Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Heinrich Collin Strasse 30, 1140 Vienna, Austria.
Section on Heritable Disorders of Bone and Extracellular Matrix, NICHD, NIH, Bethesda, USA.
Bone. 2022 Sep;162:116451. doi: 10.1016/j.bone.2022.116451. Epub 2022 May 30.
Osteogenesis imperfecta (OI) is a heterogenous group of heritable connective tissue disorders characterized by high bone fragility due to low bone mass and impaired bone material properties. Atypical type VI OI is an extremely rare and severe form of bone dysplasia resulting from a loss-of-function mutation (p.S40L) in IFITM5/BRIL,the causative gene of OI type V and decreased osteoblast secretion of pigment epithelium-derived factor (PEDF), as in OI type VI. It is not yet known which alterations at the material level might lead to such a severe phenotype. We therefore characterized bone tissue at the micrometer level in a novel heterozygous Ifitm5/BRIL p.S42L knock-in murine model at 4 and 8 weeks of age.
We evaluated in female mice, total body size, femoral and lumbar bone mineral density (BMD) by dual-energy X-ray absorptiometry. In the femoral bone we examined osteoid deposition by light microscopy, assessed bone histomorphometry and mineralization density distribution by quantitative backscattered electron imaging (qBEI). Osteocyte lacunae were examined by qBEI and the osteocyte lacuno-canalicular network by confocal laser scanning microscopy. Vasculature was examined indirectly by qBEI as 2D porosity in cortex, and as 3D porosity by micro-CT in third trochanter. Collagen orientation was examined by second harmonic generation microscopy. Two-way ANOVA was used to discriminate the effect of age and genotype.
Ifitm5/BRIL p.S42L female mice are viable, do not differ in body size, fat and lean mass from wild type (WT) littermates but have lower whole-body, lumbar and femoral BMD and multiple fractures. The average and most frequent calcium concentration, CaMean and CaPeak, increased with age in metaphyseal and cortical bone in both genotypes and were always higher in Ifitm5/BRIL p.S42L than in WT, except CaMean in metaphysis at 4 weeks of age. The fraction of highly mineralized bone area, CaHigh, was also increased in Ifitm5/BRIL p.S42L metaphyseal bone at 8 weeks of age and at both ages in cortical bone. The fraction of lowly mineralized bone area, CaLow, decreased with age and was not higher in Ifitm5/BRIL p.S42L, consistent with lack of hyperosteoidosis on histological sections by visual exam. Osteocyte lacunae density was higher in Ifitm5/BRIL p.S42L than WT, whereas canalicular density was decreased. Indirect measurements of vascularity revealed a higher pore density at 4 weeks in cortical bone of Ifitm5/BRIL p.S42L than in WT and at both ages in the third trochanter. Importantly, the proportion of bone area with disordered collagen fibrils was highly increased in Ifitm5/BRIL p.S42L at both ages.
Despite normal skeletal growth and the lack of a collagen gene mutation, the Ifitm5/BRIL p.S42L mouse shows major OI-related bone tissue alterations such as hypermineralization of the matrix and elevated osteocyte porosity. Together with the disordered lacuno-canalicular network and the disordered collagen fibril orientation, these abnormalities likely contribute to overall bone fragility.
成骨不全症(OI)是一组遗传性结缔组织疾病,其特征是由于骨量低和骨材料特性受损而导致骨脆性增加。非典型 6 型 OI 是一种极其罕见和严重的骨发育不良形式,由 IFITM5/BRIL 中的功能丧失突变(p.S40L)引起,IFITM5/BRIL 是 OI 类型 V 的致病基因,并且骨母细胞分泌的色素上皮衍生因子(PEDF)减少,如 OI 类型 VI。目前尚不清楚哪些物质水平的改变可能导致如此严重的表型。因此,我们在 4 周和 8 周龄的新型杂合性 Ifitm5/BRIL p.S42L 敲入鼠模型中,在微观水平上对骨组织进行了表征。
我们评估了雌性小鼠的总体大小、股骨和腰椎骨矿物质密度(BMD),采用双能 X 射线吸收法。在股骨中,我们通过光镜观察类骨质沉积,通过定量背散射电子成像(qBEI)评估骨组织形态计量学和矿化密度分布。通过 qBEI 观察骨细胞陷窝,通过共聚焦激光扫描显微镜观察骨细胞陷窝-管腔网络。通过 qBEI 间接观察皮质中的 2D 孔隙作为血管化,通过第三转子的微 CT 作为 3D 孔隙作为血管化。通过二次谐波产生显微镜观察胶原取向。采用双因素方差分析来区分年龄和基因型的影响。
Ifitm5/BRIL p.S42L 雌性小鼠具有活力,与野生型(WT)同窝仔相比,体型、体脂和瘦体重无差异,但全身、腰椎和股骨 BMD 降低,且骨折多发。在两种基因型中,骨代谢活跃部位和皮质骨的平均和最常见的钙浓度 CaMean 和 CaPeak 随年龄增长而增加,且 Ifitm5/BRIL p.S42L 中的 CaMean 和 CaPeak 始终高于 WT,除了 4 周龄时的骨代谢活跃部位的 CaMean。高矿化骨面积分数 CaHigh 在 8 周龄的 Ifitm5/BRIL p.S42L 骨代谢活跃部位和皮质骨中均增加,在两个年龄均增加。低矿化骨面积分数 CaLow 随年龄减少,在 Ifitm5/BRIL p.S42L 中不增加,这与组织学切片上通过肉眼观察到的无高骨样化一致。Ifitm5/BRIL p.S42L 中的骨细胞陷窝密度高于 WT,而管腔密度降低。血管化的间接测量显示,在 4 周龄时,Ifitm5/BRIL p.S42L 皮质骨中的孔密度高于 WT,在两个年龄时,第三转子中的孔密度也高于 WT。重要的是,在两个年龄的 Ifitm5/BRIL p.S42L 中,排列紊乱的胶原纤维比例都显著增加。
尽管骨骼生长正常,且没有胶原基因突变,Ifitm5/BRIL p.S42L 小鼠仍表现出主要的 OI 相关骨组织改变,如基质过度矿化和骨细胞孔隙度增加。加上紊乱的陷窝-管腔网络和紊乱的胶原纤维取向,这些异常可能导致整体骨脆弱。