Musculoskeletal diseases affect millions of people in the United States and present severe consequences for national and local health systems1. These disorders are characterized by loss of bone and joint function that require extensive treatment and long periods of recovery. Commonly, a relative increase in the number and/or activity of osteoclasts, cells specialized to resorb bone, in osteoporosis and arthritis is observed2. Under physiological conditions the number and activity of osteoclasts is regulated by receptor activator of nuclear factor κ-B ligand (RANKL), which is produced by osteoblasts. Osteoprotegerin (OPG), a decoy receptor for RANKL is also produced by osteoblasts3. In vivo animal models that involve systemic overexpression of sRANKL, or deletion of OPG are very valuable in osteoporosis research; however, these methods require the generation of transgenic mice4,5. Here, a novel alternative method of overexpressing sRANKL for the study of musculoskeletal-related disorders is described. Specifically, minicircle (MC) DNA technology and hydrodynamic delivery methods were used to achieve gene transfer of sRANKL in vivo and overexpress mouse sRANKL systemically6.
This method is also complementary to other in vivo models of osteoporosis, such as hormonal modulation of osteoclasts following ovariectomy7 and dietary intervention by low-calcium diet8. These models are very useful to study different aspects of musculoskeletal-related disorders however they require surgical procedures and may take up to several months, at a significant cost9. Ovariectomized (OVX) rodent model is an experimental animal model where removal of ovaries leads to estrogen deficiency thereby mimicking human postmenopausal osteoporosis10. Human post-menopausal osteoporosis, a condition where estrogen deficiency leads to increased risk of bone fractures and osteoporosis affects approximately eight million women in the United States alone. Although the OVX model is useful for post-menopausal osteoporosis it offers limited advantages in studying osteoporosis in general. Estrogen suppresses bone loss, by inducing osteoclast and inhibiting osteoblast apoptosis, therefore in its absence an increased osteoclast activity is observed10-12. A RANKL-OPG ratio imbalance that favors bone resorption is also observed13. However, estrogen deficiency in vivo is also accompanied by decreased levels of transforming growth factor β (TGF β), increased interleukin-7 (IL-7) and TNF, IL-1 and IL-614,15. As these cytokines have known bone remodeling modulatory functions independent of the RANKL pathway, it is impossible to attribute any osteoclast activation solely to the RANKL-RANK axis. The model described in this paper enables researchers to study in vivo RANKL-RANK axis in osteoclastogenesis and bone loss without pro-inflammatory cytokines compared to OVX rodent models.
Additionally, in vitro osteoclastogenesis techniques are essential tools to study osteoclast activation for potential therapeutic treatments of musculoskeletal diseases. Previous studies have also shown that culturing mouse bone marrow derived macrophages (BMMs) with mouse macrophage colony-stimulating factor (M-CSF) and mouse sRANKL can lead to osteoclast differentiation3,16,17. Here, the protocols to generate multinucleated osteoclast-like cells from mouse bone marrow as well as from human peripheral blood mononuclear cells (PBMCs) in vitro18 are described. The cell-based assays required to define a mature terminally differentiated and fully functional osteoclast are also briefly described. These in vitro techniques complement the novel in vivo approach and together serve as powerful investigative tools to study osteoclast differentiation and activation. Using these systems, scientists are able to generate osteoclasts in vivo and in vitro and define the stimuli and signals required for their proliferation and activation as well as test the efficacy of pharmacological and biological inhibitors.