Abstract
The SOST gene, which encodes the protein sclerostin, was identified through genetic linkage analysis of sclerosteosis and van Buchem’s disease patients. Sclerostin is a secreted glycoprotein that binds to the low-density lipoprotein receptor-related proteins 4, 5, and 6 to inhibit Wnt signaling. Since the initial discovery of sclerostin, much understanding has been gained into the role of this protein in the regulation of skeletal biology. In this article, we discuss the latest findings in the regulation of SOST expression, sclerostin mechanisms of action, and the potential utility of targeting sclerostin in conditions of low bone mass.
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van Bezooijen R, ten Dijke P, Papapoulos SE, Lowik CW. SOST/sclerostin, an osteocyte-derived negative regulator of bone formation. Cytokine Growth Factor Rev. 2005;16:319–27.
van Hul W, Balemans W, van Hul E, Dikkers F, Obee H, Stokroos R, et al. van Buchem Disease (hyperostosis corticalis generalisata) maps to the chromosome 17q12-q21. Am J Hum Genet. 1998;62:391–9.
Balemans W, Van Den Ende J, Freire Paes-Alves A, Dikkers FG, Willems PJ, Vanhoenacker F, et al. Localization of the Gene for Sclerosteosis to the van Buchem Disease-Gene Region on Chromosome 17q12-q21. Am J Hum Genet. 1999;64:1661–9.
Balemans W, Ebeling M, Patel N, Van Hul E, Olson P, Dioszegi M, et al. Increased bone density in sclerosteosis is due to the deficiency of a novel secreted protein (SOST). Hum Molec Genet. 2001;10(5):537–43.
Brunkow M, Gardner JC, Van Ness J, Paeper BW, Kovacevich BR, Proll S, et al. Bone dysplasia sclerosteosis results from loss of the SOST gene product, a novel cystine knot-containing protein. Am J Hum Genet. 2001;68:577–89.
van Lierop A, Hamdy NAT, Hamersma H, van Bezooijen RL, Power J, Loveridge N, et al. Patients with sclerosteosis and disease carriers: human models of the effect of sclerostin on bone turnover. J Bone Miner Res. 2011;26(12):2804–11. This manuscript provides evidence that decreased or absent sclerostin leads to increased bone mass in humans. Importantly, decreased sclerostin in sclerosteosis carriers correlated with increased bone mass without disease symptoms.
Balemans W, Patel N, Ebeling M, Van Hul E, Wuyts W, Lacza C, et al. Identification of a 52 kb deletion downstream of the SOST gene in patients with van Buchem disease. J Med Genet. 2002;39:91–7.
van Lierop A, Hamdy NAT, van Egmond ME, Bakker E, Dikkers FG, Papapoulos SE. Van Buchem Disease: clinical, biochemical, and densitometric features of patients and disease carriers. J Bone Miner Res. 2013;28(4):848–54. This manuscript provides evidence that there is a gene-dose effect of the VBD mutation on circulating sclerostin, suggesting that altered sclerostin levels affects the severity of the bone phenotype in VBD and sclerosteosis patients.
Burgers T, Williams BO. Regulation of Wnt/ß-catenin signaling within and from osteocytes. Bone. 2013;54:244–9.
Rossini M, Gatti D, Adami S. Involvement of WNT/ß-catenin Signaling in the treatment of osteoporosis. Calcif Tissue Int. 2013;93:121–32.
Little R, Carulli JP, Del Mastro RG, Dupuis J, Osborne M, Folz C, et al. A mutation in the LDL receptor-related protein 5 gene results in the autosomal dominant high-bone-mass trait. Am J Hum Genet. 2002;70:11–9.
Boyden L, Mao J, Belsky J, Mitzner L, Farhi A, Mitnick MA, et al. High bone density due to a mutation in LDL-receptor-related protein 5. N Engl J Med. 2002;346:1513–21.
Gong Y, Slee RB, Fukai N, Rawadi G, Roman-Roman S, Reginato AM, et al. LDL Receptor-related protein 5 (LRP5) affects bone accrual and eye development. Cell. 2001;107(4):513–23. doi:10.1016/S0092-8674(01)00571-2.
Ott S. Editorial: sclerostin and Wnt signaling—the pathway to bone strength. J Clin Endo Metab. 2005;90(12):6741–3.
Ohyama Y, Nifuji A, Maeda Y, Amagasa T, Noda M. Spaciotemporal association and bone morphogenetic protein regulation of sclerostin and osterix expression during embryonic osteogenesis. Endocrinology. 2004;145(10):4685–92. doi:10.1210/en.2003-1492.
van Bezooijen RL, Roelen BA, Visser A, van der Wee-Pals L, de Wilt E, Karperien M, et al. Sclerostin is an osteocyte-expressed negative regulator of bone formation, but not a classical BMP antagonist. J Exp Med. 2004;199(6):805–14. doi:10.1084/jem.20031454.
Van Bezooijen R, Bronckers A, Gortzak R, Hogendoorn P, van der Wee-Pals L, Balemans W, et al. Sclerostin in mineralized matrices and van Buchem disease. J Dental Res. 2009;88(6):569–74.
Moester M, Papapoulos SE, Lowik CWGM, van Bezooijen RL. Sclerostin: current knowledge and future perspectives. Calcif Tissue Int. 2010;87:99–107.
Kusu N, Laurikkala J, Imanishi M, Usui H, Konishi M, Miyake A, et al. Sclerostin is a novel secreted osteoclast-derived bone morphogenetic protein antagonist with unique ligand specificity. J Biol Chem. 2003;278(26):24113–7. doi:10.1074/jbc.M301716200.
Pederson L, Ruan M, Westendorf JJ, Khosla S, Oursler MJ. Regulation of bone formation by osteoclasts involves Wnt/BMP signaling and the chemokine sphingosine-1-phosphate. Proc Natl Acad Sci U S A. 2008;105(52):20764–9. doi:10.1073/pnas.0805133106.
Ota K, Quint P, Ruan M, Pederson L, Westendorf JJ, Khosla S, et al. Sclerostin is expressed in osteoclasts from aged mice and reduces osteoclast-mediated stimulation of mineralization. J Cell Biochem. 2013;114(8):1901–7. doi:10.1002/jcb.24537.
Tang W, Li Y, Osimiri L, Zhang C. Osteoblast-specific Transcription Factor Osterix (Osx) is an upstream regulator of Satb2 during bone formation. J Biol Chem. 2011;286(38):32995–3002. doi:10.1074/jbc.M111.244236.
Sevetson B, Taylor S, Pan Y. Cbfa1/RUNX2 directs specific expression of the sclerosteosis gene (SOST). J Biol Chem. 2004;279(14):13849–58. doi:10.1074/jbc.M306249200.
Yang F, Tang W, So S, de Crombrugghe B, Zhang C. Sclerostin is a direct target of osteoblast-specific transcription factor osterix. Biochem Biophys Res Commun. 2010;400(4):684–8. doi:10.1016/j.bbrc.2010.08.128.
Delgado-Calle J, Sanudo C, Bolado A, Fernandez AF, Arozamena J, Pascual-Carra MA, et al. DNA methylation contributes to the regulation of sclerostin expression in human osteocytes. J Bone Min Res. 2012;27(4):926–37. doi:10.1002/jbmr.1491. These data show that epigenetics contributes to the regulation of sclerostin expression.
Delgado-Calle J, Arozamena J, Perez-Lopez J, Bolado-Carrancio A, Sanudo C, Agudo G, et al. Role of BMPs in the regulation of sclerostin as revealed by an epigenetic modifier of human bone cells. Mol Cell Endocrinol. 2013;369(1-2):27–34. doi:10.1016/j.mce.2013.02.002. These data demonstrate that epigenetic modulation of the sclerostin promoter contributes to the ability microenvironment factors to affect sclerostin expression.
Kamiya N, Ye L, Kobayashi T, Mochida Y, Yamauchi M, Kronenberg HM, et al. BMP signaling negatively regulates bone mass through sclerostin by inhibiting the canonical Wnt pathway. Development. 2008;135(22):3801–11. doi:10.1242/dev.025825.
Papanicolaou SE, Phipps RJ, Fyhrie DP, Genetos DC. Modulation of sclerostin expression by mechanical loading and bone morphogenetic proteins in osteogenic cells. Biorheology. 2009;46(5):389–99. doi:10.3233/BIR-2009-0550.
Collette NM, Genetos DC, Economides AN, Xie L, Shahnazari M, Yao W, et al. Targeted deletion of SOST distal enhancer increases bone formation and bone mass. Proc Natl Acad Sci U S A. 2012;109(35):14092–7. doi:10.1073/pnas.1207188109. Deletion of the ECR5 enhancer region causes a bone phenotype similar to van Buchem's Disease.
Leupin O, Kramer I, Collette NM, Loots GG, Natt F, Kneissel M, et al. Control of the SOST bone enhancer by PTH using MEF2 transcription factors. J Bone Min Res. 2007;22(12):1957–67. doi:10.1359/jbmr.070804.
Loots GG, Keller H, Leupin O, Murugesh D, Collette NM, Genetos DC. TGF-beta regulates sclerostin expression via the ECR5 enhancer. Bone. 2012;50(3):663–9. doi:10.1016/j.bone.2011.11.016.
Quinn ZA, Yang CC, Wrana JL, McDermott JC. Smad proteins function as co-modulators for MEF2 transcriptional regulatory proteins. Nucleic Acids Res. 2001;29(3):732–42.
Keller H, Kneissel M. SOST is a target gene for PTH in bone. Bone. 2005;37(2):148–58. doi:10.1016/j.bone.2005.03.018.
Genetos DC, Yellowley CE, Loots GG. Prostaglandin E2 signals through PTGER2 to regulate sclerostin expression. PLoS One. 2011;6(3):e17772. doi:10.1371/journal.pone.0017772.
Ellies DL, Viviano B, McCarthy J, Rey JP, Itasaki N, Saunders S, et al. Bone density ligand, sclerostin, directly interacts with LRP5 but not LRP5G171V to modulate Wnt activity. J Bone Min Res. 2006;21(11):1738–49. doi:10.1359/jbmr.060810.
Veverka V, Henry AJ, Slocombe PM, Ventom A, Mulloy B, Muskett FW, et al. Characterization of the structural features and interactions of sclerostin: molecular insight into a key regulator of Wnt-mediated bone formation. J Biol Chem. 2009;284(16):10890–900. doi:10.1074/jbc.M807994200.
Winkler DG, Sutherland MK, Geoghegan JC, Yu C, Hayes T, Skonier JE, et al. Osteocyte control of bone formation via sclerostin, a novel BMP antagonist. Embo J. 2003;22(23):6267–76. doi:10.1093/emboj/cdg599.
Collette NM, Genetos DC, Murugesh D, Harland RM, Loots GG. Genetic evidence that SOST inhibits WNT signaling in the limb. Dev Biol. 2010;342(2):169–79. doi:10.1016/j.ydbio.2010.03.021.
Itasaki N, Jones CM, Mercurio S, Rowe A, Domingos PM, Smith JC, et al. Wise, a context-dependent activator and inhibitor of Wnt signalling. Development. 2003;130(18):4295–305.
Li X, Zhang Y, Kang H, Liu W, Liu P, Zhang J, et al. Sclerostin binds to LRP5/6 and antagonizes canonical Wnt signaling. J Biol Chem. 2005;280(20):19883–7. doi:10.1074/jbc.M413274200.
Leupin O, Piters E, Halleux C, Hu S, Kramer I, Morvan F, et al. Bone overgrowth-associated mutations in the LRP4 gene impair sclerostin facilitator function. J Biol Chem. 2011;286(22):19489–500. doi:10.1074/jbc.M110.190330. This publication shows that interaction of sclerostin with LRP4 can also contribute to the regulation of human bone metabolism.
Holdsworth G, Slocombe P, Doyle C, Sweeney B, Veverka V, Le Riche K, et al. Characterization of the interaction of sclerostin with the low density lipoprotein receptor-related protein (LRP) family of Wnt co-receptors. J Biol Chem. 2012;287(32):26464–77. doi:10.1074/jbc.M112.350108. These data characterize the binding of sclerostin to LRP.
Bourhis E, Wang W, Tam C, Hwang J, Zhang Y, Spittler D, et al. Wnt antagonists bind through a short peptide to the first beta-propeller domain of LRP5/6. Structure. 2011;19(10):1433–42. doi:10.1016/j.str.2011.07.005.
Semenov MV, He X. LRP5 mutations linked to high bone mass diseases cause reduced LRP5 binding and inhibition by SOST. J Biol Chem. 2006;281(50):38276–84. doi:10.1074/jbc.M609509200.
Sutherland MK, Geoghegan JC, Yu C, Turcott E, Skonier JE, Winkler DG, et al. Sclerostin promotes the apoptosis of human osteoblastic cells: a novel regulation of bone formation. Bone. 2004;35(4):828–35. doi:10.1016/j.bone.2004.05.023.
Robling AG, Niziolek PJ, Baldridge LA, Condon KW, Allen MR, Alam I, et al. Mechanical stimulation of bone in vivo reduces osteocyte expression of SOST/sclerostin. J Biol Chem. 2008;283(9):5866–75. doi:10.1074/jbc.M705092200.
Tu X, Rhee Y, Condon KW, Bivi N, Allen MR, Dwyer D, et al. SOST downregulation and local Wnt signaling are required for the osteogenic response to mechanical loading. Bone. 2012;50(1):209–17. doi:10.1016/j.bone.2011.10.025. Transgenic SOST expression prevents the loading-induced osteogenic response, demonstrating that the modulation of SOST expression in osteocytes is a mechanism by which mechanical-loading stimulates bone formation.
Lin C, Jiang X, Dai Z, Guo X, Weng T, Wang J, et al. Sclerostin mediates bone response to mechanical unloading through antagonizing Wnt/beta-catenin signaling. J Bone Min Res. 2009;24(10):1651–61. doi:10.1359/jbmr.090411.
Galea GL, Sunters A, Meakin LB, Zaman G, Sugiyama T, Lanyon LE, et al. SOST down-regulation by mechanical strain in human osteoblastic cells involves PGE2 signaling via EP4. FEBS Lett. 2011;585(15):2450–4. doi:10.1016/j.febslet.2011.06.019.
Nguyen J, Tang SY, Nguyen D, Alliston T. Load regulates bone formation and Sclerostin expression through a TGFbeta-dependent mechanism. PLoS One. 2013;8(1):e53813. doi:10.1371/journal.pone.0053813.
Lips P, Courpron P, Meunier PJ. Mean wall thickness of trabecular bone packets in the human iliac crest: changes with age. Calcif Tissue Res. 1978;26(1):13–7.
Modder UI, Hoey KA, Amin S, McCready LK, Achenbach SJ, Riggs BL, et al. Relation of age, gender, and bone mass to circulating sclerostin levels in women and men. J Bone Min Res. 2011;26(2):373–9. doi:10.1002/jbmr.217.
Wijenayaka AR, Kogawa M, Lim HP, Bonewald LF, Findlay DM, Atkins GJ. Sclerostin stimulates osteocyte support of osteoclast activity by a RANKL-dependent pathway. PLoS One. 2011;6(10):e25900. doi:10.1371/journal.pone.0025900.
Kogawa M, Wijenayaka AR, Ormsby R, Thomas GP, Anderson PH, Bonewald LF, et al. Sclerostin regulates release of bone mineral by osteocytes by induction of carbonic anhydrase 2. J Bone Min Res. 2013;28:2436-2448 doi:10.1002/jbmr.2003.
Qiang YW, Chen Y, Brown N, Hu B, Epstein J, Barlogie B, et al. Characterization of Wnt/beta-catenin signalling in osteoclasts in multiple myeloma. Br J Haematol. 2010;148(5):726–38. doi:10.1111/j.1365-2141.2009.08009.x.
Ruan M, Pederson L, Hachfeld C, Thomson M, Prakash YS, Howe A, et al. Deletion of Wnt Receptors Lrp5 and Lrp6 or β-catenin in late osteoclast precursors differentially suppress osteoclast differentiation and bone metabolism. J Bone Miner Res. 2012;27(Suppl 1).
Wei W, Zeve D, Suh JM, Wang X, Du Y, Zerwekh JE, et al. Biphasic and dosage-dependent regulation of osteoclastogenesis by beta-catenin. Mol Cell Biol. 2011;31(23):4706–19. doi:10.1128/MCB.05980-11.
Otero K, Shinohara M, Zhao H, Cella M, Gilfillan S, Colucci A, et al. TREM2 and beta-catenin regulate bone homeostasis by controlling the rate of osteoclastogenesis. J Immunol. 2012;188(6):2612–21. doi:10.4049/jimmunol.1102836.
Albers J, Keller J, Baranowsky A, Beil FT, Catala-Lehnen P, Schulze J, et al. Canonical Wnt signaling inhibits osteoclastogenesis independent of osteoprotegerin. J Cell Biol. 2013;200(4):537–49. doi:10.1083/jcb.201207142.
Kramer I, Loots GG, Studer A, Keller H, Kneissel M. Parathyroid hormone (PTH)–induced bone gain is blunted in SOST overexpressing and deficient mice. J Bone Min Res. 2010;25(2):178–89. doi:10.1359/jbmr.090730.
Cain CJ, Rueda R, McLelland B, Collette NM, Loots GG, Manilay JO. Absence of sclerostin adversely affects B-cell survival. J Bone Min Res. 2012;27(7):1451–61. doi:10.1002/jbmr.1608.
Brandenburg VM, Kramann R, Koos R, Kruger T, Schurgers L, Muhlenbruch G, et al. Relationship between sclerostin and cardiovascular calcification in hemodialysis patients: a cross-sectional study. BMC Nephrol. 2013;14:219. doi:10.1186/1471-2369-14-219.
Claes KJ, Viaene L, Heye S, Meijers B, d'Haese P, Evenepoel P. Sclerostin: another vascular calcification inhibitor? J Clin Endocrinol Metab. 2013;98(8):3221–8. doi:10.1210/jc.2013-1521.
Noordzij M, Cranenburg EM, Engelsman LF, Hermans MM, Boeschoten EW, Brandenburg VM, et al. Progression of aortic calcification is associated with disorders of mineral metabolism and mortality in chronic dialysis patients. Nephrol Dial Transplant. 2011;26(5):1662–9. doi:10.1093/ndt/gfq582.
Gardner J, van Bezooijen RL, Mervis B, Hamdy NAT, Lowik CWGM, Hamersma H, et al. Bone mineral density in sclerosteosis: affected individuals and gene carriers. J Clin Endo Metab. 2005;90(12):6392–5.
Li X, Ominsky MS, Warmington KS, Morony S, Gong J, Cao J, et al. Sclerostin antibody treatment increases bone formation, bone mass, and bone strength in a rat model of postmenopausal osteoporosis. J Bone Min Res. 2009;24(4):578–88. doi:10.1359/jbmr.081206.
Ominsky MS, Vlasseros F, Jolette J, Smith SY, Stouch B, Doellgast G, et al. Two doses of sclerostin antibody in cynomolgus monkeys increases bone formation, bone mineral density, and bone strength. J Bone Min Res. 2010;25(5):948–59. doi:10.1002/jbmr.14.
Tian X, Jee WS, Li X, Paszty C, Ke HZ. Sclerostin antibody increases bone mass by stimulating bone formation and inhibiting bone resorption in a hindlimb-immobilization rat model. Bone. 2011;48(2):197–201. doi:10.1016/j.bone.2010.09.009.
Padhi D, Jang G, Stouch B, Fang L, Posvar E. Single-dose, placebo-controlled, randomized study of AMG 785, a sclerostin monoclonal antibody. J Bone Min Res. 2011;26(1):19–26. doi:10.1002/jbmr.173. The first-in-human study assessing the effects of sclerostin monoclonal antibody AMG 785 on the skeleton.
McColm J, Hu L, Womack T, Tang CC, Chiang AY. Single- and multiple-dose randomized studies of blosozumab, a monoclonal antibody against sclerostin, in healthy postmenopausal women. J Bone Min Res. 2013. doi:10.1002/jbmr.2092. This study assesses the effects of the sclerostin monoclonal antibody blosozumab on the skeleton.
Acknowledgments
This work was supported by the National Institutes of Health (P01 AG004875, R01 DK091146, F32 AR064679, T32 AR056950).
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M. M. Weivoda declares that she has no conflicts of interest.
M. J. Oursler declares that she has no conflicts of interest.
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All studies by Merry Jo Oursler involving animal subjects were performed after approval by the appropriate Institutional Animal Care and Use Committee.
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Weivoda, M.M., Oursler, M.J. Developments in Sclerostin Biology: Regulation of Gene Expression, Mechanisms of Action, and Physiological Functions. Curr Osteoporos Rep 12, 107–114 (2014). https://doi.org/10.1007/s11914-014-0188-1
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DOI: https://doi.org/10.1007/s11914-014-0188-1