Cytokine & Growth Factor Reviews 24 (2013) 297–310
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Survey
Angiogenic factors in bone local environment Shek Man Chim a, Jennifer Tickner a, Siu To Chow a, Vincent Kuek a, Baosheng Guo b, Ge Zhang b, Vicki Rosen c, Wendy Erber d, Jiake Xu a,* a
Molecular Lab, School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA 6009, Australia Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China c Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA d Translational Cancer Lab, School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA 6009, Australia b
A R T I C L E I N F O
A B S T R A C T
Article history: Available online 20 April 2013
Angiogenesis plays an important role in physiological bone growth and remodeling, as well as in pathological bone disorders such as fracture repair, osteonecrosis, and tumor metastasis to bone. Vascularization is required for bone remodeling along the endosteal surface of trabecular bone or Haversian canals within the cortical bone, as well as the homeostasis of the cartilage-subchondral bone interface. Angiogenic factors, produced by cells from a basic multicellular unit (BMU) within the bone remodeling compartment (BRC) regulate local endothelial cells and pericytes. In this review, we discuss the expression and function of angiogenic factors produced by osteoclasts, osteoblasts and osteocytes in the BMU and in the cartilage-subchondral bone interface. These include vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), BMP7, receptor activator of NF-kB ligand (RANKL) and epidermal growth factor (EGF)-like family members. In addition, the expression of EGFL2, EGFL3, EGFL5, EGFL6, EGFL7, EGFL8 and EGFL9 has been recently identified in the bone local environment, giving important clues to their possible roles in angiogenesis. Understanding the role of angiogenic factors in the bone microenvironment may help to develop novel therapeutic targets and diagnostic biomarkers for bone and joint diseases, such as osteoporosis, osteonecrosis, osteoarthritis, and delayed fracture healing. ß 2013 Elsevier Ltd. All rights reserved.
Keywords: Bone remodeling Angiogenesis EGF-like Bone remodeling compartment
Contents 1. 2. 3. 4.
5.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bone remodeling and angiogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . The bone remodeling compartment: a vascularized structure at the Angiogenic factors in bone remodeling compartment . . . . . . . . . . . . VEGF, bFGF and ET-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1. RANKL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2. 4.3. BMP7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EGF-like family members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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1. Introduction
* Corresponding author at: School of Pathology and Laboratory Medicine, 1st Floor, M Block, QEII Medical Centre, Nedlands, Australia. Tel.: +61 9346 2739; fax: +61 9346 2891. E-mail address:
[email protected] (J. Xu). 1359-6101/$ – see front matter ß 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.cytogfr.2013.03.008
Bone is a connective tissue that is characterized by a mixture of organic collagen and inorganic hydroxyapatite. It continuously undergoes remodeling to maintain skeletal size, shape and structural integrity. Angiogenesis plays a pivotal role during bone remodeling. Vasculature that supplies oxygen, nutrients, hormones, cytokines, as well as osteoblast and osteoclast precursor
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cells, is important in bone remodeling. The bone remodeling compartment (BRC), an anatomical structure identified at the site of bone remodeling, is closely associated with blood vessels. The initiation of sprouting angiogenesis from existing bone vasculature toward the BRC and maintenance of newly formed vessels could be regulated by osteoclasts, osteoblasts, and osteocytes. Cumulative evidence shows that bone cells are capable of producing angiogenic factors, while the endothelium could contribute osteogenic factors, indicative of intercellular communication between bone cells and endothelial cells. In recent years, a role for EGF-like family members has been identified in bone biology, including factors such as EGF, heparin binding-EGF (HBEGF), transforming growth factor-alpha (TGFa), betacellulin (BTC), and EGF-like protein 6 (EGFL6). Interestingly, the EGF-like family also plays an important role in angiogenesis. This review aims to provide a summary focusing on the expression of angiogenic factors in the bone microenvironment, and the complex interrelationship between angiogenesis and osteogenesis. 2. Bone remodeling and angiogenesis Bone is a living tissue and, in order to maintain mechanical integrity, it is continuously undergoing remodeling [1]. Bone remodeling is accomplished by two important steps, bone resorption followed by new bone formation. Osteoclasts are the principal cells in bone resorption. Osteoclasts remove old and damaged bone by attachment to the bone surface and degradation of bone matrix. The resorption area is then filled with osteoblasts, which play an important role in bone mineralization and deposition of new bone matrix. The balancing act of osteoclasts and osteoblasts is essential in regulating the volume of bone resorption and deposition in order to maintain bone size and shape. Bone remodeling is tightly regulated by a multitude of local and systemic factors which control the cellular activities during the remodeling process [1–5]. An imbalance of osteoblastic bone formation and osteoclastic bone resorption will lead to various skeletal diseases. For example, increased osteoclastic bone resorption relative to bone formation would result in low bone mass and skeletal fragility, which is associated with bone lytic disorders such as osteoporosis and Paget’s disease. On the other hand, decreased osteoclastic bone resorption relative to bone formation is clinically associated with osteopetrosis [6,7]. The vasculature is important for skeletal development during the embryonic stage, postnatal growth and bone remodeling. Bone tissues are invaded by blood vessels which bring in precursors of osteoblasts and osteoclasts, nutrients, growth factors and differentiation factors [8,9]. During the embryonic stage, mesenchymal precartilage condensation occurs in the region of the embryonic limb bud where mesenchymal precursors differentiate into cartilage cells [10]. At this stage, immature blood vessels formed by endothelial cells invade the cartilage from the connective tissues surrounding the bone. This process is regulated by VEGF expression in chondrocytes undergoing differentiation [11,12]. In postnatal growth, the endothelial cells invade the cartilage at the growth plate region and form a vascular channel which provides access for the cells involved in bone formation [10]. The cartilage is gradually degraded by osteoclasts and replaced by osteoblasts, and subsequent ossification occurs. The vasculature also provides a scaffold for bone-forming cells and directs new bone formation [9,10,13,14]. Evidence has also been presented for a role for angiogenesis in the regulation of homeostasis of the cartilage-subchondral bone interface. Cartilage is avascular and resistant to vascular invasion, partly due to the expression of anti-angiogenic protease inhibitors [15], and high expression of chondromodulin-I (ChM-I) [16]. Vascular invasion can occur at the cartilage-subchondral bone
interface driven by increased expression of pro-angiogenic markers, and decreased expression of ChM-I [16,17]. Reduction in the expression levels of ChM-I from articular cartilage might cause the loss of resistance to vascularization, leading to blood vessel invasion into the cartilage. Abnormal angiogenesis that occurs at the cartilage-subchondral bone interface could potentially contribute to the progression of osteoarthritis. The cortical bone is associated with a network of capillaries, which is in continuity with periosteum and endosteum. Periosteum lines the outer surface of cortical bone and is covered by capillaries running in circular and longitudinal patterns along the bone. The endosteum is a highly vascular membrane lining the inner surface of cortical bone [18,19]. To link the vascular system between endosteum and periosteum a network of intracortical canals consisting of longitudinal Haversian canals and transversal Volkmann canals exists, which allows a continuous connection between periosteum and endosteum [20]. Collectively, as shown in Fig. 1, angiogenesis is an integral part of bone remodeling, taking place along the endosteal surface of trabecular bone, on the periosteal and endosteal surface and Haversian canals within the cortical bone, and at the cartilage-subchondral bone interface. Moreover, angiogenesis is important in fracture repair during hematoma formation, soft callus formation, hard callus formation and post-fracture bone remodeling [21]. It has been demonstrated that angiogenesis has an important role in bone formation during distraction osteogenesis and that it is under the regulation of angiogenic and osteogenic related genes such as VEGF, fibroblast growth factors (FGFs), and bone morphogenic proteins (BMPs). Conversely, inhibition of angiogenesis in distraction osteogenesis prevents normal osteogenesis during the healing processes and results in fibrous nonunion [22]. Recently, microvascular pericytes have been shown to have multilineage potential and to contribute to bone tissue formation [23,24]. Pericytes are relatively undifferentiated cells that wrap around the abluminal wall of blood vessels [25]. Pericytes have been shown to be capable of differentiating into osteoblasts, chondrocytes, adipocytes and fibroblasts [24,26,27]. It is well established that the platelet-derived growth factor (PDGF)-B/PDGFRb signaling pathway is critical in pericyte proliferation and recruitment [28]. PDGF-B is secreted by endothelial cells and regulates pericytes by a paracrine mechanism [28,29]. Moreover, a recent study suggested that EGF-like family member, HB-EGF regulates pericyte proliferation and recruitment along blood vessels [29]. Interestingly, PDGF-B and HB-EGF are also expressed by bone cells [30–32]. These findings indicate that bone cells could regulate pericytes in the bone local environment. The interaction between vasculature and bone remodeling at the cellular level is still unclear. Understanding the coupling process between bone endothelium and bone cells is vital for us to modulate bone homeostasis and develop novel targeted therapeutic approaches for bone diseases. Cumulative evidence demonstrates that numerous skeletal pathologies are strongly related to changes in vascularization; Paget’s disease of bone [2], osteopetrosis [33–35], osteoporosis [36,37], osteoarthritis [38], rickets [39,40], avascular necrosis [41– 43], inflammatory bone loss [44,45], multiple myeloma [46–48], and metastatic bone disease [49,50]. 3. The bone remodeling compartment: a vascularized structure at the site of remodeling Bone remodeling takes place in a specialized vascular structure called the BRC [51]. The BRC is a narrow sinus on the bone surface, which is formed between the bone marrow and the remodeling surface. When the bone remodeling process is initiated the lining cells of the endosteal membrane detach from the bone by disruption of the gap junctions to form the roof of the BRC
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Fig. 1. Schematic diagram showing vascular supply in bone. Vascular supply is important for all regions of bone. Blood vessels invade into bone and provide nutrients and hormones required for development and remodeling at (A) trabecular bone within epiphysis, (B) cartilage-subchondral bone interface, (C) trabecular bone within diaphysis, and (D) cortical bone.
[5,52]. It is well accepted that capillaries are associated with the BRC. There are two hypothetical models of capillary orientation in the BRC. The association of capillaries with the BRC has been demonstrated using a 3D reconstructed model, suggesting that the communication between capillaries and BRC is through a contact point [53]. An alternative model has also been presented suggesting that capillaries might physically penetrate the canopy into the BRC [54,55]. It has been suggested that the association of blood vessels with the BRC via the canopy of cells is necessary to provide a vascular supply for the cells in the BRC and regulate the coupling between bone resorption and bone formation [56,57]. Importantly, pathological studies in multiple myeloma and Cushing’s syndrome demonstrated that the canopy of cells covering the BRC plays a critical role in bone remodeling [58,59]. A recent study suggested that coverage of BRC canopies is important during the whole remodeling process, including bone resorption by osteoclasts, recruitment and differentiation of osteoblasts, and bone formation by osteoblasts. Disruption of the coverage results in deficient bone restitution [58].
The BRCs most likely serve the following purposes: firstly, the BRC provides an anatomical structure that integrates with the microvasculature of bone and the process of bone remodeling. Cellular responses within the BRC are regulated by systemic hormones such as thyroid hormone, estrogen, vitamin D and parathyroid hormone (PTH), which are provided from the circulating blood supply. Moreover, osteoblast and osteoclast precursor cells within the blood supply have been shown to be recruited to the bone remodeling site [60,61]. Secondly, the BRC is an ideal compartment for the coupling between osteoblasts and osteoclasts. The membrane bound receptor activator of the NF-kB ligand (RANKL) expressed by osteoblasts is required for osteoclast differentiation and activation. Direct cell to cell interaction between osteoblast and osteoclast precursors is needed for osteoclast activation. The identification of lining cells in the canopy of the BRC, which exhibit an osteoblast phenotype and express RANKL, has shed light on this. These lining cells interact with osteoclast precursors which enter the BRC through the blood supply [3,5]. Thirdly, the BRC could be a structure to receive
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Fig. 2. Schematic diagram showing hypothetical model of angiogenic processes regulated by osteocytes, osteoclasts and osteoblasts in BRC. Bone remodeling is initiated by stimuli such as microdamage. Damaged osteocytes produce angiogenic factors which lead angiogenic sprouting toward bone remodeling site. Osteoclast precursors are recruited into BRC and differentiated to mature osteoclast. Osteoclasts resorb bone, and also secrete angiogenic factors and release them from ECM. Osteoblast precursors are recruited into BRC. Osteoblasts synthesize osteoid to fill the space in BRC and also produce angiogenic factors during bone formation. Some osteoblasts differentiate into osteocytes and embedded in mineralized osteoid.
mechanosensory signals from the osteocyte network and trigger the remodeling events on the bone surface. The osteocyte plays a pivotal role in bone remodeling, they are the most numerous and longest-living cells in bone. Events of mechanical stress, such as microdamage to the bone could initiate bone remodeling events. The mechanical signal is transmitted to the lining cells through the gap junctions. The lining cells then release paracrine factors, such as insulin-like growth factor and prostaglandins, to stimulate the formation of osteoblasts from their precursor cells and the formation of new bone [5,62,63]. In addition, osteocyte apoptosis and microdamage in bone caused by skeletal loading or pathologic conditions could initiate bone remodeling [5,7]. Fourthly, the canopy serves to create a unique microenvironment that allows localization of signaling molecules to the site of bone remodeling. It has been postulated that the BRC serves to concentrate cytokines,
allowing them to reach critical mass by preventing them from dispersing within the marrow, and also protecting the cells within the BRC from high levels of activating cytokines in the marrow that could potentially cause unwanted effects [3]. It is understood that a directional sprouting of endothelial cells from existing vasculature toward the BRC is required in the initial step of bone remodeling, followed by formation of new blood vessels over BRC canopies. Here, we propose a hypothetical model of angiogenic processes regulated by osteoclasts, osteoblasts and osteocytes during bone remodeling (Fig. 2). 4. Angiogenic factors in bone remodeling compartment Locally produced angiogenic factors in the bone mircoenvironment are critical for bone remodeling. Osteoclasts, osteoblasts, and
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osteocytes, three major cells in bone remodeling, could produce angiogenic factors which influence the directional angiogenesis and maintain the blood supply above BRC canopies during the entire remodeling cycle. Previous reviews identify a myriad of molecules produced by osteoblasts and osteoclasts that could regulate endothelial cell activities, including proliferation, migration, survival and angiogenesis [9]. Recently, osteocytes were found to play a pivotal role in the initiation of bone remodeling, via producing angiogenic factors, such as VEGF [64–66], RANKL [67,68] and BMP7 [69–71]. 4.1. VEGF, bFGF and ET-1 VEGF is a potent mitogen and angiogenic factor for endothelial cells and its role in the vascularization of bone tissues has been well characterized. VEGF interacts with two receptor tyrosine kinases, VEGFR-1 and VEGFR-2 to regulate endothelial cell activities [72–74]. VEGF is highly expressed in chondrocytes both in the lower hypertrophic and mineralized regions of the cartilage of developing embryonic bones. Angiogenesis in these areas is an important step toward ossification [11,75]. VEGF is also expressed during osteoblast differentiation, and its expression level is enhanced by stimulators of osteoblast differentiation such as IGF and Vitamin D3 [76,77]. The expression of VEGF receptors has been identified during primary osteoblast differentiation [78,79]. It has been demonstrated that VEGF acts as a potent chemoattractant for osteoblasts and osteoclasts [80,81]. Moreover, VEGF expression is upregulated during osteoclast differentiation through NF-kB induction of HIF-1a [82]. VEGF expression is also increased in direct response to hypoxia in osteoclasts, and hypoxia stimulates osteoclast formation [83]. In addition, osteoclasts express VEGF receptors and VEGF directly enhances osteoclastic bone resorption and osteoclast survival [40,84–87]. Interestingly, VEGF is also expressed in haematopoietic and endothelial cells regulated by TGFb1, a major cytokine released from the bone matrix during bone remodeling. This raises the possibility that TGFb1 released from osteoclasts could induce VEGF expression in cells within the BRC to help maintain the vascular supply [88,89]. Recent studies suggest that osteocytes are also a source of VEGF in the BRC. VEGF is released by MLO-Y4 osteocytes in response to mechanical loading by pulsatile fluid shear stress [65,66]. There is emerging evidence to demonstrate that microdamage to the bone could initiate osteocyte apoptosis and bone remodeling events [7,90,91]. In vitro studies have shown that VEGF expression significantly increased in osteocytes undergoing apoptosis induced by TNFa [64]. bFGF is a member of the FGF family which has pleiotropic effects on different cells and organ development in vitro and in vivo [92–95]. It is produced by various cells including fibroblasts, endothelial cells and osteoblasts [96–98]. bFGF is a potent mitogenic factor for several different cell types, including fibroblasts and endothelial cells. It induces angiogenesis through functioning as an autocrine and paracrine factor which stimulates endothelial cell proliferation, migration, and expression of proteases, growth factors and integrins involved in angiogenesis [99–102]. bFGF binds to its receptors FGFR-1, FGFR-2, FGFR-3 and FGFR-4 to activate signaling cascades that mediate endothelial cell activities [103–105]. Moreover, bFGF contributes significantly to bone development, remodeling, and repair [106–109]. bFGF is a strong stimulator of osteogenesis and adipogenesis and has been shown to have a strong stimulatory effect on bone formation in osteopenic ovariectomized rats [110]. In osteoblasts, bFGF was produced in response to prostaglandins and TGF-b [111–113]. bFGF also acts via autocrine and paracrine mechanisms to promote proliferation of osteoblast precursor cells and their differentiation into mature osteoblasts [114–116]. In osteoclasts, bFGF has been
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shown to induce osteoclastogenesis by regulating the production of osteoclast differentiation factors such as RANKL and COX-2 [117–119]. It also regulates osteoclastic bone resorption through the activation of FGF receptor and ERK signaling pathways [120]. Using a chick embryo chorioallantoic membrane assay (CAM) implanted with a bone chip, it has been shown that bFGF promotes osteoclast recruitment, formation, differentiation, and resorption activity on bone at sites of stimulated angiogenesis [95]. During fracture repair, it has been demonstrated that mature osteoclasts produce heparanase. This functions to degrade heparin sulfate proteoglycans, a major component in ECM, and release heparin-binding growth factors including VEGF and bFGF, resulting in the promotion of angiogenesis, and regulation of osteoblast and osteoclast activity [95,121–123]. In addition, angiogenic factors such as VEGF, FGFs and their receptors are upregulated during distraction osteogenesis [22,124–126]. Conversely, inhibition of angiogenesis prevents fracture healing [22,127]. Rapamycin has anti-angiogenic activities and can cause delayed fracture healing via inhibiting neovascularization in the callus [128]. Moreover, shock waves have been shown to improve fracture healing and tendon repair by stimulating the production of VEGF in osteoblasts, which in turn induces angiogenesis [129]. In recent studies, endothelial cells have been shown to produce BMP-2 and BMP-4 when they are subjected to mechanical stimuli, VEGF, or hypoxic environments. BMPs potently stimulate osteoblast differentiation to promote fracture healing [9,130–132]. The intracellular Smad molecules in BMP signaling pathways can be regulated by protein degradation via ubiquitin-mediated proteasomal degradation [133]. We have recently identified casein kinase-2 interacting protein-1 (CKIP-1) as an auxiliary factor of ubiquitin ligase Smad ubiquitylation regulatory factor 1 (Smurf1) to ubiquitylate Smad1/ 5. As shown in Fig. 3, by interrupting the BMP signaling pathway, CKIP-1 not only down-regulates bone formation but also suppresses angiogenesis during bone fracture healing as evidenced by improved vascular structures found in CKIP-1 knockout mice (Dr. Zhang Ge, Institute for Advancing Translational Medicine in Bone & Joint Diseases, Hong Kong Baptist University). Endothelin-1 (ET-1) is expressed by endothelial cells and osteoblasts, and may play an important role in the regulation of angiogenesis and bone formation during bone remodeling [57,134–137]. There are two types of ET-1 receptors, ETA and ETB [138]. It has been suggested that ET-1 directly regulates angiogenesis by promoting endothelial cell migration, proliferation and differentiation, or indirectly by inducing VEGF production in endothelial cells [139–144]. ET-1 also regulates VEGF production in osteoblastic cells [145–147]. Interestingly, a study has revealed that the matrix mineralization in bone is disrupted in ET1 knockout mice [148]. It has been suggested that ET-1 stimulates both proliferation and differentiation of osteoblasts [149]. Taken together, these studies show that VEGF, bFGF and ET-1 regulate the communication between endothelial cells and bone cells via autocrine and paracrine mechanisms in the BRC. 4.2. RANKL The RANK/RANKL/osteoprotegerin (OPG) system has an essential role in bone biology, and has recently been identified as a regulator of vascular biology. RANKL binds as a homotrimer to its receptor (RANK) on osteoclast precursor cells and mature osteoclasts, and regulates multiple intracellular signaling pathways resulting in osteoclast differentiation and activation [150– 152]. The binding of RANKL to RANK on endothelial cells also plays an important role in maintaining endothelial cell survival through the PI3K/Akt signal transduction pathway [153]. RANKL also possesses angiogenic activity in vitro and in vivo. RANKL stimulates DNA synthesis, migration, and tube-like structure formation in
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Fig. 3. Angiography of callus at 1 week and 2 weeks after fracture operation. The angiograph of callus from CKIP-1 knockout (KO) and wide-type (WT) mice was reconstructed by micro CT at 1 week and 2 weeks after fracture operation. Larger blood vessel volume was indicated in red color. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of the article.)
endothelial cells in vitro. Using a Matrigel plug assay in mice, and a chick chorioallantoic membrane assay in vivo, RANKL has also been shown to potently induce angiogenesis. RANKL-induced angiogenic activity occurs through the activation of the mitogenactivated protein kinases ERK1/2 and focal adhesion kinase in a time- and dose-dependent manner [154]. RANKL actions are blocked by OPG, a soluble receptor expressed by a variety of cells including osteoblasts, stromal cells, and endothelial cells. OPG functions as a decoy receptor preventing RANKL/RANK interaction [45,155–158]. In addition, OPG and RANKL also affect endothelial cell survival and angiogenic activities. It was discovered that OPG mediates integrin-dependent survival of endothelial cells. The expression of OPG is induced by integrin avb3 binding to osteopontin [159]. OPG then directly binds and forms a complex with tumor necrosis factor-related apoptosis-inducing ligands (TRAIL) to prevent TRAIL interaction with apoptosis-inducing TRAIL receptors on endothelial cells [160]. OPG and RANKL expression in osteoblasts and bone marrow stromal cells is regulated by various stimuli such as PTH, Vitamin D3, prostaglandin E2, dexamethasone and IL-11. Interestingly, endothelial cells also produce both OPG and RANKL in response to stimuli, including
inflammatory cytokines TNF-a and IL-1a, but not PTH and Vitamin D3 [45,161–163]. It has also been suggested that the RANKL/RANK/ OPG system mediates the process of vascular calcification [157]. Osteocytes are also a major source of RANKL. RANKL is secreted by damaged MLO-Y4 osteocytes after mechanical scratching [164]. Conditional knockout models have recently identified osteocytes as the major producer of RANKL controlling postnatal bone remodeling [68]. 4.3. BMP7 BMPs belong to the TGFb superfamily. The binding of BMPs to BMP type I and type II receptors regulates downstream signaling molecules, such as Smad and MAPK [165,166]. BMPs play essential roles in skeletal embryogenesis, cartilage development and bone formation [132,167]. Moreover, BMPs regulate proliferation and migration of endothelial cells, and are important in angiogenesis [165,166]. A recent study in a zebra fish model suggested that BMPs play a distinct role in angiogenic sprouting of venous endothelial cells. In this study, it was demonstrated that sprouting angiogenesis in the dorsal aorta is driven by VEGF signaling, but
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not BMP signaling, whereas sprouting angiogenesis in the axial vein is regulated by BMPs through the activation of Smad and Erk1/ 2 [166]. BMP7 binds to BMP type II receptors, A (BMPRII ctRIIA, ActRIIB), and Type I receptors (ALK2/3/6) [165]. It has been suggested that BMP7 promotes endothelial cell survival [71] and induces angiogenesis [168] indirectly by increasing VEGF expression [169]. Interestingly, BMP7 expression has been detected in osteocytes [69,70], osteoclasts [170,171] and osteoblasts [69,172]. Immunohistochemical staining revealed that osteoblasts and osteocytes expressed BMP7 at the endosteal surface of cortical bone [69,70]. Like VEGF, BMP7 gene and protein expression is upregulated in osteocytes in response to mechanical loading by pulsatile fluid shear stress [69]. 4.4. EGF-like family members EGF has been shown to directly stimulate epidermal growth and keratinization [173,174], and play an important role in angiogenesis [175]. EGF is a single polypeptide chain consisting of 53 amino acid residues. It is characterized by three intramolecular disulfide bonds formed by interactions between spatially cysteine residues. These disulfide bonds are important for the biological activity of EGF, and a disruption to these disulfide bonds could result in inactivation of EGF [176,177]. EGF-like proteins, which contain single or multiple EGF-like repeats have been identified as
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membrane-bound proteins or secreted proteins. The EGF-like domains contain 30–40 amino acid residues that have significant homology to EGF. The EGF-like domains are characterized by a consensus sequence consisting of six spatially conserved cysteine residues forming three disulfide bonds [178–181]. The spatially conserved disulphide bridges of the EGF-like proteins result in a similar secondary structure to EGF. It has been suggested that these highly homologous domains share some common functional features [178,180,182,183]. EGF-like factors mediate their biological effects through binding to a group of four transmembrane tyrosine kinase receptors, including EGFR, ErbB2, ErbB3 and ErbB4. The activation of EGF receptors triggers numerous intracellular signaling cascades, including PI3 kinase, MAP kinase and STAT pathways [183–187]. The EGF ligand family comprises typical members; including EGF, HB-EGF, BTC, TGFa, Epigen (EPGN), amphiregulin (AREG), epiregulin (EREG) and neuregulins (NRG1-4) [183]. Interestingly, NRGs also belong to a complex growth factor family which encodes NRG1-4, which all contain an EGF-like domain. NRGs have been reported to produce many isoforms by alternative splicing [188,189]. EGF-like factors usually require proteolytic cleavage to release mature soluble EGF-like domains which bind and activate EGF receptors [183,186]. However, membrane associated EGF family members such as EGF, HB-EGF, and TGFa can act as juxtacrine factors to regulate cellular activities [190–193]. It has
Fig. 4. Schematic representations of domain structures of EGF-like family members. EGF-like family members contain differing number of EGF domains and vary in amino acid length.
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become clear that EGF-like family members play an important role in bone biology [194,195]. EGF receptors are expressed in a number of cell types, including osteoblasts, osteoclasts, and endothelial cells [196–199]. Interestingly, there is accumulating evidence demonstrating that EGF-like family members might facilitate the communication between osteoclasts, osteoblasts and endothelial cells that is essential for the bone remodeling process. The expression of EGF-like family members has been detected in osteoblasts, osteoclasts and endothelial cells. To date, it has been demonstrated that EGF, HB-EGF, AREG, EREG, and NRG are expressed during osteoclast differentiation [31]. Osteoblasts express EGF, HB-EGF, AREG, BTC, EREG and TGFa [32,200]. Recently, EGF-like genes such as EGFL2, EGFL3, EGFL5, EGFL6, EGFL7, EGFL8 and EGFL9 were found differentially expressed in the BMU [201]. EGFL3, EGFL5, EGFL6 and EGFL9 were preferentially expressed in osteoblasts, whereas EGFL2, EGFL7 and EGFL8 were expressed abundantly in both osteoclasts and osteoblasts. EGF-like family members are predicted as membrane-bound or secreted proteins. EGFL2, EGFL5 and EGFL9 contain transmembrane domains, whereas EGFL3, EGFL6, EGFL7 and EGFL8 lack transmembrane domains [201]. Schematic representations of EGF-like family members are shown in Fig. 4. EGF-like family members vary in amino acid length and contain differing number of EGF domains. Among all EGFL members, EGF, HB-EGF, TGFa, BTC and EGFL7 are also expressed in endothelial cells, indicative of both an autocrine and paracrine regulation [198,202–208]. EGF and some of the EGF-like members are angiogenic factors. It was demonstrated that EGF had angiogenic activity in vivo using a rabbit cornea model [175]. EGF significantly promotes human umbilical vein endothelial cell and tumor endothelial cell proliferation [209,210]. It has also been demonstrated that EGF can induce endothelial cell migration and tube formation in vitro via the activation of PI3K and MAPK signaling pathways [198,211]. Similarly, HB-EGF also induces angiogenesis through the activation of PI3K and MAPK signaling pathways [198]. Moreover, HB-EGF induces endothelial cell migration by stimulating endothelial nitric oxide synthase and nitric oxide production [212]. BTC plays an important role in hair follicle development and hair cycle
induction. In a wound healing experiment, it has been demonstrated that the area covered by blood vessels was significantly increased in transgenic mice overexpressing BTC. The blood vessel size and density in BTC transgenic mice were also increased [213]. Moreover, it was shown that BTC induces endothelial cell migration and tube formation through the activation of ERK1/2 and AKT signaling pathways [184]. TGFa has been demonstrated as a potent chemoattractant for endothelial cells [214]. It stimulated extensive formation of new capillaries in a hamster cheek pouch assay in vivo [215]. Subsequently, a study has found that treatment with TGFa significantly increases blood vessel area surrounding infarct site in a brain injury model [216]. AREG has been implicated in tumor angiogenesis. It has been demonstrated that inhibition of AREG significantly reduced vascular density and size of tumors [217–221]. NRG1 is the most well studied member of NRG family that shares the common EGF-like domain that is critical for its function. NRG1 plays a important role in cardiovascular biology by regulating blood pressure and angiogenesis [222]. Recently, it has been reported that EGFL6 induces angiogenesis by a paracrine mechanism in which EGFL6 is expressed in osteoblastic like cells but promotes migration and angiogenesis of endothelial cells. It has been demonstrated that EGFL6 gene and protein expression is upregulated during osteoblast differentiation. In addition, EGFL6 proteins were expressed during bone development. Interestingly, EGFL6 induces endothelial cell migration and tube-like structure formation via the activation of ERK1/2. EGFL6 might interact with integrins to regulate endothelial cell activities [201]. EGFL2, EGFL3, EGFL5, EGFL6, EGFL8 and EGFL9 are relatively newly identified EGF-like family members, and their cellular functions are still not fully understood. However, they contain EGF domains which could potentially regulate endothelial cell activities through EGF receptors. Notably, they are abundantly expressed in osteoblastic like cells, raising the possibility that these EGF-like family proteins might play an important role in angiogenesis and bone biology. EGFL7 has been recently identified in osteoclasts and osteoblasts [201]. It has been demonstrated that EGFL7 induces endothelial cell migration and plays an important role in
Fig. 5. Angiogenic factors produced in BRC. BRC is closely associated with blood vessels, which provide essential nutrients, and recruiting osteoclast and osteoblast precursor cells to bone remodeling site. Angiogenic factors such as VEGF, bFGF, ET-1, RANKL, BMP7 and EGF-like family members are produced by osteoclasts and osteoblasts, and regulate endothelial cell activities above the BRC canopies.
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Table 1 Expression of angiogenic factors in BRC and their roles in angiogenic activities. Angiogenic factors
Receptors
Angiogenic activities
Expression in osteoblasts
Expression in osteocytes
Expression in osteoclasts
VEGF
VEGFR1, VEGFR2
H [76,77]
H [64–66]
H [82]
bFGF ET-1 RANKL BMP7 EGF HB-EGF TGFa EGFL6 EGFL7 AREG BTC
FGFR1, FGFR2, FGFR3, FGFR4 ETA, ETB RANK BMPRII, ActRIIA, ActRIIB, ALK2/3/6 EGFR EGFR, ErbB4 EGFR EGFRs (potential), Integrins EGFR, Notch EGFR EGFR, ErbB4
Proliferation, migration, survival, angiogenesis [73]. Induction of MMPs [74] Proliferation, migration, survival, angiogenesis [99,100] Proliferation, migration, angiogenesis [139–144] Migration, survival, angiogenesis [153,154] Proliferation, survival, angiogenesis[71,168] Proliferation, migration, angiogenesis [198,209,210] Migration, angiogenesis [198,212] Proliferation, migration, angiogenesis [208,214,215] Migration, angiogenesis [201] Migration, angiogenesis [203,223–225] Angiogenesis [217–221] Migration, angiogenesis[184,213]
? ? H [67,68] H [69,70] ? ? ? ? ? ? ?
? ? [150–152] H [170] H [31] H [31] ? [201] H [201] H [31] ?
H H H H H H H H H H H
[97,98] [137] [150–152] [69,172] [199,200] [32,200] [200] [201] [201] [200] [200]
H, Expression was detected; , no expression was detected; and ?, expression was not reported.
tubulogenesis, the process by which blood vessels form during embryogenesis [203,223,224]. EGFL7-knockout mice were characterized by a severe delay in the development of the vasculature, and 50% of knockout embryos die in utero. EGFL7 regulates migration of endothelial cells and spatial organization in angiogenic sprouts [225]. EGFL7 has been shown to function through EGFR. Inhibition of EGFR significantly impaired EGFL7induced cell motility [226]. Moreover, EGFL7 also acts as an antagonist to Notch and regulates ligand-mediated receptor signaling [227]. The expression of angiogenic factors in the BRC and their roles in endothelial cell activities are summarized in Fig. 5 and Table 1. There are many other angiogenic factors which might play distinct roles in the BRC, such as interleukins and TGFb. The discovery of angiogenic factors in the BRC expands the knowledge of bone vascular biology, and may facilitate the development of therapeutic strategies for the treatment of skeletal disease associated with pathological angiogenesis. 5. Conclusion Vasculature of bone is important for skeletal development during the embryonic stage, postnatal growth, and bone remodeling. However, the role of angiogenesis and local angiogenic factors produced in the BRC remain to be fully elucidated. Formation of blood vessels near the BRC canopy is necessary for the bone remodeling process. The directional sprouting of endothelial cells toward the BRC could be driven by angiogenic factors expressed within the BRC. Interestingly, evidence shows that EGF-like family members could play an important role in angiogenesis. It is possible that EGF family members might fulfill a vital role in the cross-talk between bone cells and endothelial cells during bone remodeling. Moreover, aberrant angiogenesis is closely associated with many bone pathologies, including delayed bone fracture repair, osteoarthritis and osteonecrosis. Thus, understanding of the intercellular communication between bone endothelium and bone cells is vital for us to modulate bone homeostasis and develop novel targeted therapeutic approaches for bone diseases, such as osteoporosis, osteonecrosis, osteoarthritis, and delayed fracture healing. Disclosure All authors state that they have no conflicts of interest. Acknowledgments This work was funded in part by National Health and Medical Research Council of Australia, Western Australia Medical & Health Research Infrastructure Fund, and a grant from the National
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S.M. Chim et al. / Cytokine & Growth Factor Reviews 24 (2013) 297–310 Siu To Chow received his BSc in Molecular Medicine and Biochemistry and Master of Infectious Disease in School of Pathology and Laboratory Medicine at the University of Western Australia. He was involved in research projects investigating novel molecules secreted by osteoblasts and osteoclasts which have potential to regulate angiogenesis and bone homeostasis via paracrine/autocrine mechanism.
Vincent Kuek is a PhD student in Molecular Laboratory, School of Pathology and Laboratory Medicine at The University of Western Australia (UWA). He completed his Bsc (Hons) in Microbiology at UWA. His research project focuses on the discovery of genes and their mechanisms involved in the intercellular crosstalk between osteoblasts, osteoclasts and endothelial cells, which may potentially lead to the development of new therapeutic treatments and improved treatments for bone diseases.
Dr. Baosheng Guo is the Postdoctoral Research Fellow of the Hong Kong Baptist University. He was graduated from the Hebei North University, Hebei, China and perused his Bachelor Degree of Medicine in 2005. Then, he began his postgraduate research project of Master Degree at the Shanghai University of Chinese Medicine, Shanghai, China and the Hong Kong Polytechnic University, Hong Kong. He finished his PhD study at Department of Orthopaedics & Traumatology of the Chinese University of Hong Kong in 2012. He previously worked as resident at the Luo Yang Orthopeadic & Traumatology Hospital in 2006 and research assistant at Department of Rehabilitation Sciences of the Hong Kong Polytechnic University, Hong Kong from 2008 to 2009. Dr. Baosheng Guo has the technical expertise on bone biomechanics, bone bioimaging and bone biology and focused research study on muscle atrophy as well as RNAi-based or phytotherapy-based translational research in osteoporosis. Relate research work has been published on PloS One, Nature Medicine and Bone. Prof. Ge Zhang is the associate professor of the Hong Kong Baptist University and the author of over 106 peerreviewed papers on RNAi-based or phytotherapy-based translational research, targeted delivery in osteoporosis, osteonecrosis, osteoarthritis, rheumatoid arthritis and facture repair. He was educated at the Shanghai University of Chinese Medicine, Shanghai, China and got the Doctor Degree of Medicine in 1995. Then, he started his research career at the Institute of Orthopaedics & Traumatology, Shanghai University of Chinese Medicine, China in 1997 and finished his PhD project from 2000 to 2003. Then, he worked as Postdoctoral Research Fellow at Department of Orthopaedics & Traumatology of the Chinese University of Hong Kong from 2004 to 2007. In 2007, he was the Research Assistant Professor of the Chinese University of Hong Kong. In 2012, Prof. Ge Zhang was appointed as Associate Professor of the Hong Kong Baptist University. Prof. Ge Zhang has comprehensive expertise on bone bioimaging, bone biology and bone biomechanics and interested in RNAi-based or phytotherapy-based translational research on joint and musculoskeletal diseases. The research work was published on over 106 peer-reviewed journals, such as Nature Medicine, Arthritis & Rheumatism, Journal of Bone and Mineral Research and Bone.
Prof. Vicki Rosen arrived at Harvard School of Dental Medicine (HSDM) by way of industry, having spent the majority of her research career as a scientist at Genetics Institute, a biotechnology company, where she was part of a research team that identified the bone morphogenetic protein (BMP) genes in 1988. She became a professor in the Faculty of Medicine in 2001, and chair of the Department of Developmental Biology at HSDM in 2005. Prof. Rosen’s lab studies the physiological roles that BMPs play in the development, maintenance, and repair of musculoskeletal tissues (bone, cartilage, tendon, ligament, meniscus, muscle) using molecular, cellular, and genetic approaches in a variety of model systems. Prof. Rosen believes that enhancing our current understanding of BMP biology will lead to the development of novel strategies for repair and regeneration of individual components of the musculoskeletal system, and also will provide new models for examining the complex tissue interactions that are required for its function. Prof. Erber graduated in Medicine with 1st class honours from the University of Sydney. She undertook her Haematology training at the Royal North Shore Hospital of Sydney and the University of Oxford (as a Rhodes Scholar) where she undertook research leading to Doctorate of Philosophy. She has held Haematologist posts at Royal Perth Hospital, PathCentre, and most recently Addenbrooke’s Hospital in Cambridge. She took up her current appointment as Chair and Head of the School of Pathology and Laboratory Medicine at the University of Western Australia in May 2011. Throughout her professional career Prof. Erber’s major interest has been the adoption of new cutting-edge technologies, translating these into diagnostic pathology practice, especially in the field of haematological malignancies. She has more than 140 publications in peer-reviewed journals and published 3 books. Prof. Jiake Xu is Winthrop Professor and Head of Molecular Laboratory in the School of Pathology and Laboratory Medicine at the University of Western Australia (UWA). He is also a founding Fellow, Faculty of Science, the Royal College of Pathologists of Australia, and has been appointed the President-elect of the Australian and New Zealand Orthopaedic Research Society (ANZORS). He finished his medical training in Guangzhou Medical College in China in 1985. After completing his PhD studies at UWA in 1994, he carried out his postdoctoral research at Stanford University from 1994 to 1998. He returned to UWA in 1998, and has since undertaken research and teaching in the Schools of Surgery and Pathology and Laboratory Medicine. His current research activities are focused on gene discovery, molecular mechanisms of osteoclast functions and the intercellular communication between osteoclasts and osteoblasts, which have significant implication in bone diseases; including osteoporosis, Paget’s disease of bone and malignancy-related osteolysis.