Osteoporosis (OP) is a serious global health concern characterized by an alarming incidence of osteoporosis-related fractures occurring at a frequency of one every 3 seconds worldwide (Ganesan et al. 2023; Johnell and Kanis 2006). Such a disease is marked by a disruption in the dynamic equilibrium of bone remodeling with reduced bone formation by osteoblasts and increased bone resorption by osteoclasts resulting in weaker bones that are more prone to fracture (Munoz, Robinson, and Shibli-Rahhal 2020; Riggs, Khosla, and Melton 1998).
The existing treatments face major constraints related to their effectiveness as well as their long-term use. One of the most commonly used antiresorptive medications for OP is bisphosphonates, which are effective in reducing fracture risk. However, these treatments, while beneficial, come with limitations, including modest gains in bone density and the potential for rare but severe side effects (Adler et al. 2016). In contrast to antiresorptive treatments, anabolic agents work by stimulating bone formation and increasing bone density. Such treatments are exemplified by teriparatide, a synthetic form of parathyroid hormone (PTH), which is the one and only clinically available anabolic reagent approved for the treatment of osteoporosis (Canalis, Giustina, and Bilezikian 2007). Teriparatide, when daily administrated, has demonstrated high efficacy in improving bone density. Ongoing treatment is required to maintain such benefits which makes the treatment costly (Canalis et al. 2007; Carson and Clarke 2018).
Biominerals, which have garnered attention in the field of bone research, can be defined as minerals produced by living organisms (Carson and Clarke 2018). Mollusks, the second largest phylum of metazoans, have played and continue to play a crucial role in the comprehension of the mechanisms of biomineralization (Evans 2019). Mollusk shells are primarily composed of calcium carbonate in the form of aragonite or calcite (Table 1) or a mix of both polymorphs. Some variations in the arrangement of the crystallites are observed between different species (Marin, Le Roy, and Marie 2012), in particular in the bivalve class, characterized by an extraordinary diversity of shell microstructures (Taylor, Kennedy, and Hall, 1969, 1973).
Many bivalve shells – in particular within the pteriomorphids clade that contains edible mussels and pearl oysters – are of the 'nacro-prismatic' type and exhibit a three-layered structure. The outer layer called the periostracum, is mostly organic and results from a quinone-tanning process. Ontogenetically speaking, it represents the first shell layer formed by bivalve larvae and its role is to support the early underlying mineralization and to protect the shell against dissolution. The middle layer is prismatic and made of long needles of calcite, developed perpendicularly or obliquely to the outer shell surface. At last, the inner layer is aragonitic and presents a lustrous aspect; this is nacre also known as mother-of-pearl and the focus of the present study (Hahn et al. 2012). In bivalves, nacre consists of a stack of tiny flat tablets arranged in a brick-wall manner, while, in gastropods and cephalopods, nacre tablets are arranged in columns. Like bone, nacre contains both organic and inorganic components (Marie et al. 2009). Its organic matrix is a mixture of proteins, peptides, glycoproteins, lipids, chitin, and pigments (De Muizon et al. 2022). In their paper, Gonzalez and Vallejo reviewed the historical therapeutic applications of marine mollusk shells in Spanish ethnomedicine (González J and Vallejo J 2023). They uncovered intricate practices, such as using nacre from seashells for various dermatological purposes, including treating acne, eliminating facial spots through maceration in lemon juice, and dissolving mother-of-pearl buttons in lemon juice or vinegar for addressing skin conditions like chloasma (also called ‘pregnancy mask’, i.e., pigmentation disorder) and freckles. Additionally, the authors highlighted the traditional remedy of placing small mother-of-pearl buttons under the eyelid for extracting foreign bodies and discussed the potential pharmacological activities of these marine-derived products (González J and Vallejo J 2023). In addition, nacre demonstrated the capacity of increasing the cell osteogenic activity without exhibiting toxicity (Lopez et al. 1992). This remarkable property led to the hypothesis that nacre might contain elements capable of inducing mineralization and promoting the proper functioning of human bone (Lopez et al. 2004; De Muizon et al. 2022; Westbroek and Marin 1998).
Within nacreous molluscs, the Polynesian pearl oyster Pinctada margaritifera has proven having the capacity to induce mineralization in mouse pre-osteoblastic cell line MC3T3-E1 (Brion et al. 2015; Rousseau et al. 2003, 2008). On the other hand, the water-soluble-matrix (WSM) of Pinctada fucata, the Japanese 'Akoya' pearl oyster, confirmed its efficacy in enhancing osteoblast differentiation (Chaturvedi, Singha, and Dey 2013). Taken together, these findings emphasize the effects of the nacre matrix on bone. Previous studies primarily focused on nacreous mollusks, specifically on different species of the Pinctada genus; to our knowledge, no studies have investigated the effects of non-nacreous mollusk biominerals on bone regeneration.
Therefore, in the present study, we have broadened the scope by investigating the osteogenic capacity of other nacreous mollusks different from Pinctada genus. We cautiously selected species that are taxonomically and geographically distant from Pinctada (Fig. 1). To gain a more comprehensive understanding of nacre-bone mineralization relationship, we also investigated the osteogenic capacity of non-nacreous mollusks, including one cephalopod (the cuttlefish) and two gastropods, among which, one nacreous. At last, we also added in the study an extra-group representative, the purple sea urchin. We assessed the effects of all these biominerals on osteoblasts using the pre-osteoblastic MC3T3-E1 cell line.