Osteoporosis is a common degenerative disease in clinics, but the underlying mechanisms involved remain unclear[29]. Under physiological conditions, bone metabolism is maintained through a delicate balance between bone formation and bone resorption. Nevertheless, this balance is disrupted in osteoporosis[30, 31]. Previous reports have shown that inflammation plays an important role in the development of osteoporosis[32, 33]. TNF-α is located at the top of the inflammatory cascade, plays an important role in the occurrence of osteoporosis[9]. TNF-α can lead to decreased activity of osteoblasts and increased number and activity of osteoclasts, resulting in bone loss[6, 25].
In osteoarthritis, inflammatory bowel disease, and psoriasis, PGRN can effectively inhibit the inflammatory signaling pathway mediated by TNF-α and reduce the expression of downstream inflammatory factors, thus inhibiting the inflammatory response mediated by TNF-α[34, 35]. In TNF-α transgenic mice, TNF-α over-expression resulted in significant bone loss, which was significantly reduced by the application of exogenous PGRN[36]. Moreover, PGRN can mediate bone formation induced by BMP-2[36, 37]. Further studies have shown that PGRN can promote fracture healing under physiological conditions[5, 38]. It was hypothesized that Atsttrin as an engineered protein derived from PGRN, would regulate bone metabolism balance through a mechanism highly similar to that of PGRN. In the current study, BMDMs were treated with receptor activator of nuclear factor kappa-Β ligand (RANKL) (100 ng/mL) for 7days to induce osteoclast differentiation. We found that TNF-α can enhance the activity of osteoclasts and promote the proliferation of osteoclasts, while Atsttrin attenuated this progress. Furthermore, we established a TNF-α-induced inflammatory response model of RAW264.7 cells to explore the role of Atsttrin in inhibiting osteoclastogenesis and to investigate the mechanism of this effect, and found that Atsttrin effectively prevented TNF-α-mediated inflammatory catabolism signaling pathway, evidenced by the expression levels of IL-1β, IL-6,IL-17,COX-2 and iNOS were significantly suppressed and reduced serum level of IL-17、IL-1β and IL-6 fragments. Moreover, TNF-α is involved in osteoclastogenesis mainly through activation of NF-κB、p38 and JNK signaling pathway. The levels of p-P38、p-PJNK and p-P65 were significantly reduced by Atsttrin treatment. In addition, the NF-κB signaling pathway plays a critical role in TNF-α function. Nuclear translocation of p65 can be inhibited after treatment with Atsttrin.
TNF-α plays an important role in the pathogenesis of osteoporosis and is a major inflammatory factor. There are two binding sites of TNF - α on the cell surface, TNF receptor-1 and TNF receptor-2[16]. The interaction between TNF-α and TNFR1 mediates inflammatory signaling[19, 20]. TNF-α induces the expression of molecules associated with inflammation in osteoclast precursors, includingIL-1β, IL-6,IL-17,COX-2 and iNOS, through binding to its receptors TNFR1. We also assessed the expression of biomarkers in TNF-α -induced osteoclastgenesis. In addition, TNF-αinhibits osteoblast precursor differentiation through TNFR1. While the additional use of Atsttrin to blocking TNFR1 prominently repressed this process. Previous reports demonstrate that TNFR2 mediates protective signaling[39, 40]. We found that Atsttrin can enhance osteoblastogenesis through binding to TNFR2. Therefore, during the progression of osteoporosis, we found that Atsttrin exhibited its effect through both inhibiting TNFα/TNFR1-mediated inflammation and activating anabolic TNFR2 pathways.
We found that Erk1/2 and Akt signaling are involved in osteoblastogenesis. In detail, in the presence of osteoblastogenesis medium, Atsttrin strongly activates Akt/Erk1/2 signaling. However, in normal media, Atsttrin can activate the Akt/Erk1/2 signaling pathways weakly. Furthermore, Atsttrin completely lost its effect when using specific inhibitors of Akt and Erk1/2 signaling. Consequently, we found that the Atsttrin-mediated anabolic effect in osteoblastogenesis depends on TNFR2-Akt/Erk1/2 signaling.
Ovariectomy-Induced mouse model is a well-accepted research method to study the pathogenesis of osteoporosis in vivo[41, 42]. Our finding that intraperitoneal injection of recombinant Atsttrin could dramatically prevent bone loss in VOX model. In the current study, we confirmed the role of Atsttrin in osteoclastogenesis and osteoblastogenesis. Although Atsttrin is derived from PGRN, whether PGRN can prevent osteoporosis has not been reported, which needs further investigation.
Above all, Atsttrin exerts its effect in enhancing osteoblastogeneis and inhibiting osteoclastogenesis under inflammatory condition through at least 3 pathways: a) Atsttrin directly binding to TNFR1, inhibited TNF-α-induced osteoclastogenesis; b) Atsttrin competitively binding to TNFR1, rescued TNF-α-mediated inhibition of osteoblastogenesis; c) Atsttrin synthesized with osteoblastogenesis medium, enhanced osteoblast formation and activity via TNFR2-Akt/Erk1/2 signaling (Fig. 8G). It provides new ideas for research on the mechanism of osteoblast-osteoclast regulation under inflammatory condition and provides potential therapeutic target for clinical treatment.