microRNA 29b, um microRNA com papel estabelecido durante a diferenciação osteogênica, sugerindo um mecanismo de regulação dependente da quantidade de RNAm do seu gene alvo, o COL1A1. / Osteogenesis imperfecta (OI) is characterized as a genetic disorder in which a generalized osteopenia leads to short stature, bone fragility and serious skeletal deformities. Mesenchymal stem cells (MSCs) are precursors present in adult bone marrow that can differentiate into osteoblasts, adipocytes and myoblasts that have been given great importance as a source cell therapy. The aim of this study was to analyze the gene expression profile during osteogenic differentiation from mesenchymal stem cells from bone marrow taken from patients diagnosed with Osteogenesis Imperfecta and control subjects. Samples were collected from three normal individuals and five samples from patients with Osteogenesis Imperfecta. Mononuclear cells (MON) were isolated to obtain mesenchymal cells that were expanded until third passage when the stimulus for osteogenic differentiation was induced. Analyses were also conducted to count the CFU-F and for four of the five samples from patients with OI, the number of CFU-F observed was lower than generally found for normal samples. Cells were collected for analysis of cell immunophenotyping by flow cytometry and RNA was extracted from the resulting sample called T0. Remaining cells were stimulated for osteogenic differentiation. After a day in culture with stimulation, cells from another bottle had their RNA extracted (T1), and the same procedure was performed on days 2 (T2), 7 (T7), 12 (T12), 17 (T17) and 21 (T21). All samples have shown potential of in vitro differentiation into osteoblasts and adipocytes. Immunophenotyping of mesenchymal cells was performed and samples of all patients had immunophenotypic profile consistent with previous works. We identified mutations in COL1A1 and / or COL1A2 responsible for developing the disease for four of five patients. For the patient with Osteogenesis Imperfecta and Bruck Syndrome, coding region of the gene PLOD2 was also sequenced, but no mutations were found. The gene expression analysis was performed by microarray and identified several genes with differential expression. Some genes of fundamental importance in osteoblast differentiation showed lower expression in samples from patients with OI, suggesting a minor involvement of MSCs of patients with osteogenic lineage. Other genes also confirmed their differential expression by Real Time PCR. We observed an increased expression of genes related to adipocytes, suggesting an increased adipogenic differentiation at the expense of osteogenic differentiation. The expression of PLOD2 gene variants proved to be different between normal samples, OI and the patient with Bruck Syndrome. There was also evidence of differential expression of 29b microRNA, with established role during osteogenic differentiation, suggesting a mechanism dependent regulation of mRNA abundance of its gene target, COL1A1.

Abstract The extracellular matrix is not just a scaffold for cells and tissues, but rather a dynamic part of the human body. Characteristics of collagens, the major protein components of the extracellular matrix, are determined already during synthesis and mutations in genes encoding collagens, unbalance of regulators or dysfunction of collagen modifying enzymes, for instance, can lead to severe clinical complications. Certain hydroxylysine residues formed by lysyl hydroxylases (LHs) function in collagens as precursors of collagen cross-links that stabilize collagenous structures and thereby tissues. In humans, a deficiency of LH1, which is known to hydroxylate lysines in the helical regions of collagen polypeptides, causes Ehlers-Danlos syndrome VIA (EDS VIA). It is characterized e.g. by progressive kyphoscoliosis and hypermobile joints. Mutations in LH2, which is known to hydroxylate lysines in the telopeptides of collagen polypeptides, cause Bruck syndrome type 2 (BS2). BS2 patients suffer from fragile bones and congenital joint contractures, for instance, but the syndrome is usually not lethal. In this work we have generated and analyzed genetically modified LH1 and LH2 null mouse lines to study the in vivo functions and roles of these enzymes. Analyses concentrated also on collagen cross-links that were determined from several null or heterozygous mouse tissues. In the present work we also studied the effects of known BS2 mutations on recombinant human LH2 polypeptides to understand the molecular pathology of the syndrome. As an animal model for human EDS VIA, LH1 null mice had certain characteristics typical for EDS VIA, such as muscular hypotonia, but generally the symptoms were milder. Like EDS VIA patients, the mice have an increased risk of arterial ruptures and ultrastructural changes can be seen in the wall of the aorta, explained by inadequate helical lysine hydroxylation accompanied by a changed cross-linking state of tissues. Similarly, analysis of the LH2 null mouse line demonstrated the importance of the enzyme in cross-link formation. We showed that even a reduced amount of LH2 in adult mice changes the cross-linking pattern in tissues and a total lack of the enzyme leads to embryonic lethality. Furthermore, we demonstrated that LH2 is particularly important in tissue structures supporting blood vessels in the developing mouse embryo or in extraembryonic tissues. Finally, our in vitro studies with recombinant human LH2 polypeptides revealed that the known BS2 mutations severely affect the activity of the enzyme thus explaining the clinical symptoms of the patients, but the mutations do not lead to a total inactivation of the enzyme, which may be critical for the survival of patients. / Tiivistelmä Solunulkoinen matriksi ei ole ainoastaan soluja ja kudoksia tukeva rakenne, vaan se on dynaaminen osa ihmiskehoa. Kollageenien, solunulkoisen matriksin yleisimpien proteiinien ominaisuudet määräytyvät jo kollageenien synteesivaiheessa ja mutaatiot kollageeneja koodittavissa geeneissä, säätelytekijöiden epätasapaino tai esimerkiksi kollageeneja muokkaavien entsyymien toimintahäiriöt voivat johtaa vaikeisiin kliinisiin komplikaatioihin. Tietyt lysyylihydroksylaasien (LH) muodostamat hydroksilysiinitähteet toimivat kollageeneissa kollageeniristisidosten esiasteina. Ristisidokset vakauttavat kollageenirakenteita ja siten myös kudoksia. LH1 hydroksyloi lysiinejä kollageenipolypeptidien kolmoiskierteisellä alueella ja ihmisellä entsyymin puutos aiheuttaa tyypin VIA Ehlers-Danlosin syndrooman (EDS VIA), jossa potilailla on esimerkiksi etenevää kyfoskolioosia ja yliliikkuvat nivelet. Mutaatiot LH2-entsyymissä, joka hydroksyloi lysiinejä kollageenipolypeptidien telopeptidialueilla, aiheuttavat tyypin 2 Bruckin syndrooman (BS2). BS2-potilaat kärsivät mm. luiden hauraudesta ja niveljäykkyydestä, mutta syndrooma ei yleensä ole letaali. Tässä työssä loimme ja analysoimme geneettisesti muunnellut LH1 ja LH2 hiirilinjat, joiden kyseinen LH-geeniaktiivisuus on hiljennetty. Linjojen avulla halusimme tutkia näiden entsyymien toimintaa ja merkitystä in vivo. Analyysit keskittyivät myös kollageeniristisidoksiin, joita tutkittiin useista poistogeenisten tai heterotsygoottisten hiirten kudoksista. Ymmärtääksemme BS2:n molekyylipatologiaa, tutkimme tässä työssä myös tunnettujen BS2-mutaatioiden vaikutuksia ihmisen LH2-rekombinanttiproteiinissa. EDS VIA:n eläinmallina LH1 poistogeenisillä hiirillä on joitakin ominaisuuksia, kuten lihashypotonia, jotka ovat tyypillisiä EDS VIA:lle, mutta yleisesti oireet ovat lievempiä. Kuten EDS VIA-potilailla, hiirillä on kohonnut valtimoiden repeytymisriski ja aortan seinämän ultrarakenteessa voidaankin havaita muutoksia. Oireita voidaan selittää riittämättömällä kollageenien kolmoiskierteisen alueen lysiinien hydroksylaatiolla, joka muuttaa kollageenien ristisidostilaa kudoksissa. Myös LH2-hiirilinjan analysointi osoitti kyseisen entsyymin tärkeyden ristisidosten muodostamisessa. Jo alentunut LH2:n määrä aikuisissa hiirissä muuttaa kudosten kollageeniristisidoksia ja täydellinen entsyymin puuttuminen johtaa sikiön kuolemaan. Lisäksi osoitimme, että LH2 on erityisen tärkeä kudosrakenteissa, jotka tukevat kehittyvän hiiren sikiön tai sikiön ulkopuolisten kudosten verisuonia. In vitro-tutkimukset ihmisen LH2-rekombinanttiproteiinilla paljastivat, että tunnetut BS2-mutaatiot vaikuttavat erittäin haitallisesti entsyymin toimintaan, mikä selittää potilaiden kliiniset oireet, mutta mutaatiot eivät kuitenkaan aiheuta entsyymin täydellistä inaktivaatiota, mikä voi olla kriittistä potilaiden selviytymisen kannalta.