Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Bone. 2018 Jul;112:42-50. doi: 10.1016/j.bone.2018.04.008. Epub 2018 Apr 13.
Spondyloepiphyseal dysplasia (SED) exemplifies a group of heritable diseases caused by mutations in collagenous proteins of the skeletal system. Its main feature is altered skeletal growth. Pathomechanisms of SED include: changes in the stability of collagen II molecules, inability to form proper collagen fibrils, excessive intracellular retention of mutant molecules, and endoplasmic reticulum stress. The complexity of this pathomechanism presents a challenge for designing therapies for SED. Our earlier research tested whether such therapies only succeed when applied during a limited window of development. Here, employing an inducible mouse model of SED caused by the R992C mutation in collagen II, we corroborate our earlier observations that a therapy must be applied at the prenatal or early postnatal stages of skeletal growth in order to be successful. Moreover, we demonstrate that blocking the expression of the R992C collagen II mutant at the early prenatal stages leads to long-term positive effects. Although, we could not precisely mark the start of the expression of the mutant, these effects are not significantly changed by switching on the mutant production at the early postnatal stages. By demonstrating the need for early therapeutic interventions, our study provides, for the first time, empirically-based directions for designing effective therapies for SED and, quite likely, for other skeletal dysplasias caused by mutations in key macromolecules of the skeletal system.
脊椎干骺端发育不良(SED)是一组由骨骼系统胶原蛋白突变引起的遗传性疾病的典范。其主要特征是骨骼生长异常。SED 的发病机制包括:胶原 II 分子稳定性改变、无法形成适当的胶原原纤维、突变分子在细胞内过度滞留以及内质网应激。这种发病机制的复杂性给 SED 的治疗设计带来了挑战。我们之前的研究测试了这种治疗方法是否仅在骨骼生长的有限窗口内应用才会成功。在这里,我们使用由 II 型胶原 R992C 突变引起的可诱导小鼠模型,证实了我们之前的观察结果,即治疗必须在骨骼生长的产前或新生儿早期阶段应用才能成功。此外,我们还证明,在产前早期阶段阻断 R992C 胶原 II 突变体的表达可带来长期的积极效果。尽管我们无法准确标记突变体表达的开始,但通过在新生儿早期阶段开启突变体的产生,这些效果并没有明显改变。通过证明早期治疗干预的必要性,我们的研究首次为 SED 及其他由骨骼系统关键大分子突变引起的骨骼发育不良的有效治疗方法的设计提供了基于经验的方向。