As Osteogêneses Imperfeitas (OI) são um grupo de doenças genéticas que afetam a biossíntese do colágeno. São caracterizadas por fragilidade óssea, baixa estatura e DI (dentinogênese imperfeita). O quadro clínico gera uma limitação funcional na maioria dos pacientes, o que acarreta a necessidade da assistência de um cuidador. Objetivo: avaliar a qualidade de vida (QV) de indivíduos com OI e a QV dos cuidadores de crianças e adolescentes com OI em tratamento no CROI-RS (Centro de Referência em Osteogênese Imperfeita do Rio Grande do Sul). Métodos: estudo transversal, com amostragem por conveniência. O WHOQOLBref e o PedsQLTM foram os instrumentos utilizados para a mensuração da QV dos pacientes com idade E 18 anos e > 18 anos, respectivamente, sendo que, para os pacientes com idade <5 anos, o instrumento foi respondido por procuração. Para avaliação nos cuidadores foi utilizado o WHOQOL- Bref. Resultados: avaliação da QV dos pacientes com OI: foram incluídos 32 indivíduos com OI, com idade de 2-4 anos (n= 5), 5 a 12 anos (n= 13), 13-17 anos (n= 6) e maiores de 18 anos (n= 8). Dezenove indivíduos apresentavam OI tipo I, 11 tipo IV e 2 tipo III. Foi observada diferença significativa no domínio emocional (p= 0,025) entre a OI tipo I (mediana do escore= 50) e tipo IV (mediana do escore= 75). Quando comparados os tratamentos recebidos com os escores de QV, foi observada diferença significativa no domínio ambiental em relação ao tratamento não farmacológico (mediana dos escores= 50) e uso de alendronato (mediana= 75; p= 0,018). Os escores de QV não variaram de acordo com o número de fraturas prévias. Avaliação da QV dos cuidadores: foram incluídos 27 cuidadores (média de idade= 37 ± 8,1 anos; mães= 19/27), sendo que 5 também apresentavam o diagnóstico de OI. Vinte e dois cuidadores assistiam apenas um indivíduo com OI. Em relação ao tipo de OI dos assistidos, 16 indivíduos apresentavam o tipo IV, 14 o tipo I e 4 o tipo III. Considerando a amostra total, a média do escore total (ET) 4-20 do WHOQOL-Bref foi 14,09 no domínio físico; 13,45 no psicológico; 14,27 no social; 12,13 no ambiental; e do escore total de QV foi 14,0. Não foi observada diferença significativa dos escores de QV de acordo com o tipo de OI do assistido ou com o número de fraturas apresentadas. A correlação entre o nível econômico e os escores de QV não se mostrou significativa. Conclusões: A QV dos indivíduos com OI no domínio emocional apresentou uma distribuição diferente e com maior comprometimento com significância estatística comparação da OI do tipo I com relação ao tipo IV (mais comprometida no tipo I). Em relação à QV de cuidadores de pacientes com OI, esta, mostrou-se comprometida quando comparada com indivíduos normais. / Osteogenesis imperfecta (OI) is a group of genetic disorders that affects collagen biosynthesis. It is characterized by bone fragility, short stature, and dentinogenesis imperfecta. Clinical symptoms lead to functional limitation in most patients. Objective: To assess the quality of life (QOL) of Brazilian individuals with OI and caregivers. Methods: This was a cross-sectional study with convenience sampling. The WHOQOL-BREF was used to measure QOL in patients aged >18 years and the PedsQL™ in patients E18 years. In patients <5 years of age, the instrument was answered by proxy respondents. Results: Assessment individuals with OI: The sample consisted of 32 individuals with OI aged 2-4 years (n= 5), 5-12 years (n= 13), 13-17 years (n= 6), and >18 years (n= 8). Nineteen individuals had OI type I, 11 had OI type IV, and 2 had OI type III. There was a significant difference in the psychological health (p= 0.025) between OI type I (median score= 50) and type IV (median score= 75). When treatment received was compared to QOL scores, there was a significant difference in the environment domain between non-pharmacological treatment (median score=50) and alendronate therapy (median score= 75, p= 0.018). Assessment caregivers of OI: A total of 27 caregivers were included (mean age, 37 ± 8.1 years), 19 of whom were mothers and 5 of whom also had OI. Twenty-two caregivers cared for only one patient with OI. Regarding OI subtype, 16 patients had type IV, 14 had type I, and 4 had type III disease. Overall, mean total WHOQOL-Bref scores (range 4–20) were 14.09 for the physical health domain, 13.45 for the psychological domain, 14.27 for the social relationships domain, and 12.13 for the environment domain, yielding a mean total QoL score of 14.0. There were no significant differences in QoL scores associated with OI subtype or number of fractures of the care recipient. There was no significant correlation between economic status and QoL scores. Conclusions: The QOL of individuals with OI in the psychological health showed a different distribution and a worst distribution with statistical significance in comparison with the OI type I with respect to the type IV. Regarding QOL of caregivers of patients with OI, this, was compromised when compared with normal subjects.

O sucesso do tratamento com implantes osseointegráveis dependente do processo de reparo da ferida e do potencial osteogênico das células. Com o objetivo de aumentar a formação óssea na superfície dos implantes, vários tratamentos têm sido propostos, entre eles, a terapia com laser de baixa intensidade. Neste contexto, o objetivo do presente estudo foi investigar o efeito do laser diodo de Arseneto-Gálio-Alumínio (AsGaAl) em culturas osteogênicas humanas crescidas sobre titânio. Após exposição das culturas, aos 3 e 7 dias, a uma dose de 3 J/cm2, foram avaliados os seguintes parâmetros: 1) proliferação celular aos 10 e 14 dias; 2) atividade de fosfatase alcalina (ALP) em 10, 14 e 17 dias; 3) formação de matriz mineralizada em 17 dias; 4) imunolocalização de proteínas não-colágenas e do antígeno nuclear Ki-67 por fluorescência indireta em 8, 10, 14 e 17 dias; 5) expressão de genes relacionados ao desenvolvimento do fenótipo osteoblástico aos 14 dias. Os resultados dos ensaios de proliferação celular mostraram que a radiação laser aumentou a proliferação de 10 para 14 dias, mas tanto a atividade de ALP como a formação de matriz mineralizada aparentemente não foram afetadas. A análise das culturas por epifluorescência mostrou que as culturas controle e irradiadas apresentaram comportamento distintos. Aos 14 dias, foi demonstrado que a exposição à radiação laser, na dose utilizada, promoveu aumento na expressão relativa dos genes ALP, OC, BSP, BMP-7 e OPG e redução dos níveis de expressão de Runx2 e osteopontina, mas não afetou a expressão gênica de COL I, RANK-L e ICAM. As culturas irradiadas apresentaram áreas sem células após 24 h da última irradiação, que posteriormente foram repovoadas por células mais proliferativas e menos diferenciadas. Em conclusão, os resultados indicam que a radiação do laser diodo de AsGaAl estimula a expressão do fenótipo osteoblástico de culturas osteogênicas humanas crescidas sobre titânio. / The success of treatment with osseointegrated implants depends on wound healing and the osteogenic potential of cells. Aimed at increasing bone formation onto implant surfaces, several treatments have been proposed and low-intensity laser therapy is one of them. Thus, the purpose of this study was to investigate the effect of the Gallium-Aluminum-Arsenic (GaAlAr) diode laser on human osteogenic cultures grown on titanium. After irradiation of osteogenic cultures with 3 J/cm2 of GaAlAr laser at the days 3 and 7, the following parameters were evaluated: 1) cell proliferation at 10 and 14 days; 2) alkaline phosphatase activity (ALP) at 10 days; 3) mineralized matrix formation at day 17, 4) non-collagenous bone proteins and nuclear antigen Ki-67 immunolocalization by indirect fluorescence at 8, 10, 14 and 17 days; and 5) Expressions of a panel of genes related to osteoblastic phenotype at day 14. Apparently cell proliferation, ALP activity and mineralized matrix formation were not significantly different between irradiated and control cultures in any period. Epifluorescence revealed that control and irradiated cultures had presented different behaviors. At 24 h after irradiation procedures, irradiated cultures displayed areas with no cells, which were repopulated later on by proliferative and apparently less-differentiated cells. Laser radiation increased relative gene expression of ALP, OC, BSP, BMP-7, and OPG; reduced the gene expression of Runx2 and OPN; and did not affect the expression of COL-1, RANK-L and ICAM. Altogether these results indicated that the GaAlAr laser stimulates the expression of osteoblastic phenotype of human osteogenic culture cells grown on titanium.

Estudo anterior de nosso grupo demonstrou que superfície de titânio (Ti) com nanotopografia obtida por condicionamento com H2SO4/H2O2 e funcionalizada com GDF-5 por simples adsorção promove o aumento da mineralização de culturas primárias de células osteogênicas. O presente estudo teve como objetivos avaliar: 1) os efeitos da pós-adsorção de proteínas principais do plasma- albumina, fibrinogênio e fibronectina, em superfícies de Ti controle e com nanotopografia, funcionalizadas com GDF-5 a 200 ng/mL por simples adsorção, sobre a formação de matriz mineralizada in vitro; 2) parâmetros moleculares e fenotípicos característicos da aquisição do fenótipo osteogênico in vitro sobre superfícies de Ti funcionalizadas com GDF-5 por simples adsorção ou por filmes LbL; 3) parâmetros de formação óssea adjacente a implantes de Ti com nanotopografia funcionalizada com GDF-5 pelos dois métodos, em modelo de tíbia de coelhos. Os resultados mostraram que a pós-adsorção de proteínas plasmáticas não afetou o potencial osteogênico in vitro, com exceção para o efeito inibidor da albumina, quando pós-adsorvida isoladamente. Tanto a superfície de Ti como o método de funcionalização de GDF-5 afetaram, quantitativamente, as formações de matriz mineralizada, com a maior diferenciação osteogênica para Ti com nanotopografia funcionalizada com GDF-5 por simples adsorção e a menor, para os filmes LbL, independentemente das superfícies sobre as quais eles eram montados. A atividade de ALP foi maior em culturas sobre nanotopografia de Ti, incluindo aquelas funcionalizadas com GDF-5, cujos valores, no entanto, não corresponderam, necessariamente, à maior atividade osteogênica. Apesar disso, todos os grupos exibiram expressão de marcadores de diferenciação osteoblástica, com sobre-expressão de osteopontina e osteocalcina para culturas sobre LbL. As análises microtomográfica, histológica e histomorfométrica não revelaram diferenças qualitativas e quantitativas in vivo entre nanotopografias de Ti funcionalizadas ou não com GDF-5, ainda que uma tendência à maior formação óssea tenha sido observada para as superfícies funcionalizadas e, entre essas, para os filmes LbL. Considerados conjuntamente, os resultados do presente estudo contribuem para o melhor entendimento das respostas de osteoblastos e do tecido ósseo quando se propõe a estratégia de funcionalização de superfícies de Ti com GDF-5 visando à otimização da osseointegração. / It has been demonstrated that a nanostructured titanium (Ti) surface obtained by treatment with H2SO4/H2O2 and functionalized with GDF-5 by simple adsorption promotes the enhancement of mineralized matrix formation in osteogenic cell cultures. This study aimed to evaluate: 1) the effects of post-adsorption of major plasma proteins, i.e. albumin, fibrinogen and fibronectin, on control and nanostructured Ti surfaces, functionalized with 200 ng/mL GDF-5 by simple adsorption, on mineralized matrix formation by calvarial osteogenic cell cultures; 2) molecular and phenotypic parameters characteristics of the acquisition of the osteogenic phenotype in vitro on Ti surfaces functionalized with GDF-5 by either simple adsorption or layer by layer (LbL) films; 3) parameters of bone formation adjacent to Ti implants with a nanostructured surface functionalized with GDF-5 by the two methods described in item 2, in a rabbit tibia model. The results showed that the post-adsorption of plasma proteins did not affect the osteogenic potential of cultures, except for the inhibitory effect of albumin when post-adsorbed alone. Either the Ti surface topography or the method for GDF-5 functionalization quantitatively affected mineralized matrix formation, with the higher osteogenic differentiation for nanostructured Ti functionalized with GDF-5 by simple adsorption and the lower one for LbL films, irrespective of the Ti surface topography on which they were mounted. ALP activity was higher for cultures grown on nanostructured Ti, including those functionalized with GDF-5, whose values, however, did not necessarily correspond to the higher osteogenic activity. Despite that, all groups expressed osteoblast differentiation markers, with a remarkable increase in osteopontin and osteocalcin mRNA levels for cultures grown on LbL films. The microtomographic, histologic and histomorphometric analyses revealed no qualitative or quantitative differences in vivo among the nanostructured Ti implants, yet a tendency for enhanced bone formation was observed for the functionalized surfaces and, between them, for the LbL films. Taken together, the results of the present in vitro and in vivo studies contribute to a better understanding of osteoblast and bone tissue responses to the functionalization of Ti surfaces with GDF-5 aiming to optimize osseointegration.

Osteogenesis imperfecta (OI) is a genetic condition commonly known as Brittle Bones. The purpose of this study was to listen to and document the experiences of those with OI to investigate if there were barriers to inclusive education for students with osteogenesis imperfecta (OI). Persons with OI are often small in stature, have limited strength and varying degrees of mobility. Adventurous behaviour or everyday activities may result in fractures. Often in the world of disability the focus is on the medical condition rather than the personal experiences of those with the condition. This study provided an opportunity to articulate the personal experiences of the participants. In this study two specific aspects of educational experiences were examined. The first aspect explored was the way students managed physically within the educational setting, while the second aspect examined how students coped emotionally. Five major questions were used to determine if special education policies have affected the quality of inclusiveness for students with OI in New Zealand classrooms over a period of forty years. These questions examined what barriers exist in the past and whether the same barriers still exist within today's educational setting. The questions investigated what or who may be the cause of these barriers and what possible effects these barriers might have on the student The present situation was compared with the past and finally how might these barriers be overcome was investigated. This qualitative study focused on three individuals, each representing a different generation. The participants exemplified a particular phenomenon, specifically the daily school lives in New Zealand of those with OI. The difficulties these students faced were explored through semi-structured interviews to encourage the three participants to voice their individual experiences. All three participants gave freely of their thoughts in an articulate, thoughtful and open manner, sharing both their positive and unpleasant experiences. This study revealed that some New Zealand schools have yet to implement recent inclusive education policies set out by the Ministry of Education. The three participants identified barriers to inclusive education from their own personal perspectives. The physical environment of school presented challenges. Distance between classrooms and assembly halls and accessibility to the playground, ramps and toilet facilities created difficulties for students with OI who did not walk independently. Attitudes of parents, teachers, and the wider school community impacted on the self-attitude of students with OI. Over-protection, fear and anxiety were identified as unintentional attitudes that placed limitations on participation of meaningful activities and added to student feelings of isolation and difference. Lack of knowledge of the medical and psychosocial aspects of students with OI could account for the continued barriers imposed by some teachers. Barriers do still exist in some New Zealand schools for students with osteogenesis imperfecta. Improved access could result in more participation. More participation could allow for an improved quality of social interaction and thus result in greater focus on the person and less focus on the disability. Collaboration between all school staff, parents and students with OI is essential to minimise barriers and maximise academic and social opportunities.

Bibliography: leaves 457-506. / 2 v. (506 leaves) : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Addresses the problem of giving genetic counselling to parents of a "sporadic" case of severe osteogenesis imperfecta, either of the perinatally lethal or severe deforming variety. / Thesis (M.D.)--University of Adelaide, Dept. of Paediatrics, 1994

The osteogenic effects of bone morphogenetic protein-2 (BMP-2) on human mesenchymal stem cells (MSCs) are less profound than expected as compared with rodent cells, and supraphysiological dose of BMP-2 is required to achieve desired clinical outcome. The mechanism for this phenomenon is unclear. In this study, we examined the effects of macrophages and noggin suppression on the BMP-2-induced osteogenesis of human bone marrow MSCs in vitro. Our data show that macrophage conditioned medium significantly decreased the migration capacity, metabolic activity and BMP-2-induced osteogenesis of MSCs. In addition, knocking down noggin by small interfering RNA (siRNA) also significantly decreased BMP-2-induced osteogenesis and proliferation of MSCs. In summary, our studies demonstrated that macrophages and knocking down the expression of noggin decreased BMP-2-induced osteogenesis of human MSCs in vitro. In the future, manipulation on macrophage activation and noggin expression may allow us to achieve higher BMP-2-induced osteogenesis that leads to better bone healing. / Experimental Surgery

Tissue engineering applies principles of biology and engineering to the development of functional substitutes for damaged or lost tissues. Tools for the neo-generation of tissue in tissue engineering research include cells, biomaterials and soluble factors. One main obstacle in tissue engineering is the limited availability of autologous tissue specific progenitor cells. This has led to interest into using autologous cells with stem cell plasticity. Bone marrow derived stem cells were the first adult stem cells shown to have multilineage potential. Since, several reports have been published indicating that cells from other tissues; fat, muscle, connective tissue e.g., possess potential to differentiate into lineages distinct from their tissue of origin. The optimal cell type for use in tissue engineering applications should be easy to obtain, cultivate and store. The human dermal fibroblast is an easily accessible cell source, which after routine cell expansion gives a substantial cell yield from a small skin biopsy. Hence, the dermal fibroblast could be a suitable cell source for tissue engineering applications.The main aim of this thesis was to investigate the differentiation capacity of human dermal fibroblasts, and their possible applications in bone and cartilage tissue engineering applications. Human dermal fibroblasts were shown to differentiate towards adipogenic, chondrogenic, and osteogenic phenotypes upon subjection to specific induction media. Differentiation was seen both in unrefined primary cultures and in clonal populations (paper I). Fibroblasts could be used to create three-dimensional cartilage- and bone like tissue when grown in vitro on gelatin microcarriers in combination with platelet rich plasma (paper II). 4 weeks after in vivo implantation of osteogenic induced fibroblasts into a fracture model in athymic rats, dense cell clusters and viable human cells were found in the gaps, but no visible healing of defects as determined by CT-scanning (paper III). After the induction towards adipogenic, chondrogenic, endotheliogenic and osteogenic lineages, gene expression analysis by microarray and quantitative real-time-PCR found several master regulatory genes important for lineage commitment, as well as phenotypically relevant genes regulated as compared to reference cultures (paper IV). In conclusion, results obtained in this thesis suggest an inherent ability for controllable phenotype alteration of human dermal fibroblasts in vitro. We conclude that dermal fibroblasts could be induced towards adipogenic, chondrogenic, endotheliogenic or osteogenic novel phenotypes which suggest a genetic readiness of differentiated fibroblasts for lineage-specific biological functionality, indicating that human dermal fibroblasts might be a suitable cell source in tissue engineering applications.

Bone morphogenetic protein-2 (BMP-2) is considered a promising adjuvant for the treatment of bone regeneration. However, BMP-2 delivery in a conventional collagen scaffold needs a high dose to achieve an effective outcome. Moreover, such dosage may lead to serious side effects. The aim of the following thesis was to find clinically acceptable strategies reducing the required dose of BMP-2 by improving the delivery and optimizing the preclinical testing of the new approaches. In all the studies hyaluronic acid (HA) hydrogels was used as a carrier for BMP-2. The HA hydrogel/BMP-2 construct was modified with bioactive matrix components in order to obtain an effective release of BMP-2 and an enhanced bone formation. The most promising were two strategies. In the first one, BMP-2, precomplexed with the glycosaminoglycans dermatan sulfate or heparin prior to loading it into HA hydrogel, protected and prolonged the delivery of the protein, resulting in twofold larger bone formation in comparison to non-complexed BMP-2. In the second strategy, the fibronectin fragment integrin-binding domain (FN) was covalently incorporated into HA hydrogel. The FN remarkably improved the capacity of the material to support the cells attachment and spreading, providing the formation of twice as much bone in comparison to non-functionalized HA hydrogel/BMP-2. Furthermore, the importance of a proper design of the preclinical study for BMP-2 delivery systems was highlighted. Firstly, proper physicochemical handling of BMP-2 showed the improvement in further in vivo activity.  The use of glass storage vials and an acidic formulation buffer was superior to plastic surfaces and physiological pH. Secondly, while regenerative medicine strategy testing required the use of animal models that matched the research questions related to clinical translation, two new animal models were developed. The subperiosteal mandibular and calvarial models in rats were found to be minimally invasive, convenient and rapid solution for the evaluation of a broad range of approaches including bone augmentation, replacement and regeneration. Both models are primarily relevant for the initial testing of the injectable bone engineering constructs.  Those clinically translatable approaches presented here could prove to be a powerful platform for a wider use of BMP-2 in orthopedic, plastic surgery and regenerative medicine research.

Skeletal development requires stringent control of programs for gene activation and suppression in response to physiological cues. There has been a principal focus on the identification of the mechanisms by which a particular cell phenotype is activated. MicroRNAs (miRNAs, miRs) have emerged as key negative regulators of diverse biological and pathological processes, including developmental timing, organogenesis, apoptosis, cell proliferation and differentiation; how they regulate osteoblast specific gene expression, is poorly understood. miRNAs are small 22 nucleotides (nt) endogenous non-coding RNAs (ncRNAs) that anneal to 3’ untranslated region (3’UTR) of target messenger RNA (mRNA) to mediate inhibition of translation and lower protein level. It remains to be established how specific miRNAs contribute to regulate the onset of a tissue-specific phenotype. One previously identified important player in the activation of skeletal-related genes that control formation of bone tissue is Wnt (wingless) signaling. The Wnts are regulating the differentiation of multiple cell types but also are driving embryonic stem cells (ESCs) into specific lineages, for example they support osteoblastogenesis. By attaching to the membrane, Wnts direct a signaling cascade for accumulation of β-catenin (CatnB), which in turn activates osteoblast-essential genes. The contribution of global mechanisms is equally important for understanding tissue development and diseases. The aim of this study was to identify miRNAs that are differentially expressed in osteogenically differentiated ESCs. In addition, functional characterization of these miRNAs was performed to further unravel the molecular mechanisms underlying osteogenesis. Finally, an important goal was to identify the mRNA targets of these miRNAs, which are required for differentiation of ESCs into osteoblasts with a primary focus on mRNAs associated with the Wnt signaling pathway. miRNA expression profiling reveals an overall down-regulation of miRNAs during osteogenic differentiation of ESCs To identify miRNAs that are potentially involved in osteogenesis ESCs were differentiated into osteoblasts and compared to undifferentiated ESCs using a miRNA microarray. miRNA profiling during the initial stages of osteoblast differentiation showed 25 miRNAs significantly differentially expressed. Differential expression of 4 miRNAs tested was confirmed using quantitative real-time PCR (RT-qPCR). Many miRNAs were expressed at low levels in differentiated ESCs. Indeed, down-regulation of miRNAs appeared to be common during differentiation. Furthermore, related miRNAs encoded on the same chromosome showed similar expression profiles. In summary, though several miRNAs were identified that can significantly distinguish between undifferentiated and osteogenically differentiated ESCs, 11 were chosen for further functional analysis. Functional studies show that miR-127, miR-183, miR-291b-5p, miR-293, miR-361, miR-467b and miR-665 affect osteogenesis of ESCs Undifferentiated and differentiated ESCs were used for functional studies of 11 miRNAs (miR-22, miR-127, miR-130a, miR-183, miR-291b-5p, miR-293, miR-300, miR-361, miR-467b, miR-665 and miR-690), which were down-regulated during osteogenic differentiation. To asses the function of these miRNAs, gain- and loss-of-function experiments were performed. Overexpressing and knocking down these miRNAs caused changes in cell survival, cell morphology, and osteogenic differentiation capacity as measured with calcium deposition, ALP activity and expression of osteogenic markers. Particularly, overexpression of miR-361 and knockdown of miR-665 significantly enhanced mineralization and expression levels of osteogenic markers. Thus, both miRNAs might regulate osteogenic differentiation in the early stages of lineage specification and commitment. miRNAs are modulators of osteogenic differentiation To identify miRNA target candidates that may account for the observed effects on cell survival and osteogenic differentiation of ESCs, a combined approach of bioinformatic predictions, mRNA expression analysis, and TurboGFP reduction upon miRNA overexpression coupled with the search of known literature was performed to identify cellular events that the identified miRNAs might be involved in. Target identification suggested that the candidate miRNAs may interfere with the Wnt pathway as many target candidates were detected that were known to be Wnt signaling-associated. To confirm that miR-183, miR-293, miR-361, miR-665 and miR-690 regulated osteoblast differentiation, target mRNA/miRNA interaction was studied using RT-qPCR. Overexpression of these miRNAs reduced the levels of the key factors involved in Wnt signaling; particularly Wnt inhibitor factor 1 (WIF-1) levels were decreased by miR-293, nuclear factor of activated T cells 3 (NFATc-3) and Prickle-1 by miR-361, Dishevelled 1 (Dvl-1) by miR-665 and for forkhead box O 3 (FoxO-3), Ras homolog gene family, member A (RhoA) and CatnB-1 by miR-690. Thus, to address the hypothesis that miR-361 activates osteoblast differentiation by targeting Prickle-1 and NFATc-3, the p2FP-RNAi vector system was applied. It was shown that expression of miR-361 down-regulates Prickle-1 levels, which to our knowledge have not been described so far. As it was found previously, Prickle-1 reduced Dvl-3 levels by promoting its ubiquitination, resulting in inhibition of Wnt canonical signaling in liver cancer. Since Dvls are positive regulators of osteogenesis by elevating CatnB levels and stimulating lymphoid enhancer factor/T cell factor proteins (LEF/TCF) -dependent transcription in the canonical Wnt pathway, Prickle-1 might be a negative regulator of osteogenic differentiation by eliminating Dvls from the complex. This interaction offers a novel mechanism of Wnt signaling activation in osteogenesis and can be explored to identify key components in the Wnt signaling pathway. In summary, we suggested that miR-361 acts as an activator in osteogenic differentiation of ESCs. / Die Embryonalentwicklung des Skelettsystems ist in Bezug auf programmierte Genaktivierung in Antwort auf physiologische Schlüsselreize strikten Kontrollen unterworfen. Studien zur Untersuchung solcher Kontrollelemente haben sich dabei vor allem auf die Identifikation von Mechanismen fokussiert, die einen bestimmten zellulären Phänotyp aktivieren. Zum Vorschein kamen microRNAs (miRNAs), die als negative Schlüsselregulatoren diverser biologischer und pathologischer Prozesse wirken, wie zum Beispiel der zeitlichen Regulation von Entwicklung, der Organogenese, Apoptose, zellulärer Proliferation und Differenzierung. Wie sie allerdings die Osteogenese, den Prozess der Knochenbildung, regulieren ist weitestgehend unbekannt. MiRNAs sind kurze 22 Nukleotid lange endogene nicht-kodierende RNAs (ncRNAs), die an die 3\' nicht translatierte Region (3\'UTR) einer Ziel mRNA binden und somit die Inhibition der Translation vermitteln, was letzten Endes zu einer Erniedrigung des Proteinlevels führt. Es bleibt allerdings zu etablieren, wie spezifische miRNAs zur Spezifikation in einen bestimmten Zell- oder Gewebephänotyps beitragen. Einer der bisher identifizierten Akteure, der die Aktivierung von skelettalen Genen kontrolliert, ist der Wnt (wingless) Signalweg. Wnt Moleküle regulieren die Differenzierung vieler unterschiedlicher Zelltypen, aber lenken auch die Differenzierung von embryonalen Stammzellen (ESCs) in spezifische Richtungen, so z.B. in die Richtung von Knochenzellen, den Osteoblasten. Indem sie an die Zellmembran andocken, dirigieren Wnts eine Signalkaskade, die die Akkumulation von beta-catenin (CatnB) im Zellkern nach sich zieht, wodurch knochenspezifische Gene aktiviert werden. Obwohl die Wnt Signalkaskade weitestgehend beschrieben ist, ist der Beitrag globalerer Regulationsmechanismen, wie die der miRNAs, an der Osteogenese jedoch gleichfalls für das Verständnis von Gewebeentwicklung und -fehlfunktion von Bedeutung. Das Ziel dieser Arbeit war es deshalb bestimmte miRNAs zu identifizieren, die differentiell in ESCs exprimiert werden, die zu Knochenzellen ausdifferenzieren. Desweiteren sollten diese miRNAs funktionell charakterisiert werden, um die molekularen Mechanismen, die der Osteogenese unterliegen, aufzudecken. Letztendlich war es ein weiteres wichtiges Ziel die Ziel mRNAs der knochenspezifischen miRNAs zu identifizieren und deren Bezug zum Wnt Signalweg zu charakterisieren. miRNA Expression ist während der osteogenen Differenzierung herunter reguliert Um solche miRNAs zu identifizieren, die potentiell in die Osteogenese eingreifen, wurden ESCs zu Osteoblasten differenziert und mit undifferenzierten ESCs mit Hilfe eines miRNA Microarrays verglichen. Das so durchgeführte miRNA Profiling zeigte, dass 25 miRNAs während der initialen Phase der osteogenen Differenzierung signifikant unterschiedlich exprimiert wurden. Die differentielle Expression von 4 getesteten miRNAs wurde in einem nächsten Schritt über quantitative real-time PCR (RT-qPCR) beispielhaft bestätigt. Generell zeigte sich, dass differenzierende ESCs viele miRNAs auf geringem Niveau exprimieren. Tatsächlich schien die Herunterregulation der miRNA Expression mit der Differenzierung der Zellen einherzugehen. Desweiteren zeigten miRNAs, die auf dem gleichen Chromosom kodiert sind, ähnliche Expressionsmuster. Zusammenfassend fanden sich etliche miRNAs, die in undifferenzierten Zellen im Vergleich zu differenzierenden Zellen unterschiedlich exprimiert werden, von denen schlussendlich 11 für weitere Analysen ausgewählt wurden (miR-22, miR-127, miR-130a, miR-183, miR-291b-5p, miR-293, miR-300, miR-361, miR-467b, miR-665 and miR-690). miR-127, miR-183, miR-291b-5p, miR-293, miR-361, miR-467b und miR-665 beeinflussen die Osteogenese In einem nächsten Schritt wurden undifferenzierte und differenzierende ESCs für funktionelle Studien dieser 11 herrunterregulierten miRNAs herangezogen. Um die Funktion dieser miRNAs aufzudecken, wurden sogenannte Gain-of-function und Loss-of-function Studien durchgeführt. Die experimentelle Überexpression und der Knock-down dieser miRNAs führten zu Änderungen in der zellulären Morphologie, der Viabilität und der osteogenen Differenzierungskapazität wie durch einen Kalziumdepositionsassay, einen ALP Aktivitätsassay und die Expression knochenspezifischer Markergene gezeigt werden konnte. Im Besonderen erhöhte die Überexpression der miR-361 und der Knock-down der miR-665 den Mineralisierungsgrad der Zellen und die Expressionniveaus knochenspezifischer Gene. Daher ist zu schließen, dass beide miRNAs das Potential besitzen, die Osteogenese - besonders in den frühen Stadien der Keimbahnspezifikation - zu regulieren. miRNAs als Modulatoren der Osteogenese Um miRNA Zielkandidaten zu identifizieren, die die beobachteten Effekte auf die Zellviabilität und auf die osteogene Differenzierungen bedingen könnten, wurde ein kombinierter Ansatz aus Bioinformatischer Sequenz- und Prädiktionsanalyse, mRNA Expressionsanalyse und TurboGFP Reduktion nach miRNA Überexpression gewählt. Gepaart mit einer Literatursuche deutete diese Zielkandidatenanalyse darauf hin, dass die identifizierten miRNAs tatsächlich den Aktivierungsstatus des Wnt Signalwegs manipulieren könnten, da viele der prädiktierten Target mRNAs bekannt dafür sind, mit dem Wnt Signalweg zu interagieren. Um zu bestätigen, dass miR-183, miR-293, miR-361, miR-665 und miR-690 die Osteogenese regulieren, wurde die mRNA/miRNA Interaktion indirekt mittels RT-qPCR studiert. Die Überexpression dieser miRNAs führte zu einer Erniedrigung des mRNA Expressionsspiegels von WIF-1 (Wnt inhibitory factor 1) durch miR-293, NFATc-3 (nuclear factor of activated T cells 3) und Prickle-1 durch miR-361, Dishevelled 1 (Dvl-1) durch miR-665, sowie forkhead box O3 (FoxO-3), Ras homolog gene family, member A (RhoA) und CatnB durch miR-690. In einem nächsten Schritt konnte durch Nutzung eines speziellen Reportersystems (TurboGFP) eine direkte Interaktion zwischen miR-361 und Prickle-1 nachgewiesen werden. Wie bereits in anderen Studien gezeigt, ist Prickle-1 in der Lage, die Spiegel an Dvl-3 durch Ubiquitinierung des Proteins zu reduzieren, was zur Inhibierung des kanonischen Wnt Signalweges führt. Da Dvls als positive Regulatoren der Osteogenese bekannt sind, indem sie den CatnB Spiegel erhöhen und die lymphoid enhancer factor/T cell factor protein (LEF/TCF) abhängige Transkription stimulieren, könnte Prickle-1 als negativer Regulator fungieren, indem es Dvls von diesem Transkriptionskomplex entfernt. Abschließend lässt sich zusammenfassen, dass miR-361 in dieser Arbeit als neuartiger Aktivator der osteogenen Differenzierung vorgeschlagen wird. Die molekulare Interaktion zwischen miR-361, Prickle-1 und Dvls bietet einen neuartigen Mechanismus der Wnt Signalaktivierung während der Osteogenese und kann für weitere Untersuchungen zur Identifizierung von Schlüsselkomponenten des Wnt Signalweges herangezogen werden.

It has been shown that stem cells exist within adult adipose tissue. These stem cells are named adipose-derived mesenchymal stem cells (ASCs), are derived from the mesoderm, and can differentiate into a number of cells including osteoblasts, chondrocytes, and adipocytes. However, before these cells can be used clinically it is important that we understand how factors like age, sex, and ethnicity affect ASC number and potential. Additionally, since men and women vary in their distribution of adipose tissue, it will be important to see if the ideal source of ASCs is different for each sex. The goal of this study was to assess how age and sex affects ASCs. We used flow cytometry to investigate how age and sex affected the number of ASCs in adipose tissue. Additionally, we plated these cells in culture and treated them with an osteogenic media (OM) with the intention of pushing them towards osteoblast differentiation. The purpose of this was to see if age or sex affected the potential of the ASCs to undergo osteogenesis in culture. For this study we used real-time PCR and biochemical assays to look at markers of early and late osteogenic differentiation. Finally, we used immunohistochemistry to demonstrate where in adipose tissue the CD73 and CD271 positive cell population exists. It is our hope that this work will shed light on how age and sex affect ASCs so that clinicians can optimize their ASC harvest depending on the patient's physiology.