A acidose metabólica causa perda de mineral ósseo e a estimulação mecânica causa remodelamento ósseo adaptativo. A reabsorção óssea que caracteriza essas mudanças ósseas depende da acidificação extracelular pela secreção vetorial de H+ pelos osteoclastos. A H+-ATPase vacuolar em paralelo com o trocador Cl-/H+ (CLC7) são os mecanismos conhecidos envolvidos na reabsorção óssea, entretanto, os osteoclastos também expressam canais para H+ dependentes a voltagem. Este trabalho foi realizado para avaliar a contribuição dos canais para H+ na função celular visando à compreensão de seu relacionamento com a H+-ATPase vacuolar e o CLC7 (1); analisar se o fluxo de fluido extracelular modifica a secreção de H+ (2) e avaliar a diferenciação dos osteoclastos in vitro sob acidose metabólica devido à redução do HCO3- (3). Osteoclastos de ratos Wistar foram obtidos diretamente dos animais ou foram diferenciados in vitro (com M-CSF e RANKL) e semeados sobre vidro, plástico ou substratos mineralizados em <font face=\"Symbol\">&#945;-MEM + 10% SFB, em pH 7,4 ou 6,9, e então mantidos em incubadora com 5% CO2, a 37<font face=\"Symbol\">&#176;C. A diferenciação celular foi avaliada pela contagem de células TRAP-positivas ou de núcleos marcados por DAPI. A secreção de H+ foi avaliada por epifluorescência, utilizando-se BCECF-AM, sensível a pH. Os registros do pH intracelular foram feitos na vigência de soluções tamponadas por HEPES, na ausência de CO2/HCO3- (pH 7,4, 300 mOsm/L H2O, a 37<font face=\"Symbol\">&#176;C), na presença ou ausência de perfusão contínua de fluido extracelular a uma velocidade de 5 ml/min. Na ausência de perfusão, os osteoclastos exibiram variações cíclicas do pHi (acidificação e alcalinização espontâneas), com período de 12 a 45 minutos (n = 35) e amplitude de 0,12 a 1,43 unidades de pHi. As oscilações não foram abolidas por concanamicina (100 mM) (n = 3), por NPPB (100 <font face=\"Symbol\">mM) (n = 3), na ausência de Na+ extracelular (n = 5) ou na ausência de Cl- extracelular (n = 3). O fluxo de fluido aboliu as oscilações e a ausência de Cl- extracelular modificou significativamente seu padrão. Na ausência de perfusão, a secreção de H+ após acidificação intracelular induzida foi abolida por Zn2+ (100 <font face=\"Symbol\">mM) (n = 5). Além disso, na presença de perfusão, a secreção de H+ após acidificação intracelular induzida foi abolida por NPPB (n = 4) e não foi abolida por bafilomicina (200 nm) (n = 3). A acidose metabólica não modifica o número de osteoclastos diferenciados in vitro, entretanto, o tratamento das culturas com Zn2+ causou redução do numero de células mononucleares e aumento relativo do número de osteoclastos multinucleados em relação ao controle tanto em pH 7,4 quanto em pH 6,9. / Metabolic acidosis can cause a loss of bone mineral and the mechanic stimulation can cause adaptative bone remodeling. The bone resorption characteristic of these bone changes aforementioned depends on the extracellular acidification by osteoclastmediated proton secretion. The H+ secretion by vacuolar H+-ATPase together with Clsecretion through a Cl-/H+ exchanger (CLC7) are the known mechanisms involved in the bone resorption; however, osteoclasts also express voltage-gated proton channels. The proposed aims of these work were to evaluate the contribution of proton channels in the osteoclast function for better understanding its relation with vacuolar H+-ATPase and CLC7 (1); to analyze whether the flow of extracellular fluid modifies the H+ secretion or not (2); and to analyse the osteoclast differentiation in vitro under metabolic acidosis due to HCO3- reduction (3). Osteoclasts were freshly isolated or generated from bone marrow precursor cells (using M-CSF and RANK- L) from of Wistar rats. The cells were placed on glass coverslips, plastic coverslips, or on mineralized substrate in <font face=\"Symbol\">&#945;-MEM + 10% FBS, pH 7.4 or 6.9, and then maintained in a 5% CO2 incubator at 37<font face=\"Symbol\">&#176;C. The differentiation was analyzed by counting of TRAP-stained cells or DAPIstained nuclei. The H+ secretion was analysed by epifluorescence, using the pHsensitive dye BCECF-AM. The intracellular pH record was done using a standard HEPES-buffered solution free of CO2/HCO3- (pH 7.4, 300 mOsm/L H2O, at 37<font face=\"Symbol\">&#176;C), with or without continuous perfusion of extracellular fluid at a rate of 5 ml/min. In the absence of perfusion, the osteoclasts exhibit cyclic pHi variations (spontaneous acidification and alkalinization), with a period of 12 to 45 minutes (n = 35) and amplitude difference between maximal and minimal pHi of 0.12 to 1.43 units pHi. These oscillations were not abolished in the presence of oncanamycin (100 mM) (n = 3), NPPB (100 <font face=\"Symbol\">mM) (n = 3), in the absence of Na+ (n = 5) or in the absence of Cl- (n = 3) in the extracellular solution. The fluid flow itself abolished the pH oscillations and the absence of extracellular Cl- modifies significantly these patterns. In the absence of perfusion, the H+ secretion after induced intracellular acidification was abolished by Zn2+ (100 <font face=\"Symbol\">mM) (n = 5). In addition, in the presence of perfusion, the H+ secretion after induced intracellular acidification was abolished by NPPB (n = 4) and was not abolished by bafilomycin (200 nm) (n = 3). Metabolic acidosis does not modify the number of osteoclasts differentiated in vitro, however, when the cell culture was treated with Zn2+, there was a significant reduction in the number of mononuclear cells and a relative increase in the number of multinucleated osteoclasts compared to control, both in pH 7.4 and pH 6.9 medium.

Alors que les phases de résorption et de couplage du cycle de remodelage de l’os sont de plus en plus connues et ont permis le développement d’agents thérapeutiques, la phase d’activation reste peu étudiée. L’objectif global de ce travail est d’analyser les évènements cellulaires mis en jeu au cours de la phase d’activation du remodelage de l’os. Les objectifs spécifiques ont été 1- de caractériser le trafic cellulaire dans le périoste au cours de la phase d’activation du remodelage et 2- d’étudier le rôle d’une enzyme, la nicotinamide phosphorybosyl transférase (Nampt) dans ces évènements. Dans notre premier travail, nous montrons dans un modèle de remodelage synchronisé de l’os alvéolaire, une expression précoce de ICAM-1 par les vaisseaux qui serait impliquée dans la diapédèse observée de monocyte-macrophages CD68+. Ces cellules migreraient à travers le compartiment non ostéogénique puis ostéogénique, guidées par des cellules de type fibroblastes puis des OB exprimant VCAM-1. Le nombre des cellules RANKL+ dans le compartiment ostéogénique augmente graduellement lors de la phase d’activation. En parallèle, l’expression de la sémaphorine 3a, qui inhibe l’ostéoclastogénèse, diminue chez les OB et les ostéocytes superficiels. Dans notre second travail, nous trouvons que l’expression basale de la Nampt est accrue dans les cellules de la couche ostéogénique au cours de la phase d’activation du remodelage. Inhiber son activité via le FK866 permet de diminuer l’ostéoclastogenèse indiquant que la Nampt serait impliquée dans le recrutement et l’activité des OC. En culture primaire d’ostéoblastes murins, nous montrons que son expression augmente au cours de la différentiation et qu’elle régule l’expression de marqueurs tardifs de différentiation. L’ensemble de ces données montre une série d’évènements coordonnés qui servent au recrutement des précurseurs ostéoclastiques et à leur migration vers la surface osseuse à résorber. La Nampt semble jouer un rôle dans l’acquisition des ostéoblastes d’un phénotype favorable à ces évènements. / Resorption and inversion phases of bone remodeling are well understood, which have permitted the development of therapeutic agents. At the opposite, activation phase remains poorly characterized. This work aims to analyze cellular events involved in the activation phase of bone remodeling. Specific goals were: 1- To characterize cellular traffic in the periosteum during the activation phase of bone remodeling. 2- To study the role of NicotinAMide Phosphorybosyl Transférase (NAMPT) enzyme during activation. In the first study, we show an early expression of ICAM-1 by vessels in a synchronized alveolar-bone-remodeling model. The ICAM-1 expression may be involved in the observed diapedesis of monocytes – macrophages CD68+. These cells migrate through non osteogenic and osteogenic layers, steered by fibroblast-like cells and then by VCAM+ osteoblasts (OB). The number of RANKL+ cells in osteogenic layer gradually increases during the activation phase. Simultaneously, the expression of semaphorine 3a inhibiting osteoclastogenesis, decreases in osteoblasts and superficial osteocytes. In the second study, we show that basal expression of NAMPT increases in osteogenic-layer cells during the activation phase of bone remodeling. Inhibiting its activity with FK866 enhables to decrease osteoclastogenesis, suggesting an involvement of NAMPT in osteoclast recruitment and activity. In primary culture of murine OB, we show that NAMPT expression increases during differentiation. It also regulates OB late-differentiation markers expression. All these data show a series of coordinated events which serve in osteoclasts precursors’ recruitment and migration towards bone surface. NAMPT seems to contribute to acquiring an OB phenotype more favorable to OC recruitment.

Ce travail de thèse a eu comme objectif la mise en place et la validation d’une méthodologie expérimentale pour le suivi de l’évolution in-vitro de substituts osseux à base de phosphates de calcium. Du phosphate dicalcique dihydraté (DCPD, CaHPO4·2H2O) et du phosphate tricalcique bêta (β-TCP, β-Ca3(PO4)2) ont été choisis comme matériaux modèles de deux grandes classes de substituts osseux: les “biosolubles” (sujets à dissolution après implantation) et les “biorésorbables” (sujets à résorption cellulaire après implantation). Pour l’étude des phénomènes de dissolution et de reprécipitation observés lorsque les phosphates de calcium sont plongés en solution, ces matériaux ont été produits sous forme d’échantillons microporeux (60% de porosité pour le DCPD, 75% pour le β-TCP) et soumis à des tests de dissolution in-vitro en conditions statiques ou dynamiques (sans ou avec renouvellement du liquide) dans différentes solutions tamponnées à pH physiologique (TRIS et PBS) et pour des durées s’étalant entre 30 minutes et 2 mois. L’analyse des propriétés physico-chimiques, microstructurales et mécaniques des échantillons avant et après immersion a permis d’évaluer l’influence du type de milieu et des conditions de test choisies sur l’évolution des échantillons. Une attention particulière a été prêtée à la caractérisation mécanique: la technique de micro-indentation instrumentée sphérique a été préférée à autres essais plus conventionnels. Cette technique permet d’évaluer plusieurs paramètres tels que la dureté et le module de Young de façon quasi non-destructive et à une échelle locale. En conséquence, l’utilisation de la micro-indentation s’est avérée d’une grande aide pour le suivi des caractéristiques d’échantillons dégradés qui présentaient un gradient de propriétés entre la surface (où le processus de dégradation commence) et le cœur (sujet à des changements sur plus long terme). La dernière partie de cette étude a été dédiée à l’étude du deuxième phénomène qui entraine la résorption de substituts osseux in-vivo, à savoir la résorption cellulaire. Pour cela des essais cellulaires avec des cellules précurseurs d’ostéoclastes ont été réalisés sur des échantillons denses de β-TCP pur ou dopé avec 5% molaire de magnésium. L’addition de cet élément est censée modifier les propriétés du matériau (notamment sa solubilité) et, par conséquence, modifier le comportement cellulaire. Les résultats des tests ont confirmé la cytocompatibilité des deux types de β-TCP, mais ont également mis en avant une difficulté d’activation des ostéoclastes. Deux des causes possibles seraient liées à la topographie de surface des échantillons et au relargage des ions calcium suite à la dissolution du matériau. / The present Ph.D. thesis work was aimed to establish and assess an experimental methodology to monitor the in-vitro evolution of calcium phosphate (CaP) bone substitutes. Dicalcium phosphate dihydrate and beta-tricalcium phosphate were chosen as model of two main classes of bone substitutes: “biosoluble” ones (which undergo dissolution after implantation) and “bioresorbable” ones (which undergo cellular resorption after implantation). In order to study the dissolution and precipitation phenomena, which take place once CaPs are immersed in solution, these materials were produced in the form of micro-porous samples (60% of porosity for DCPD, 75% for β-TCP) and used for dissolution tests in-vitro in static and dynamic conditions (without or with liquid renewal) in different buffered solutions at physiologic pH (TRIS and PBS) and for periods of time ranging between 30 minutes and 2 months. The analysis of the physico-chemical, microstructural and mechanical properties of the samples before and after immersion allowed to evaluate the influence of the chosen medium and immersion conditions on the evolution of the specimens. Particular attention was paid to the mechanical characterisation: instrumented spherical micro-indentation was preferred to other more conventional tests. This technique enables the evaluation of several parameters such as the hardness and the Young’s modulus in a quasi-non-destructive way and on a local scale. As a consequence, the use of micro-indentation proved to be of great help for monitoring the characteristics of the degraded specimens, which presented a gradient of properties between the surface (where the degradation process starts) and the core (subject to changes on a longer period). The last part of this work was focused on the study of the second main phenomenon, which takes part in the in-vivo resorption of bone substitutes, that is to say the cellular resorption. For this purpose, cellular tests with osteoclast-precursor cells were carried out on dense samples made of pure and magnesium-doped β-TCP (5 mol.% of Mg). The addition of magnesium was aimed to modify the properties of the material and, as a consequence, the cellular behavior. The results confirmed the cytocompatibility of both types of β-TCP, but they also showed a difficult activation of osteoclasts. Two of the possible causes would be linked to the topography of the surface of the specimens and to the release of calcium ions due to the dissolution of the material.

This study focused on the role of RANKL in prostate cancer EMT progression and metastasis. Activation of RANK, a receptor activator of NF-kB, by its ligand RANKL, in a paracrine manner is responsible for osteoclast differentiation and bone remodeling. RANK activation in cancer cells, however, is thought to be promoted by both autocrine and paracrine mechanisms because RANKL has been shown to be derived from either tumor or its microenvironment, such as osteoblasts, infiltrating inflammatory cells and stromal fibroblasts. In the present study, we demonstrated that autocrine and paracrine RANKL-RANK signaling could be responsible for driving prostate cancer bone metastasis by promoting epithelial to mesenchymal transition (EMT). We further characterized a novel converging RANKL-c-Met signaling network in which the activation of RANKL was found to promote the expression of both RANKL and c-Met in an autocrine manner in prostate cancer cells. The induced RANKL and c-Met in prostate cancer cells is biologically functional and contributes to increased osteoclastogenesis, epithelial to mesenchymal transition (EMT), cell motility, migration and invasion and conferred bone and soft tissue metastases. Remarkably, RANKL expression by 1,000 prostate cancer cells can provoke bone and soft tissue metastases of a “dormant” population of prostate cancer cells which by themselves failed to form tumors and colonize mouse skeleton, suggesting RANKL can serve as a factor in “reawakening” cancer dormancy to initiate the re-growth and metastasis of cancer cells. We also showed that RANKL-induced RANKL feed-forward autocrine regulation is mediated through cMyc transactivation, allowing the establishment of a “vicious cycle” further promoting prostate cancer growth and metastasis. The converging RANKL-c-Met signaling network is therefore a novel target that could be further manipulated for delaying the lethal progression of castration-resistant human prostate cancer bone metastasis.

Abstract Osteoclasts are multinuclear bone degrading cells differentiated from monocytes which can be isolated from bone marrow and peripheral blood. Complex signaling between osteoclast precursors and other bone cells, such as mesenchymal stromal cells (MSC) occurs during the differentiation. Gap junctional communication (GJC) is one of the mechanisms in the cell fusion. GJC can be modulated with several substances such as the specific GJC stimulators, antiarrhythmic peptides (AAP). Due to their promising clinical value in the treatment of cardiac disorders, the effects of AAPs in cardiac tissue are studied extensively. This study was conducted in order to investigate the roles of GJC and AAPs in bone cell cultures. Further, the contribution of the MSCs on the effects of AAPs was studied along with comparison of two types of osteoclastogenesis cultures with differing quantities of MSCs. GJC in osteoclastogenesis was studied with both GJC inhibitors and stimulators in mouse monocyte line RAW 264.7 cells and primary cultures with bone marrow hematopoietic cells. The following studies were made with human monocytes from peripheral blood and bone marrow where the effects of AAP10 were investigated in normal and acidic environments. In addition, comparison of osteoclastogenesis from bone marrow and peripheral blood monocytes was carried out in in vitro cell cultures on bovine or human bone slices. The cells were analyzed with regard to multinuclearity, bone resorption and the expression of several osteoclast markers. The results show that GJC is utilized in osteoclastogenesis, but it is not indispensable. GJC in monocytes can be stimulated with the AAPs during osteoclastogenesis, but the effects depend on the culture conditions as well as on the presence of MSCs in the culture. The AAPs can also activate the MSCs leading to indirect regulation of osteoclastogenesis, as the MSCs produce several molecules affecting the differentiation. Further, monocytes from peripheral blood showed increased potential for osteoclastogenic differentiation compared to bone marrow derived monocytes. This can be explained by the presence of the osteoclastogenesis-controlling MSCs in the bone marrow culture, while the peripheral blood cultures contain only few of these cells and thus lack their regulatory effects. / Tiivistelmä Osteoklastit ovat monitumaisia luuta hajottavia soluja, jotka ovat erilaistuneet monosyyteistä. Monosyyttejä voidaan eristää luuytimestä tai perifeerisestä verestä. Erilaistumisen aikana osteoklastien esiastesolujen sekä muiden luusolujen, kuten mesenkymaalisten stroomasolujen (MSC) välillä tapahtuu monimutkaista signalointia. Aukkoliitoskommunikointi (GJC) on eräs solufuusiossa tapahtuvista mekanismeista. GJC:tä voidaan muunnella useilla aineilla, esimerkiksi spesifisillä stimulaattoreilla, antiarytmisillä peptideillä (AAP). AAP-yhdisteiden vaikutuksia on tutkittu laajalti sydänkudoksessa johtuen niiden lupaavista kliinisistä ominaisuuksista sydänperäisten oireiden hoidossa. Tämän tutkimuksen tarkoituksena oli selvittää GJC:n ja AAP-yhdisteiden roolia luusoluviljelmissä. Lisäksi tutkittiin MSC-solujen osallistumista AAP-yhdisteiden vaikutuksiin sekä vertailtiin kahta erilaista osteoklastogeneesiviljelmää, joissa oli eri määrä MSC-soluja. GJC:tä osteoklastogeneesissä tutkittiin sekä sitä estävillä että stimuloivilla yhdisteillä hiiren monosyyttilinjan RAW 264.7 -soluissa sekä luuytimen hematopoieettisten solujen primääriviljelmissä. Seuraavat tutkimukset tehtiin ihmisen luuytimen ja perifeerisen veren monosyyteillä, ja niissä selvitettiin AAP10-yhdisteen vaikutuksia fysiologisissa sekä happamissa olosuhteissa. Lisäksi vertailtiin luuytimen ja perifeerisen veren monosyyttien osteoklastogeneesiä. In vitro -soluviljelmät tehtiin naudan tai ihmisen luulastujen päällä, ja soluista analysoitiin monitumaisuus, luun resorptio sekä useiden osteoklastimarkkereiden ilmentyminen. Tulokset osoittavat, että GJC:tä hyödynnetään osteoklastogeneesissä, mutta se ei ole korvaamaton mekanismi. GJC:tä voidaan stimuloida AAP-yhdisteillä osteoklastogeneesin aikana, mutta vaikutukset riippuvat viljelyolosuhteista sekä MSC-solujen läsnäolosta. AAP-yhdisteet voivat aktivoida myös MSC-soluja johtaen osteoklastogeneesin epäsuoraan säätelyyn, kun MSC-solut tuottavat useita erilaistumiseen vaikuttavia molekyylejä. Lisäksi perifeerisen veren monosyyteillä havaittiin korkeampi osteoklastogeeninen erilaistumispotentiaali verrattuna luuytimen monosyytteihin. Tulokset voidaan selittää osteoklastogeneesiä säätelevien MSC-solujen läsnäololla luuydinviljelmissä, kun taas perifeerisen veren monosyyttiviljelmissä näitä soluja on vain vähän, jolloin myös niiden säätelyominaisuudet puuttuvat.

Introduction: Bone is a highly active tissue throughout life and is a subject to constant remodelling. Main cells responsible for continuous resorption and de novo synthesis of bone matrix are osteoclast, osteoblasts and osteocytes. Osteoclasts are the only known type of cells able to resorb bone. These cells are formed by fusion of precursor cells in bone marrow or peripheral blood in a process called osteoclastogenesis. Formation of osteoclasts may be of importance concerning chronic inflammatory diseases that are linked with higher risk of developing osteoporosis during lifespan. Celiac disease is one of those diseases, which is characterized by destruction of intestinal mucosa after ingestion of gluten by susceptible individuals followed by induction of chronic inflammation. In this work, we focused on the potential role of osteoclastogenesis in the development of osteoporosis in patients with celiac disease and we studied roles of selected inflammatory agents (TNF-α, IL-6, IFN-γ a cfDNA) with supposed or hypothesised effects on osteoclastogenesis. Material & Methods: We obtained plasma and serum samples from newly diagnosed patients with celiac disease, patients on gluten free diet and healthy controls and analysed concentrations of cfDNA and inflammatory cytokines TNF-α, IL-6 and IFN-γ in...

Aggregatibacter actinomycetemcomitans está associado à periodontite agressiva, caracterizada pela intensa reabsorção do osso alveolar. Esta espécie produz a toxina distensora citoletal (AaCDT) que possui atividade de DNAse, e promove o bloqueio das células alvo na fase G2 ou G1/ G2. Por outro lado, CDT ativa a cascata apoptótica pela atividade de PIP3, regulando a proliferação e sobrevivência de linfócitos, pelo bloqueio de Akt. Em monócitos, AaCDT induz aumento da produção de citocinas pró-inflamatórias e inibe a produção de óxido nítrico e fagocitose. Células precursoras de osteoclastos têm origem hematopoiética e sofrem diferenciação em osteoclastos, mediada pelo RANKL, mas outros fatores co-estimulatórios estão envolvidos. A AaCDT induz a produção de RANKL por fibroblastos. Assim, formulamos a hipótese se CDT influenciaria a homeostase óssea por afetar a diferenciação de células precursoras de osteoclastos. O estudo visou determinar o efeito de AaCDT sobre a sobrevivência, diferenciação e atividade em RAW264.7 e BMC. Os dados sugerem que a CDT interfere na homeostase óssea, favorecendo a indução da diferenciação de células precursoras de osteoclastos e alterando o perfil de citocinas produzidas. / Aggregatibacter actinomycetemcomitans is associated with aggressive periodontitis, characterized by severe alveolar bone resorption. This species produces a distending toxin cytolethal (AaCDT) which has DNase activity, and promotes the blocking of target cells in G2 or G1 / G2 phase. On the other hand, CDT activates the apoptotic cascade by PIP3 activity, regulating lymphocyte proliferation and survival by blocking Akt. In monocytes, AaCDT enhances the production of proinflammatory cytokines and inhibits nitric oxide production and phagocytosis. Osteoclast precursor cells are of hematopoietic origin and must undergo differentiation into osteoclasts mediated by RANKL although other co-stimulatory factors are involved. AaCDT induces the production of RANKL by fibroblasts. Thus, CDT is hypothesized to influence bone homeostasis by affecting the differentiation of precursor cells into osteoclasts. This study aimed to determine the effect of AaCDT on survival, differentiation and activity of osteoclasts precursor cells. The data suggested that CDT interfere in bone homeostasis, favoring the differentiation of osteoclasts precursors cells and by altering their cytokines profile.

Abstract Bone remodelling occurs in humans throughout life, therefore bone is continuously renewed to better respond to changes in weightbearing circumstances. Bone remodelling is extremely vulnerable during fracture healing and integration of prostheses into the surrounding bone. Bone remodelling is a complex system in which many growth factors, cytokines and enzymes, which are essential for the differentiation of osteoblasts and osteoclasts, are involved. Some widely used drugs can affect this sensitive system of remodellation in unexpected manner. Painkillers such as cyclooxygenase (COX) inhibitors have been demonstrated in animal studies to interfere with fracture healing and a few retrospective clinical studies confirm these observations. Bisphosphonates (BP), main target of which is the bone resorbing osteoclast, have been suggested to be the drug of choice to improve periprosthetic bone density and thus prevent aseptic loosening of implants. The exact mechanism of action of clodronate (CLO), a non-amino-BP, which was selected for the study, has not been clarified thus far. In order to gain a deeper understanding of the role of the COX enzyme in the differentiation of osteoblasts we studied human mesenchymal stem cell (hMSC) cultures in the presence of different COX-inhibitors; indomethacine, parecoxib and NS398, a specific COX-2 inhibitor. We used the liposome encapsulated CLO metabolite (AppCCl2p) to study in detail the mechanism of BP induced apoptosis in osteoclast. The effects of different BPs CLO, pamidronate (PAM) and zoledronic acid (ZOL), on the differentiation of osteoblasts and osteoclasts were tested in vitro. The optimal concentration for in situ CLO rinsing in clinical study was found. Finally, the effects of in situ and per oral CLO on the periimplant bone density and integration of prostheses were studied in vivo. All tested COX-inhibitors significantly inhibited osteoblast differentiation from hMSCs and stimulated the differentiation of adipocytes. It was also demonstrated that AppCCl2p inhibits mitochondrial function by a mechanism that involves competitive inhibition of ADP/ATP translocase. In the comparison of BPs, ZOL seemed to posses the properties of both non-amino- and amino-BPs and it thus belongs to a new class of BPs. Peroral and in situ CLO seemed to have different mechanisms of action. Peroral CLO delayed the integration of prosthesis to the bone and increased peri-implant osteolysis while is situ CLO accelerated integration. In conclusion, we can alter normal bone remodellation during fracture healing and prosthesis integration. On the other hand, we can also improve the circumstances for the integration of implant to the surrounding bone by in situ BP rinsing, thus creating a better environment for bone ingrowth. / Tiivistelmä Läpi elämän luustossa tapahtuu uudelleenmuotoutumista, remodelaatiota, jonka seurauksena luu pystyy paremmin vastaamaan muuttuneisiin kuormitusolosuhteisiin. Remodelaatioprosessi on hyvin haavoittuvainen murtuman luutumisen aikana sekä proteesin kiinnittyessä ympäröivään luuhun. Luun remodelaatioon osallistuvat kasvutekijät, sytokiinit ja entsyymit, jotka puolestaan ovat välttämättömiä osteoblastien ja osteoklastien erilaistumiselle. Monet lääkeaineet voivat yllättävällä tavalla vahingoittaa tätä herkkää remodelaatiosysteemiä. Kipulääkkeet, kuten syklo-oksygenaasi (COX) estäjät, voivat häiritä murtuman luutumista aikaisempien eläintöiden ja muutamien retrospektiivisten potilastutkimusten mukaan. Lisäksi bisfosfonaatit, joiden päävaikutuskohde on luuta hajoittava osteoklasti, voisivat olla lupaavia lääkkeitä myös parantamaan proteesia ympäröivän luun laatua ja siten estämään aseptista implantin irtoamista. Tutkimuksen yhtenä tarkoituksena oli selvittää klodronaatin, ensimmäisen polven typpi-ryhmää sisältämättömän bisfosfonaatin tarkka vaikutusmekanismi. Viljelemällä ihmisen luuytimen kantasoluja indometasiinia, parekoksibia tai spesifistä COX-2 estäjää NS 398:a, sisältävässä kasvatusliuoksessa selvitettiin COX-entsyymin merkitys osteoblastien erilaistumiselle. Liposomien sisälle pakattua klodronaatin metaboliittia (AppCCl2p) käytettiin tutkittaessa millä vaikutusmekanismilla klodronaatti aiheuttaa osteoklastien apoptoosin. Bisfosfonaattien; klodronaatin, pamidronaatin ja tsoledronaatin vaikutusta osteoklastien ja osteoblastien erilaistumiseen tutkittiin soluviljelmämallissa ja määritettiin kliinisessä potilastyössä paikallisesti käytettävän klodronaattiliuoksen pitoisuus. Lopuksi potilastyössä selvitettiin paikallisen klodronaattihuuhtelun ja suun kautta annostellun klodronaatin vaikutus proteesia ympäröivän luun tiheyteen ja proteesin kiinnittymiseen ympäristöönsä. Tutkimukseen valitut COX-estäjät vähensivät ihmisen kantasolujen erilaistumista osteoblasteiksi ja lisäsivät erilaistumista rasvasoluiksi. Lisäksi todettiin, että AppCCl2p estää mitokondrioissa tapahtuvaa hengitystä estämällä ADP/ATP-vaihtajan toiminnan, saaden aikaan solukuoleman. Vertailtaessa bisfosfonaatteja, tsoledronaatilla vaikutti olevan sekä ensimmäisen, että kolmannen polven (sisältää typpi-ryhmän) bispfosfonaattien vaikutuksia, joten tsoledronaatti kuuluu aivan uuteen bisfosfonaattiryhmään. Potilastutkimuksessa suun kautta ja paikallisesti reisiluun ytimeen annostellulla klodronaatilla oli täysin erilainen vaikutus. Suun kautta syötynä klodronaatti hidasti proteesin kiinnittymistä ja aiheutti osteolyysiä. Sen sijaan paikallinen klodronaatti nopeutti merkittävästi proteesin kiinnittymistä ympäröivään luuhun. Näiden tutkimustulosten perusteella voidaan olettaa, että COX-estäjät, samoin kuin peroraalinen bisfosfonaatti, voivat tahattomasti häiritä luun remodelaatiota.

The effects of parathyroid hormone (PTH), prostaglandins (PGE1, PGE2, PGF2a), cAMP, cAMP-analogues, phosphodiesterase (PDE) inhibitors and la (OH) D3 on bone resorption and associated cellular process have been studied in a bone organ culture system using half- calvaria from 6-7 day-old mice. Bone resorption was assessed by determining the release of calcium (Ca2+), inorganic phosphate (Pi) and 45Ca from the calvarial bones to the culture media. The release of lysosomal enzymes was studied by analysing the activities of β-glucuronidase, β-N-acetyl- glucosaminidase, β-galactosidase and p-nitrophenyl phosphatase in bone expiants and culture media. The release of non-lysosomal enzymes was followed by assaying the activities of lactate dehydrogenase (LDH), aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) in the expiants as well as the media. In addition glucose consumption and lactate production was registered. The findings may be summarized as follows: 1. cAMP and PDE-inhibitors have the capacity to inhibit the initial stages of spontaneous as well as PTH- PGE1- and PGE2-stimulated bone resorption. 2. cAMP and PDE-inhibitors produce after a lag period, or a period of reduced bone resorption, a stimulatory effect on bone resorption. 3. There is a significant correlation between bone resorption and lysosomal enzyme release both as regards the inhibitory and stimulatory effect of cAMP. 4. PGE2 and la (OH) D3 increase the release of lysosomal enzymes in parallel with bone resorption. 5. Bone resorption stimulated by cAMP and PGE2 is associated with increased glucose consumption and lactate production, while la (OH) D3 promotes bone resorption without any change with regard to these parameters of glucose metabolism. It is concluded that the initial stages of bone resorption stimulated by PTH, PGE1 and PGE2 is medited by cAMP-independent mechanisms, but that this nucleotide may be an intracellular mediator of these hormones of later stages of bone resorption. It is suggested that the role played by cAMP may be related to the capacity of PTH and PGE2 to develop new osteoclasts. The observations further support the concept that lysosomal enzyme release is intimately associated with bone resorption. Finally it is concluded that increased lactate production seems to be related to bone resorption stimulated by agents which increase the level of cAMP (PTH, PGE2, dbcAMP), but that it is not an indispensible part of the mechanism by which the osteoclasts solubilize bone mineral. / digitalisering@umu.se

L'interleukine-17A (IL-17A) et le facteur de nécrose tumorale alpha (TNF-α) sont des cytokines pro-inflammatoires impliquées dans la pathogénèse de plusieurs maladies articulaires. Au cours de la polyarthrite rhumatoïde (PR), une augmentation de la destruction osseuse ainsi qu'un defaut de réparation sont responsables des dommages articulaires. Cependant au cours de la spondylarthrite ankylosante (AS), une importante ossification ectopique est observée, conduisant à la formation de syndesmophytes, associé à une perte de la masse osseuse systémique. Récemment, l'étude de ces cytokines a conduit à la publication de résultats contradictoires. Notre objectif a donc été d'étudier l'effet de ces deux cytokines sur la différenciation ostéogénique de cellules souches mésenchymateuses humaines isolées (hMSCs) et de fibroblastes de la membrane synoviale (FLS). Tous les modèles de cellules utilisés, ont démontré que l'IL-17A et le TNF-α augmentent de manière synergique l'ostéogénèse. Ceci semble se rapprocher du modèle de l'AS où une formation d'os ectopique est observée dans laquelle l'IL-17A et le TNF-α jouent un rôle majeur. En parallèle, ces deux cytokines stimulent localement les ostéoclastes, entraînant une perte de masse osseuse observée à la fois dans la PR et dans l'ostéoporose. Cibler simultanément l'IL-17A et le TNF-α pourrait conduire à une diminution de l'infiltration de cellules et de la destruction articulaire observée dans la PR et pourrait ainsi réduire les effets des FLS PR sur l'activation de l'ostéoclastogénèse / Interleukin-17A (IL-17A) and tumor necrosis factor alpha (TNF-α) are pro-inflammatory cytokines involved in the pathogenesis of several arthritic diseases. In rheumatoid arthritis (RA), joint damage is a result of an increase in bone destruction and a decrease in bone repair. In contrast, in ankylosing spondylitis (AS), a bone mass loss accompanied by a significant ectopic ossification is observed leading to the formation of syndesmophytes. Recent studies led to contradictory findings regarding the role of IL-17A and TNF-α in arthritic disease. Therefore, our objective was to study the effect of these two cytokines on the osteogenic differentiation of isolated human mesenchymal stem cells (hMSCs) and fibroblasts of the synovial membrane (FLS). In all the cell models used, we demonstrated that Il-17A and TNF α synergistically increase osteogenesis. This seems to approach the model of AS where ectopic bone formation is observed and in which IL-17A and TNF-α both are involved. These cytokines stimulate osteoclasts locally resulting in loss of bone mass observed in both RA and osteoporosis. Thus, targeting IL-17A and TNF-α could lead to a decrease in cell infiltration and joint destruction which is observed in RA and may reduce the effects of RA FLS on the activation of osteoclastogenesis