Neste trabalho, foi avaliado a participação dos osteoclastos bem como a ação das citocinas RANKL, OPG e TNF-α durante a formação e remodelação óssea em defeitos ósseos de tamanho crítico em ratos normoglicêmicos e diabéticos tratados ou não com a MAOD. Para isso, foram utilizados 250 ratos machos Wistar. Trinta ratos foram utilizados para coleta dos fêmures e tíbias, os quais foram processados para obtenção da MAOD. Os demais 220 ratos foram divididos em Grupo Não Diabétido (CTL, n=110) e Grupo Diabético (DIAB, n= 110) induzido pela aplicação de uma dose única de 47 mg/Kg de massa corporal de estreptozotocina. Um defeito transósseo de 8 mm de diâmetro foi realizado nos ossos parietais dos ratos, sendo que, nos subgrupos CTL MAOD e DIAB MAOD, os defeitos foram preenchidos com MAOD e nos grupos CTL COAG e DIAB COAG apenas com coágulo sanguíneo. Após 0, 7, 14, 21 e 42 dias, as calotas cranianas foram coletadas para determinação da densidade de volume, número de osteoclastos/mm2 na área do defeito, quantificação por imunoistoquimica e expressão do RNAm para as proteínas RANKL, OPG e TNF-α. Os resultados para volume do tecido ósseo neoformado foi maior nos grupos CTL COAG e CTL MAOD, bem como no grupo DIAB MAOD quando comparado com DIAB COAG (CTL MAOD > CTL COAG e DIAB MAOD > DIAB COAG). O número de osteoclastos nos grupos CTL aumentaram significantemente (3,69 osteoclasto/mm2), enquanto que nos grupos MAOD aumentaram gradualmente até os 42 dias (2,8 osteoclasto/mm2). Os resultados para imunomarcação mostraram que a MAOD promove 1,28 vezes maior expressão de OPG, bem como de TNF-α tanto no grupo CTL (1,59 vezes) como no DIAB (1,76 vezes). Os resultados para expressão do RNAm para OPG mostrou que a média dos valores do grupo COAG comparado com a do grupo MAOD foi 1,91 vezes maior no grupo COAG. Já os valores para expressão de RANKL permaneceram constantes no grupo DIAB MAOD, com aumento significativo de 2,57 vezes aos 42 dias, sendo 4,3 vezes maior, quando comparado com a média dos outros grupos no mesmo período. Conclui-se que nos animais normoglicemicos, o tratamento com a MAOD aumenta a expressão de OPG, RANKL e TNF-α, assim como a atividade osteoclástica, promovendo reabsorção da MAOD e formação de tecido ósseo, enquanto que nos animais diabéticos, a atividade osteoclástica foi reduzida, sem alteração nos níveis de OPG e RANKL, reduzindo a reabsorção da MAOD e consequentemente da formação óssea. / Participation of osteoclasts was evaluated in reabsorption process of demineralized allogenic bone matrix (DABM) as well as the activity of cytokines RANKL, OPG and TNF- α during formation and bone remodeling in critial size defect of normoglycemic and diabetic rats treated or not with DABM. Therefore, 250 male Wistar rats were used. Thirty rats had femurs and tibias collected and processed to obtain DABM. 220 rats were divided into control group (CTL, n=110) and diabetic group (DIAB, n= 110) injected by a single dose of 47 mg/Kg of body weight streptozotocin. Were made 8mm bone defect on skulls of rats, in subgroups CTL DABM and DIAB DABM, defects were filled with DABM and subgroups CTL CLOT and DIAB CLOT were filled with blood clot. After 0, 7, 14, 21 and 42 days, the skulls were collected to determine the volume density, number of osteoclasts/mm2 into defects area, quantification by immunohistochemistry and RNAm expression of RANKL, OPG and TNF-α cytokines. The results of volume density of newly formed bone was higher in CTL CLOT and CTL DABM, as well as in DIAB DABM compared to DIAB CLOT (CTL DABM > CTL CLOT and DIAB DABM > DIAB CLOT). The number of osteoclasts in CTL groups increased to 3,69 osteoclasts/mm2, while in subgroups treated with DABM gradually increased up until 42 days (2,8 osteoclasts/mm2). Immunohistochemistry showed that DABM promotes an increase of 1.28-fold of OPG expression, as well as TNF-a expression in CTL group (1.59-fold) and DIAB group (1.76-fold). The results of RNAm expression of OPG showed that the average values of the CLOT subgroup compared to the average values of DABM subgroup was 1.91- fold higher in CLOT subgroup. The values of RANKL RNAm expression increase 2.57-fold at 42 days, being 4.3-fold higher than the average os the other groups in the same period. In conclusion, in the normoglicemic animals (CTL group), the treatment with DABM increase the expression of OPG, RANKL and TNF-α as the activity of osteoclasts, leading to DABM resorption and bone tissue formation, while in diabetic animals, the osteoclast activity was reduced, without changes in the leves of OPG and RANKL, decreasing DABM resorption and bone formation.

A osteonecrose dos ossos maxilares relacionada ao uso prolongado de bisfosfonatos (OMRB), associada a procedimentos cirúrgicos, constitui uma entidade com menos de dez anos de ocorrência na clínica estomatológica. Os bisfosfonatos (BFs) são medicamentos antireabsortivos altamente efetivos no tratamento de diversas doenças ósseas, além de metástases. Embora a maioria dos casos de OMRB tenha sido relatada após o uso de potentes BFs da terceira geração, o alendronato de sódio (ALN), um bisfosfonato de segunda geração, é amplamente utilizado no tratamento e prevenção de doenças ósseas. O presente estudo experimental in vivo visou analisar a possível presença de OMRB no processo alveolar de ratos tratados com ALN após exodontia do segundo molar inferior. Para tanto, utilizou-se 30 ratos Wistar, machos, com 7 semanas de vida, divididos em dois grupos, ALN (tratado com alendronato) e CTL (controle, tratado com solução salina). O ALN foi administrado diariamente por injeção subcutânea na dose de 2,5 mg/kg peso por 14 dias. Nesse momento, foi realizada a exodontia, havendo sido eutanasiados cinco animais de cada grupo, 7, 14 e 21 dias após a exodontia. Após a eutanásia, a região da mandíbula foi fixada em 2,5% formaldeído e 2% glutaraldeído, em tampão cacodilato 0,1M - pH 7,4 e descalcificada em EDTA a 4,13% por 30 dias. Os espécimes foram analisados em cortes corados em HE, e foi realizada histomorfometria para análise da reabsorção da crista alveolar mesial e distal, além do tecido ósseo neoformado no interior do alvéolo, que também foi analisado através de imuno-histoquímica para as proteínas não colágenas OPN e BSP e para evidenciação de vasos sanguíneos neoformados com o anticorpo anti-CD105. Os osteoclastos foram evidenciados através de histoquímica para fosfatase ácida resistente ao tartarato (TRAP). Além disso, as células e eventos da reparação foram examinados por microscopia eletrônica de transmissão. Os resultados mostraram que os animais tratados com ALN exibiram OMRB de grau zero em todos os períodos estudados, além da presença de osteoclastos latentes TRAP-positivos e histomorfometria, onde a não reabsorção das cristas alveolares ocasionaram a permanência do osso alveolar, em contato com bactérias. Observou-se ainda, um claro atraso na formação óssea, quando comparado ao controle, além da diminuição dos vasos sanguíneos nos estágios iniciais. A localização e o padrão de marcação para as proteínas OPN e BSP foram considerados normais, observados evidente marcação em áreas ósseas imaturas e em linhas cimentantes. Assim, concluiu-se que o ALN administrado neste protocolo provocou OMRB leve, provavelmente causada pela diminuição da angiogênese, presença de osso alveolar não remodelado expostos a colônias bacterianas, além da diminuição da atividade osteoblástica. / The bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with surgery procedures, is an entity with less than 10 years of occurrence in dental practice. The bisphosphonates (BFs) are anti-resorbing drugs highly effective in the treatment of several bone diseases, including metastasis. Although the majority of cases of BRONJ had been reported with the potent third generation of BFs, sodium alendronate (ALN), a second generation bisphosphonate, is widely used for treatment or prevent bone diseases as osteoporosis. The present experimental study aimed to analyze the possible presence of BRONJ in the alveolar process of rats treated with ALN following extraction of the mandibular second molar. For this, we used thirty 7-week-old male Wistar rats, divided into two groups, ALN (treated with alendronate) and CTL (control, treated with saline solution). The administration of ALN received daily subcutaneous injection at a dose of 2.5 mg/kg for 14 days. At that moment, the extraction was performed. After 7, 14 e 21 days of surgery, five animals of each group were euthanized and the mandibular region fixed in 2.5% formaldehyde + 2% glutaraldehyde in cacodylate buffer 0.1M - pH 7.4 and decalcified in 4.13% EDTA for 30 days. The specimens were morphologically analyzed in HE stained sections, and, histomorphometry was used to analyze the resorption of mesial and distal alveolar crests, as well as the bone formed into the alveolus. Immunohistochemistry for the noncollagenous proteins OPN and BSP and for CD105 to revel neoformed blood vessels was also performed. The osteoclasts were revealed through tartrate-resistant acid phosphatase (TRAP) histochemistry. Moreover, the cells and events of alveolar healing were examined by transmission electron microscopy. The results showed light degree of BRONJ in the ALN treated animals at all the studied periods, and the presence of latent osteoclasts near the non-resorbing crest alveolar. Bacteria were observed in contact with the non-resorbed alveolar bone. An evident delay in bone formation when compared to control group was also observed, as well as the decrease of blood vessels in early stages. The distribution of immature bone and in cement lines of OPN and BSP was considered normal. Thus, we concluded that the present protocol of ALN yielded light BRONJ areas, probably by reduced angiogenesis, lock of remodeling of alveolar, presence of bacterial colonies and evident decreased osteoblastic ativitity.

A osteonecrose dos ossos maxilares relacionada ao uso prolongado de bisfosfonatos (OMRB), associada a procedimentos cirúrgicos, constitui uma entidade com menos de dez anos de ocorrência na clínica estomatológica. Os bisfosfonatos (BFs) são medicamentos antireabsortivos altamente efetivos no tratamento de diversas doenças ósseas, além de metástases. Embora a maioria dos casos de OMRB tenha sido relatada após o uso de potentes BFs da terceira geração, o alendronato de sódio (ALN), um bisfosfonato de segunda geração, é amplamente utilizado no tratamento e prevenção de doenças ósseas. O presente estudo experimental in vivo visou analisar a possível presença de OMRB no processo alveolar de ratos tratados com ALN após exodontia do segundo molar inferior. Para tanto, utilizou-se 30 ratos Wistar, machos, com 7 semanas de vida, divididos em dois grupos, ALN (tratado com alendronato) e CTL (controle, tratado com solução salina). O ALN foi administrado diariamente por injeção subcutânea na dose de 2,5 mg/kg peso por 14 dias. Nesse momento, foi realizada a exodontia, havendo sido eutanasiados cinco animais de cada grupo, 7, 14 e 21 dias após a exodontia. Após a eutanásia, a região da mandíbula foi fixada em 2,5% formaldeído e 2% glutaraldeído, em tampão cacodilato 0,1M - pH 7,4 e descalcificada em EDTA a 4,13% por 30 dias. Os espécimes foram analisados em cortes corados em HE, e foi realizada histomorfometria para análise da reabsorção da crista alveolar mesial e distal, além do tecido ósseo neoformado no interior do alvéolo, que também foi analisado através de imuno-histoquímica para as proteínas não colágenas OPN e BSP e para evidenciação de vasos sanguíneos neoformados com o anticorpo anti-CD105. Os osteoclastos foram evidenciados através de histoquímica para fosfatase ácida resistente ao tartarato (TRAP). Além disso, as células e eventos da reparação foram examinados por microscopia eletrônica de transmissão. Os resultados mostraram que os animais tratados com ALN exibiram OMRB de grau zero em todos os períodos estudados, além da presença de osteoclastos latentes TRAP-positivos e histomorfometria, onde a não reabsorção das cristas alveolares ocasionaram a permanência do osso alveolar, em contato com bactérias. Observou-se ainda, um claro atraso na formação óssea, quando comparado ao controle, além da diminuição dos vasos sanguíneos nos estágios iniciais. A localização e o padrão de marcação para as proteínas OPN e BSP foram considerados normais, observados evidente marcação em áreas ósseas imaturas e em linhas cimentantes. Assim, concluiu-se que o ALN administrado neste protocolo provocou OMRB leve, provavelmente causada pela diminuição da angiogênese, presença de osso alveolar não remodelado expostos a colônias bacterianas, além da diminuição da atividade osteoblástica. / The bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with surgery procedures, is an entity with less than 10 years of occurrence in dental practice. The bisphosphonates (BFs) are anti-resorbing drugs highly effective in the treatment of several bone diseases, including metastasis. Although the majority of cases of BRONJ had been reported with the potent third generation of BFs, sodium alendronate (ALN), a second generation bisphosphonate, is widely used for treatment or prevent bone diseases as osteoporosis. The present experimental study aimed to analyze the possible presence of BRONJ in the alveolar process of rats treated with ALN following extraction of the mandibular second molar. For this, we used thirty 7-week-old male Wistar rats, divided into two groups, ALN (treated with alendronate) and CTL (control, treated with saline solution). The administration of ALN received daily subcutaneous injection at a dose of 2.5 mg/kg for 14 days. At that moment, the extraction was performed. After 7, 14 e 21 days of surgery, five animals of each group were euthanized and the mandibular region fixed in 2.5% formaldehyde + 2% glutaraldehyde in cacodylate buffer 0.1M - pH 7.4 and decalcified in 4.13% EDTA for 30 days. The specimens were morphologically analyzed in HE stained sections, and, histomorphometry was used to analyze the resorption of mesial and distal alveolar crests, as well as the bone formed into the alveolus. Immunohistochemistry for the noncollagenous proteins OPN and BSP and for CD105 to revel neoformed blood vessels was also performed. The osteoclasts were revealed through tartrate-resistant acid phosphatase (TRAP) histochemistry. Moreover, the cells and events of alveolar healing were examined by transmission electron microscopy. The results showed light degree of BRONJ in the ALN treated animals at all the studied periods, and the presence of latent osteoclasts near the non-resorbing crest alveolar. Bacteria were observed in contact with the non-resorbed alveolar bone. An evident delay in bone formation when compared to control group was also observed, as well as the decrease of blood vessels in early stages. The distribution of immature bone and in cement lines of OPN and BSP was considered normal. Thus, we concluded that the present protocol of ALN yielded light BRONJ areas, probably by reduced angiogenesis, lock of remodeling of alveolar, presence of bacterial colonies and evident decreased osteoblastic ativitity.

O remodelamento ósseo é um processo metabólico, dentro do qual os osteoblastos e os osteoclastos, participam ativamente. Portanto, qualquer alteração neste equilíbrio, pode provocar uma modificação na densidade mineral do osso, situação observada em certas doenças osteolíticas como osteoporose, artrite reumatóide e periodontite. Nos últimos anos, há um crescente interesse em avaliar o papel da glicólise na proliferação, sobrevivência e diferenciação dos diferentes tipos celulares. Em particular, tem sido evidenciado o efeito regulador da frutose 1,6-bisfosfato (FBP), um intermediário da via glicolítica de alta energia. Considerando que ainda não existem dados na literatura que correlacionem a FBP com o funcionamento dos osteoclastos, este trabalho tem por finalidade avaliar seu papel na osteoclastogênese e reabsorção óssea in vitro. Para isso, pré-osteoclastos murinos derivados da medula óssea foram diferenciados em osteoclastos na presença de M-CSF, RANKL e duas concentrações da FBP (100 e 300 ?M). Os resultados obtidos amostram que a FBP inibe a diferenciação osteoclástica em uma relação dose-dependente, sem afetar a viabilidade celular. Observa-se também, que o tratamento com FBP diminui a expressão de genes marcadores como, Nfatc1, Trap e Catepsina K (p < 0.01) e das proteínas NFATc1 e catepsina K. Como também, promove uma redução na atividade reabsortiva dos osteoclastos depois de 96 h de cultura. O efeito inibidor da FBP não depende da atividade da piruvato quinase M2 (PKM2). Em conjunto, estes dados sugerem que a FBP é um metabolito regulador importante da osteoclastogênese, demonstrando ser um agente potencial para o tratamento de doenças osteolíticas. / Bone remodeling is a coordinated metabolic process, where the osteoblasts and osteoclasts participate actively. Therefore, any alteration in this balance may cause a change in the bone mineral density, a condition observed in certain bone loss-associated diseases such as osteoporosis, rheumatoid arthritis and periodontitis. Recently, there has been a growing interest in assessing the role of the glycolysis on the proliferation, survival, and differentiation of the different cell types. In particular, it has been demonstrated the protective effect of the Fructose 1,6-bisphosphate (FBP), a high-energy glycolytic intermediate. Considering that there is no evidence in the literature that associate FBP with the function of osteoclasts, this work aims to evaluate its role in osteoclastogenesis and bone resorption in vitro. To this end, murine bone marrow derived pre-osteoclasts were differentiated into osteoclasts in the presence of M-CSF, RANKL and two concentrations of FBP (100 and 300 ?M). The results showed that FBP inhibits the differentiation of osteoclasts in a dose dependent manner, without affecting the cell viability. It was also observed that the treatment with the FBP decreases the expression of marker genes such as Nfatc1, Trap and Cathepsin K (p < 0.01) and the NFATc1 and cathepsin K protein levels. As well, the treatment with FBP resulted in markedly fewer osteoclast activity after 96 h of culture. FBP osteoclast inhibitory effect does not involve Pyruvate Kinase M2 (PKM2) activity. Together, these data denote the important regulatory role of the FBP on osteoclastogenesis, proving to be a potential agent for the treatment of bone loss-associated diseases.

Man, Chi Wai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 141-184). / Abstract also in Chinese. / Acknowledgements --- p.ii / Abstract --- p.iv / Abbreviations --- p.xi / List of Tables --- p.xviii / List of Figures --- p.xx / Major Conference Presentations --- p.xxii / Publications in Preparation --- p.xxiv / Study Flowchart --- p.xxv / Chapter Chapter 1 --- Study Background --- p.1 / Chapter 1. --- Introduction --- p.2 / Chapter 1.1. --- General Overview of Adolescent Idiopathic Scoliosis (AIS) --- p.2 / Chapter 1.2. --- Natural History --- p.3 / Chapter 1.3. --- Current Treatments --- p.5 / Chapter 1.4. --- Additional Phenotypes Abnormalities --- p.9 / Chapter 1.5. --- Bone Modeling and Remodeling in Adolescents --- p.14 / Chapter 1.6. --- Bone Development --- p.15 / Chapter 1.7. --- Bone (re)modeling by osteoclasts and osteoblasts --- p.17 / Chapter 1.8. --- Factors Affecting Osteoblasts Regulation --- p.19 / Chapter 1.9. --- Current Hypothesis on the Etiology of AIS --- p.21 / Chapter 1.10. --- Melatonin --- p.26 / Chapter Chapter 2 --- Hypothesis and Objectives --- p.47 / Chapter 2. --- Hypothesis and Objectives --- p.48 / Chapter 2.1. --- Study Hypothesis --- p.48 / Chapter 2.2. --- Objectives --- p.48 / Chapter Chapter 3 --- Study on the Anthropometric Parameters and Bone Geometry of Girls with Severe AIS --- p.49 / Chapter 3.1. --- Introduction --- p.50 / Chapter 3.2. --- Methodology --- p.51 / Chapter 3.2.1. --- Recruitment of Subjects --- p.51 / Chapter 3.2.2. --- Evaluation of Curve Severity of Scoliosis --- p.52 / Chapter 3.2.3. --- Anthropometric Measurements --- p.53 / Chapter 3.2.4. --- Measurements of BMD --- p.53 / Chapter 3.2.5. --- Data Analysis --- p.54 / Chapter 3.3. --- Results --- p.55 / Chapter 3.3.1. --- Anthropometry --- p.55 / Chapter 3.3.2. --- BMD of Femoral Neck and Midshaft of Radius --- p.56 / Chapter 3.4. --- Discussion --- p.57 / Chapter Chapter 4 --- Response of Osteoblasts to Melatonin in AIS Girls In vitro Study --- p.69 / Chapter 4.1. --- Introduction --- p.70 / Chapter 4.2. --- Methodology --- p.72 / Chapter 4.2.1. --- Subjects Recruitments --- p.72 / Chapter 4.2.2. --- Cell Isolation --- p.73 / Chapter 4.2.3. --- Effect of Melatonin on Proliferation and Differentiation of AIS Osteoblasts --- p.76 / Chapter 4.2.4. --- Data Analysis --- p.79 / Chapter 4.3. --- Results --- p.80 / Chapter 4.3.1. --- Isolated Osteoblasts from Normal Human and AIS Patients --- p.80 / Chapter 4.3.2. --- Effect of Melatonin on Osteoblasts Proliferation --- p.80 / Chapter 4.3.3. --- Effect of Melatonin on Cell Differentiation --- p.81 / Chapter 4.4. --- Discussion --- p.83 / Chapter Chapter 5 --- Expression of MT1 and MT2 receptors in AIS Osteoblasts --- p.101 / Chapter 5.1. --- Introduction --- p.102 / Chapter 5.2. --- Methodology --- p.104 / Chapter 5.2.1. --- Osteoblast Samples --- p.104 / Chapter 5.2.2. --- Protein Expression of Melatonin Receptors in AIS Osteoblasts. --- p.105 / Chapter 5.2.3. --- Genotyping of MT2 receptors by Restriction Fragment Length Polymorphism (RFLP) --- p.109 / Chapter 5.2.4. --- Clinical Evaluations of the AIS Patients --- p.110 / Chapter 5.2.5. --- Data Analysis --- p.110 / Chapter 5.3. --- Results --- p.111 / Chapter 5.3.1. --- Semi quantification of Melatonin Receptors in AIS Osteoblasts 111 --- p.111 / Chapter 5.3.2. --- RFLP --- p.112 / Chapter 5.3.3. --- Functional Response Between the Different AIS Groups --- p.112 / Chapter 5.3.4. --- Correlation of the Clinical Phenotypes with the Different AIS Subgroups --- p.114 / Chapter 5.4. --- Discussion --- p.115 / Chapter Chapter 6 --- Summary and Conclusion --- p.132 / Chapter 6.1. --- Summary and Discussion --- p.133 / Chapter 6.2. --- Limitations and Further Studies --- p.136 / Chapter 6.3. --- Conclusion --- p.138 / Bibliography --- p.141 / Appendix I --- p.185 / Appendix II --- p.186 / Appeddix III --- p.187 / Appendix IV --- p.188 / Appendix V --- p.189 / Appendix VI --- p.190

O remodelamento ósseo é um processo metabólico, dentro do qual os osteoblastos e os osteoclastos, participam ativamente. Portanto, qualquer alteração neste equilíbrio, pode provocar uma modificação na densidade mineral do osso, situação observada em certas doenças osteolíticas como osteoporose, artrite reumatóide e periodontite. Nos últimos anos, há um crescente interesse em avaliar o papel da glicólise na proliferação, sobrevivência e diferenciação dos diferentes tipos celulares. Em particular, tem sido evidenciado o efeito regulador da frutose 1,6-bisfosfato (FBP), um intermediário da via glicolítica de alta energia. Considerando que ainda não existem dados na literatura que correlacionem a FBP com o funcionamento dos osteoclastos, este trabalho tem por finalidade avaliar seu papel na osteoclastogênese e reabsorção óssea in vitro. Para isso, pré-osteoclastos murinos derivados da medula óssea foram diferenciados em osteoclastos na presença de M-CSF, RANKL e duas concentrações da FBP (100 e 300 ?M). Os resultados obtidos amostram que a FBP inibe a diferenciação osteoclástica em uma relação dose-dependente, sem afetar a viabilidade celular. Observa-se também, que o tratamento com FBP diminui a expressão de genes marcadores como, Nfatc1, Trap e Catepsina K (p < 0.01) e das proteínas NFATc1 e catepsina K. Como também, promove uma redução na atividade reabsortiva dos osteoclastos depois de 96 h de cultura. O efeito inibidor da FBP não depende da atividade da piruvato quinase M2 (PKM2). Em conjunto, estes dados sugerem que a FBP é um metabolito regulador importante da osteoclastogênese, demonstrando ser um agente potencial para o tratamento de doenças osteolíticas. / Bone remodeling is a coordinated metabolic process, where the osteoblasts and osteoclasts participate actively. Therefore, any alteration in this balance may cause a change in the bone mineral density, a condition observed in certain bone loss-associated diseases such as osteoporosis, rheumatoid arthritis and periodontitis. Recently, there has been a growing interest in assessing the role of the glycolysis on the proliferation, survival, and differentiation of the different cell types. In particular, it has been demonstrated the protective effect of the Fructose 1,6-bisphosphate (FBP), a high-energy glycolytic intermediate. Considering that there is no evidence in the literature that associate FBP with the function of osteoclasts, this work aims to evaluate its role in osteoclastogenesis and bone resorption in vitro. To this end, murine bone marrow derived pre-osteoclasts were differentiated into osteoclasts in the presence of M-CSF, RANKL and two concentrations of FBP (100 and 300 ?M). The results showed that FBP inhibits the differentiation of osteoclasts in a dose dependent manner, without affecting the cell viability. It was also observed that the treatment with the FBP decreases the expression of marker genes such as Nfatc1, Trap and Cathepsin K (p < 0.01) and the NFATc1 and cathepsin K protein levels. As well, the treatment with FBP resulted in markedly fewer osteoclast activity after 96 h of culture. FBP osteoclast inhibitory effect does not involve Pyruvate Kinase M2 (PKM2) activity. Together, these data denote the important regulatory role of the FBP on osteoclastogenesis, proving to be a potential agent for the treatment of bone loss-associated diseases.

[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.

Includes bibliographical references (leaves 355-403) / 403 leaves : plates (some col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dental School, 2002

Bone metabolism is regulated by endocrine and paracrine signalling molecules influencing bone cells in the continuously remodelling bone tissue. These molecules include a variety of osteotropic stimulatory and inhibitory cytokines. Degradation of alveolar bone in periodontal disease is believed to be a result of local release of such osteotropic cytokines, although the relative importance of particular cytokines and their cellular origin is currently unknown. The aim of the present project was to study if, and how, pro-inflammatory cytokines in the interleukin-6 (IL-6) family of cytokines, and anti-inflammatory IL-4 and IL-13 type of cytokines, can affect osteoclast differentiation and bone resorption. Additionally, the objective was to study if gingival fibroblasts may influence alveolar bone resorption through secretion of IL-6 type cytokine release and if the secretion is regulated by pro-inflammatory as well as anti-inflammatory mediators such as IL-4 and IL-13. IL-6 in combination with its soluble receptor (sIL-6R) was found to stimulate mouse calvarial bone resorption. Similarly, two other IL-6 family members, leukemia inhibitory factor (LIF) and oncostatin M (OSM) were found to stimulate bone resorption. The stimulatory effect on bone resorption induced by the three cytokines was associated with increased expression of receptor activator of NF- κB ligand (RANKL), a cytokine which is essential in osteoclast formation and activation through binding to receptor activator of NF- κB (RANK) on osteoclastic cells. The interaction between RANKL and RANK can be inhibited by binding of the decoy receptor osteoprotegerin (OPG) to RANKL, and the expression of OPG was also regulated by IL-6, LIF and OSM (Paper I). The two related cytokines IL-4 and IL-13 were found to inhibit osteoclastogenesis and mouse calvarial bone resorption by mechanisms involving a decreased RANKL/OPG ratio in osteoblasts and decreased RANK expression in osteoclastic cells. The results further demonstrated that IL-4 and IL-13 exert their effects on both osteoblasts and osteoclasts by a mechanism involving the transcription factor signal transducer and activator of transcription 6 (STAT6) (Paper II). Constitutional expression of IL-6, LIF and another member of the IL-6 family of cytokines, IL-11, was demonstrated in human gingival fibroblasts. IL-6 type cytokine expression levels were found to be enhanced by IL-1β and tumour necrosis factor-α (TNF-α) (Paper III), whereas IL-4 and IL-13 inhibited IL 11 and LIF release from gingival fibroblasts (Paper IV). In conclusion, IL 6 type cytokines were found to be stimulators and IL-4 and IL-13 inhibitors of bone resorption in vitro via mechanisms involving RANK/RANKL/OPG interactions. Additionally, gingival fibroblasts were able to secrete several cytokines in the IL-6 family. Secretion was further enhanced by pro-inflammatory mediators and inhibited by IL-4 and IL- 13. These findings support the view that resident cells may influence the pathogenesis of periodontal disease through osteotropic cytokine production.

Repair and remodeling of bone during healing and fusion require a combination of bone resorption and formation to successfully restore the bone to its previous strength. The healing process is highly responsive to the mechanical conditions of the construct, where excessive loading can cause high strains that delay healing, but moderate loading can be beneficial. Maintaining compression at the site of fracture can benefit healing by maintaining bone congruency and increasing the stability of the bone-implant construct to prevent excessive shifting. For these reasons, compressive mechanisms are employed in many orthopaedic devices, including both intramedullary (IM) nails and external fixators for ankle arthrodesis applications. Tibiotalocalcaneal (TTC) arthrodesis is a salvage procedure that fuses both the ankle and the subtalar joints. It has become the standard of care in ankle degeneration, which can be brought on by posttraumatic arthritis, failed total ankle arthroplasty, or diabetic conditions such as Charcot arthropathy. While current devices are effective in many cases, TTC arthrodesis procedures still incur failure rates as high as 22%, where failure of the bones to successfully fuse can result in amputation. Because bone healing relies upon bone resorption, the initial compression applied to the implanted constructs can be quickly lost, which may sacrifice the stability of the structure and delay or inhibit further healing. By employing a mechanism that can sustain compression during the bone healing process, it was possible to increase the stability of the construct even during bone resorption, minimizing the failures that still occur. The focus of this study was to determine the effects of compression on the mechanical stability of the implant-bone construct found in TTC arthrodesis. A comparison was made between the torsional stability of two currently marketed intramedullary devices, as well as a prototype IM device comprised of a nickel titanium core, designed to hold constant compression for up to 9mm of resorption. Additionally, the stability of each construct over time was evaluated by correlating bone resorption to a loss in compressive force.