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Department
of Pathology (BFB, LX, AD), University of Texas Health Science Center, San
Antonio, Texas; Department of Pathology (DEH), Royal Hospital, Chesterfield,
England; Division of Human Anatomy (KRW), Loma Linda University, Loma Linda,
California |
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Bone is modeled during embryonic development by endochondral and membranous
ossification and is continuously remodeled thereafter under the influence
of local and systemic factors to provide structural support and assist
in calcium homeostasis. Recent studies of knockout and transgenic mice
have increased understanding of the regulation of bone modeling during
development and of remodeling of mature bone and have shed new light on
the pathogenesis of a number of bone disorders. For example, fibroblast
growth factor receptor-3, parathyroid hormone-related protein, and tartrate-resistant
acid phosphatase affect the function of chondrocytes during endochondral
ossification (the latter two by regulating their life spans and thus growth
plate thickness and bone length). Some ubiquitously expressed genes seem
unexpectedly to have unique functions that are largely confined to bone
cells: M-CSF, C-Fos, PU.1, and NF-KB are required for osteoclast
formation, whereas c-Src and Mitf (microphthalmia transcription factor)
are required for osteoclast activity after the cells have formed. Knockout
of these genes results in osteopetrosis, a disorder characterized by persistence
in marrow cavities of unresorbed osteocartilaginous matrix and, as in
some affected humans, by increased mortality. Some proteins seem to act
as negative regulators of bone cell function, for example osteoprotegerin
(a soluble TNF receptor) in osteoclasts; osteocalcin, bone sialoprotein,
and 5-lipoxygenase in osteoblasts. Regulation of osteoclast life span
may be an important mechanism by which estrogen and bisphosphonates prevent
bone loss in conditions characterized by increased bone resorption, such
as postmenopausal osteoporosis. The unique requirement of bone cells for
certain gene products raises the possibility that these cells may have
specific responses to inhibitory or stimulatory agents, and that signaling
molecules in these response pathways could be specific targets for novel
therapies to treat or prevent common bone diseases.
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