Mouse Models for the Evaluation of Osteocyte Functions

Similar documents
Functions of the osteocyte network in the regulation of bone mass

Bone mechanics bone strength and beyond

Pathophysiology of Postmenopausal & Glucocorticoid Induced Osteoporosis. March 15, 2016 Bone ECHO Kate T Queen, MD

Osteocytes The galaxy within

Deposition of Bone by the Osteoblasts. Bone is continually being deposited by osteoblasts, and it is continually being resorbed where osteoclasts are

Bone Cell Biology. David W. Dempster, PhD. Professor of Clinical Pathology Columbia University. Bone Remodeling

Bone Cell Biology. The Remodeling Cycle. Bone Remodeling. Remodeling Maintains Mechanical Strength. David W. Dempster, PhD

silent epidemic,. (WHO),

Skeletal Tissues. Skeletal tissues. Frame; muscles, organs and CT attach. Brain, spinal cord, thoracic organs; heart and lungs.

Generation of post-germinal centre myeloma plasma B cell.

Derived copy of Bone *

Osteocytes in Health and Disease

BONE TISSUE. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology

Tanya Zappitelli. Copyright by Tanya Zappitelli 2015

Histomorphometric Assessment of Haversian Canal and Osteocyte Lacunae in Different-Sized Osteons in Human Rib

Disclosures CONSULTANT WRIGHT MEDICAL CONSULTANT ORTHO FIX

Review. Role of osteocytes in the adaptation of bone to mechanical loading. Future Rheumatology

Osteoporosis and its Association with Rheumatoid Arthritis and Prednisolone Therapy

Modélisation par éléments finis des effets des médicaments sur le remodelage osseux : Approche mécanobiologique

The Osteocyte Network as a Source and Reservoir of Signaling Factors

The Skeletal System:Bone Tissue

Functions of the Skeletal System. Chapter 6: Osseous Tissue and Bone Structure. Classification of Bones. Bone Shapes

What are the parts of the skeletal system? Chapter 6- Part I Bones and Skeletal Tissues. Growth of Cartilage. Bones come in many shapes

The Osteocyte: An Endocrine Cell... and More. Sarah L. Dallas, Matthew Prideaux, and Lynda F. Bonewald

IMMUNOTOOLS: EFFECT OF NOTCH-DEFICIENT MACROPHAGES TO AUTOIMMUNE DISEASE WIPAWEE WONGCHANA

IL-17 in health and disease. March 2014 PSO13-C051n

Rama Nada. - Mousa Al-Abbadi. 1 P a g e

The Skeletal System:Bone Tissue

BIOLOGY and BIOMECHANICS OF NORMAL & OSTEOPOROTIC BONE

BONE HISTOLOGY SLIDE PRESENTATION

BONE REMODELLING. Tim Arnett. University College London. Department of Anatomy and Developmental Biology

Chapter 6: Skeletal System: Bones and Bone Tissue

Decline in Osteocyte Lacunar Density in Human Cortical Bone Is Associated With Accumulation of Microcracks With Age

A KL/R / AN A K/O / P O G G

Chapter 6: SKELETAL SYSTEM

Outline. Skeletal System. Functions of Bone. Bio 105: Skeletal System 3/17/2016. The material from this lecture packet will be on the lecture exam

ANATOMY C027A: MINERALIZED TISSUE BIOLOGY: SKELETAL TISSUES. Please answer THREE Questions. All questions carry equal marks.

Biology. Dr. Khalida Ibrahim

An Introduction to the Skeletal System Skeletal system includes Bones of the skeleton Cartilages, ligaments, and connective tissues

Siglec-15 Is A Potential Therapeutic Target For Postmenopausal Osteoporosis

For more information about how to cite these materials visit

2 PROCESSES OF BONE OSSIFICATION

Mutation in Osteoactivin Enhances RANKL-Mediated Signaling, Promoting Osteoclast Differentiation, Survival and Inhibiting Bone Resorption

Osteoporosis - Pathophysiology and diagnosis. Bente L Langdahl Department of Endocrinology Aarhus University Hospital Aarhus, Denmark

Introduction to Biomedical Engineering: Basic concepts and Bone Biomechanics

OpenStax-CNX module: m Bone Structure * Ildar Yakhin. Based on Bone Structure by OpenStax. Abstract

Cover Page. The handle holds various files of this Leiden University dissertation.

Chapter 6: Osseous Tissue and Bone Structure

Osteocytes-The Known and Unknown Osteositler-Bilinenler ve Bilinmeyenler

Index. Rheum Dis Clin N Am 32 (2006) Note: Page numbers of article titles are in boldface type.

Types of Bones. 5 basic types of bones: Sutural bones - in joint between skull bones

Parathyroid Hormone Receptor Signaling Induces Bone Resorption in the Adult Skeleton by Directly Regulating the RANKL Gene in Osteocytes

NIH Public Access Author Manuscript Calcif Tissue Int. Author manuscript; available in PMC 2015 January 01.

Središnja medicinska knjižnica

Ossification and Bone Remodeling

Bone Tissue- Chapter 5 5-1

Human Biology Chapter 15.3: Bone Structure *

Fructose Upregulates FGF23 Expression In MC3T3 Pre-osteoblasts

Bone and Cancer. Peter Croucher

Space radiation and osteoclastogenesis:the effects of radiation and microgravity on bone resorption:

Effects of Anti RANK ligand Denosumab on Beta Thalassemia induced osteoporosis

Flow Cytometry. What is flow cytometry?

Systemic inflammation after myocardial infarction

Cytokines (II) Dr. Aws Alshamsan Department of Pharmaceu5cs Office: AA87 Tel:

Lecture 3: Skeletogenesis and diseases

Apoptosis Chapter 9. Neelu Yadav PhD

Comment les cellules osseuses communiquent entre elles. Gérard Friedlander Journées UPA 2011

Dr. Heba Kalbouneh. Saba Alfayoumi. Heba Kalbouneh

Potential Role of Sphingosine 1-Phosphate in the. Pathogenesis of Rheumatoid Arthritis

TYPE I DIABETIC OSTEOPOROSIS AND OSTEOBLAST APOPTOSIS. Lindsay Martin Coe

New treatments of osteoporosis

Species differences in histomorphometry

b. Adult bones produce 2.5 million RBCs each second.

Module 2:! Functional Musculoskeletal Anatomy A! Semester 1! !!! !!!! Hard Tissues, Distal Upper Limb & Neurovascular Supply of Upper Limb!

Attribution: University of Michigan Medical School, Department of Microbiology and Immunology

Sensitivity of bone to glucocorticoids

THE GROWING GAP IN OSTEOPOROSIS TREATMENT

Skeletal System. Bio 105

Outline. Skeletal System. Tendons link the skeletal and the muscular systems.

Osteoclast Activity Assay Substrate

Principles of Genetics and Molecular Biology

From Fragile to Firm. Monika Starosta MD. Advocate Medical Group

SIBLINGs, cancer's multifunctional weapons

Hibernating Bears Defying Osteoporosis

BIOL1903 NOTES. Josh Bryden

ANATOMY & PHYSIOLOGY - CLUTCH CH. 8 - BONE AND CARTILAGE.

renoprotection therapy goals 208, 209

Integrity of the osteocyte bone cell network in osteoporotic fracture: Implications for mechanical load adaptation

Skeletal System. The skeletal System... Components

Osseous Tissue and Bone Structure

SKELETAL SYSTEM I NOTE: LAB ASSIGNMENTS for this topic will run over 3 Weeks. A SEPARATE WORKSHEET WILL BE PROVIDED.

SKELETAL TISSUES CHAPTER 7 INTRODUCTION TO THE SKELETAL SYSTEM TYPES OF BONES

CHAPTER 6 LECTURE OUTLINE

ANATOMY AND ULTRASTRUCTURE OF BONE HISTOGENESIS, GROWTH AND REMODELING

CIC EDIZIONI INTERNAZIONALI. Bone fragility: current reviews and clinical features. Mini review

KEY CONCEPTS Unit 6 THE SKELETAL SYSTEM

Subject Index. Bcl-2, apoptosis regulation Bone marrow, polymorphonuclear neutrophil release 24, 26

Regulation of the skeletal mass through the life span

The ubiquitin-proteasome system. in bone biology. University of Nottingham. ECTS PhD Training July 5 th Dr Rob Layfield

Transcription:

J Bone Metab 2014;21:55-60 http://dx.doi.org/10.11005/jbm.2014.21.1.55 pissn 2287-6375 eissn 2287-7029 Review Article Mouse Models for the Evaluation of Osteocyte Functions Toshihisa Komori Department of Cell Biology, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Corresponding author Toshihisa Komori Department of Cell Biology, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan Tel: +81-95-849-7630 Fax: +81-95-849-7633 E-mail: komorit@nagasaki-u.ac.jp Received: January 29, 2014 Revised: February 10, 2014 Accepted: February 10, 2014 No potential conflict of interest relevant to this article was reported. Osteocytes establish an extensive intracellular and extracellular communication system via gap junction-coupled cell processes and canaliculi, through which cell processes pass throughout bone, and the communication system is extended to osteoblasts on the bone surface. To examine the osteocyte function, several mouse models were established. To ablate osteocytes, osteocytes death was induced by diphtheria toxin. However, any types of osteocyte death result in necrosis, because dying osteocytes are not phagocytosed by scavengers. After the rupture of cytoplasmic membrane, immunostimulatory molecules are released from lacunae to bone surface through canaliculi, and stimulate macrophages. The stimulated macrophages produce interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha (TNF- α), which are the most important proinflammatory cytokines triggering inflammatory bone loss. Therefore, the osteocyte ablation results in necrosisinduced severe osteoporosis. In conditional knockout mice of gap junction protein alpha-1 (GJA1), which encodes connexin 43 in Gap junction, using dentin matrix protein 1 (DMP1) Cre transgenic mice, osteocyte apoptosis and enhanced bone resorption occur, because extracellular communication is intact. Overexpression of Bcl-2 in osteoblasts using 2.3 kb collagen type I alpha1 (COL1A1) promoter causes osteocyte apoptosis due to the severe reduction in the number of osteocyte processes, resulting in the disruption of both intracellular and extracellular communication systems. This mouse model unraveled osteocyte functions. Osteocytes negatively regulate bone mass by stimulating osteoclastogenesis and inhibiting osteoblast function in physiological condition. Osteocytes are responsible for bone loss in unloaded condition, and osteocytes augment their functions by further stimulating osteoclastogenesis and further inhibiting osteoblast function, at least partly, through the upregulation of receptor activator of nuclear factorkappa B ligand (RANKL) in osteoblasts and Sost in osteocytes in unloaded condition. Key Words: Bcl-2, Osteocyte, RANK ligand, Sost protein, Stress mechanical INTRODUCTION Copyright 2014 The Korean Society for Bone and Mineral Research This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Bone mass is determined by the balance between the activities of osteoblasts, which form bone, and those of osteoclasts, which resorb bone. Osteoporosis, which is one of the major age-related diseases in our modern world, is caused by the unbalance of these two activities, which are influenced by diet, physical activities, hormonal status, cytokines, and clinical status, such as diabetes mellitus and glucocorticoid treatment.[1] Bone mass is increased by exercise but reduced by long-term bed rest, immobilization by nerve injury, and low gravity in space, causing disuse osteoporosis.[2] http://e-jbm.org/ 55

Toshihisa Komori Osteocytes, which are embedded in the bone matrix, establish an extensive intracellular and extracellular communication system via gap junction-coupled cell processes and canaliculi, through which cell processes pass throughout bone, and the communication system is extended to osteoblasts on the bone surface.[3] Osteocytes acquire oxygen, nutrition, and survival signals, and release various signals and soluble factors through the intracellular and extracellular communication system. The lacunocanalicular network formed by osteocytes is thought to be an ideal mechanosensory system and suitable for mechanotransduction, by which mechanical energy is converted into electrical and/or biochemical signals.[4-9] 1. Can we reveal the functions of osteocytes by inducing osteocyte death? It has been very difficult to prove that osteocytes are responsible for sensing and transducing mechanical stress, because we need an animal model, in which osteocytes are deleted. By inducing osteocyte death, osteocyte functions could be examined. A typical example is osteocyte ablation by diphtheria toxin.[10] Transgenic mice expressing diphtheria toxin receptor under the control of dentin matrix protein 1 (DMP1) promoter, which directs the transgene expression to osteoblasts that are going to be embedded into bone matrix and osteocytes, showed enhanced bone resorption resulting in severe osteoporosis after injection of diphtheria toxin. However, we have to think about the special circumstance of osteocytes, which are embedded in bone. Cells die mainly through one of three pathways, i.e., apoptosis, autophagic cell death, and necrosis, in physiological and pathological conditions.[11] If cells die through apoptosis or autophagy, the death is completed with the removal of the cells through engulfment by scavengers. In these cases, the cells are quietly removed without inflammation, because the integrity of cytoplasmic membranes is maintained when the phagocytosis occurs. In contrast, strong insults cause bioenergetic failure and rapid loss of cytoplasmic membrane integrity, which are core events of necrosis. Necrosis leads to rupture of the cytoplasmic membrane, and most of the intracellular content is released into the extracellular environment. As macrophages cannot pass through the canaliculi to engulf the dying osteocytes, apoptotic or autophagic osteocyte death will end in rupture of the cytoplasmic membrane, the process called secondary necrosis.[12] After cell rupture, immunostimulatory molecules, including the so-called damage-associated molecular pattern (DAMP) molecules, such as S100 family molecules, high-mobility group box 1 (HMGB1) protein, purine metabolites, heat-shock proteins, and uric acid, are released from lacunae through canaliculi to the bone surface and vascular channels, and facilitate the recruitment and activation of macrophages, thereby promoting the production of proinflammatory cytokines including tumor necrosis factor-alpha (TNF- α), interleukin (IL)-6, and IL-1, which are the most important proinflammatory cytokines triggering inflammatory bone loss.[13,14] Therefore, induction of osteocyte death causes drastic inflammatory reaction in whole body, which leads to strong enhancement of osteoclastogenesis and bone resorption and inhibition of bone formation (Fig. 1).[12] The effects of massive necrosis of osteocytes will not be restricted to the osteoclasts and osteoblasts, and any organs and tissues will be affected. Thus, we cannot evaluate the functions of osteocytes by inducing osteocyte death. 2. Can gap junction protein alpha-1 (GJA1) conditional knockout mice be mouse models for the evaluation of osteocyte functions? Gap junctions, which are responsible for intracellular communication of osteocytes, are composed of GJA1 (connexin 43). In GJA1 conditional knockout mice using DMP1 Cre transgenic mice, the intracellular communication system is disrupted but the extracellular communication system through canaliculi is intact.[15] In this mouse model, osteocyte apoptosis is increased, osteoclast number and surface are increased at the endocortical surface, and the marrow cavity is enlarged. This indicates that the osteocyte apoptosis in conditional GJA1 knockout mice could induce bone resorption, probably because the intracellular content of dead osteocytes could be released through the intact canalicular network and trigger osteoclastogenesis and bone resorption (Fig. 1). Therefore, the effects of osteocyte death mask the functions of osteocytes. The response to mechanical stress was examined in three groups using conditional GJA1 knockout mice. However, the responses to mechanical stress in the GJA1 conditional knockout mice were variable. In the unloaded condition by hind limb muscle paralysis, bone resorption was enhanced in the endo- 56 http://e-jbm.org/ http://dx.doi.org/10.11005/jbm.2014.21.1.55

Model mice for the functional analysis of osteocytes (A) Osteocyte ablation by diphtheria toxin massive osteocyte death necrosis (B) Conditional GJA1 knockout mice release of immunostimulatory molecules activation of macrophage enhanced osteoclasto-genesis reduced bone formation low or moderate number of osteocyte death necrosis release of immunostimulatory molecules enhanced bone formation activation of macrophage enhanced osteoclasto-genesis (C) Bcl-2 transgenic mice massive osteocyte death severe reduction in canalicular number no release of immunostimulatory molecules reduced osteoclastogenesis enhanced bone formation Fig. 1. Mouse models for the evaluation of osteocyte functions. (A) Massive osteocyte necrosis enhances osteoclastogenesis and inhibits bone formation by inhibiting osteoblast maturation, resulting in severe osteoporosis. The mouse model of osteocyte ablation shows the effects of massive necrosis of osteocytes. (B) In conditional gap junction protein alpha-1 (GJA1) knockout mice, low or moderate number of osteocytes die by apoptosis. After the rupture of the cytoplasmic membrane, immunostimulatory molecules are released and osteoclastogenesis is enhanced. The increased apoptosis is associated with the enhanced bone formation. (C) In Bcl-2 transgenic mice, massive osteocyte death occurs but immunostimulatory molecules are not released due to the severe reduction in the number of canaliculi. In Bcl-2 transgenic mice, osteoclastogenesis is inhibited and bone formation is enhanced. cortical surface of tibiae in wild-type mice but not in the conditional GJA1 knockout mice using 2.3 kb collagen type I alpha1 (COL1A1) promoter Cre transgenic mice, in which GJA1 is deleted in osteoblasts and osteocytes.[16] However, the fact that bone resorption in the endocortical surface of the conditional GJA1 knockout mice was enhanced in the physiological condition makes the evaluation difficult. Two groups reported the response to mechanical stress in the GJA1 conditional knockout mice using human osteocalcin promoter Cre transgenic mice, in which GJA1 is deleted in mature osteoblasts and osteocytes. Zhang et al.[17] showed that periosteal bone formation is enhanced by mechanical loading in the conditional GJA1 knockout mice but not in wild-type mice, while Lloyd et al.[18] showed that bone formation in both endocortical and periosteal surfaces is decreased in wild-type mice but not in the GJA1 conditional knockout mice at unloading. Therefore, further evaluation of GJA1 conditional knockout mice, including GJA1 conditional knockout mice using DMP1 Cre transgenic mice, is required to reveal the involvement of intracellular communication system in the regulation of bone mass by mechanical stress. 3. Can oeteoblast-specific Bcl-2 transgenic mice be a model mouse for the evaluation of osteocyte functions? Unexpectedly, we found that overexpression of Bcl-2 in osteoblasts using 2.3 kb COL1A1 promoter eventually caused osteocyte apoptosis due to a reduction in the number of osteocyte processes.[19] Bcl-2 is able to form a complex with actin and gelsolin, which functions to decrease gelsolin-severing activity to increase actin polymerization, and to suppress cell adhesion, spreading, and motility.[20] Therefore, Bcl-2 seemed to alter cytoskeletal organization and reduced the number of osteoblast processes. When the osteoblasts with reduced number of processes are embedded into bone matrix and become osteocytes, the osteocytes also have a reduced number of processes, and the number of canaliculi, which the processes pass through, is also reduced. The osteocytes cannot get enough oxygen, nutrient, and survival factors through Gap junction and canaliculi and die by apoptosis.[19] Indeed, secondary necrosis occurs in these osteocytes but inflammatory reaction does not occur, because the number of canaliculi is severely reduced and immunostimulatory molecules can- http://dx.doi.org/10.11005/jbm.2014.21.1.55 http://e-jbm.org/ 57

Toshihisa Komori not be released from lacunae to the bone surface and vascular channels (Fig. 1). Therefore, both intracellular and extracellular communication systems are disrupted in Bcl-2 transgenic mice.[12,21] In Bcl-2 transgenic mice, osteoclastogenesis and bone resorption are reduced, indicating that osteocytes stimulate osteoclastogenesis and bone resorption in physiological condition.[21] Osteocyte death occurs during aging, after menopause, at unloading, and at pathological conditions such as microcracks, and the death of osteocytes is closely coupled with bone resorption.[22-24] As the death of osteocytes induces bone resorption, it has been generally considered that the physiological function of osteocytes is to inhibit bone resorption.[10,25] Therefore, it is critical to discriminate the effects of osteocyte death and the functions of osteocytes (Fig. 1). In Bcl-2 transgenic mice, osteoblast function and bone formation are enhanced, indicating that osteocytes inhibit osteoblast function and bone formation in physiological condition.[21] The function of osteocytes in bone formation in the physiological condition has been controversial. Ablation of osteocytes by diphtheria toxin severely reduced bone formation, indicating that osteocyte death also affects bone formation (Fig. 1).[10] In contrast, osteocyte density was negatively correlated with bone formation, and both the empty lacunar density and periosteal bone apposition increase with age, suggesting a linkage between the two phenomena.[26-30] Mice carrying a targeted mutation of COL1A1, encoding a collagenase-resistant form of type I collagen, showed osteocyte apoptosis and increased bone formation.[31] Further, enhanced bone formation at the periosteal and endocortical surfaces is localized in the area, in which viable osteocytes are lost, in the osteocyte-specific GJA1 knockout mice (Fig. 1).[15] Therefore, many previous findings also support our conclusion that osteocytes inhibit osteoblast function and bone formation in physiological condition. 4. How do osteocytes regulate bone mass in unloaded condition? In unloaded condition, which is obtained by tail suspension, bone mass is reduced due to the enhanced bone resorption and reduced bone formation in wild-type mice. In Bcl-2 transgenic mice, however, neither enhancement of bone resorption nor reduction of bone formation occurs and bone mass is maintained in unloaded condition, indicating that osteocyte network is responsible for bone mass regulation in unloaded condition.[21] In unloaded condition, receptor activator of nuclear factor-kappa B ligand (RANKL) expression is upregulated in osteoblasts in wildtype mice but not in Bcl-2 transgenic mice. Further, sclerostin (SOST) is locally induced at unloaded condition in osteocytes of wild-type mice but not Bcl-2 transgenic mice. Therefore, osteocyte network regulates bone mass in unloaded condition, at least in part, through the upregulation of RANKL expression in osteoblasts and upregulation of Sost expression in osteocytes.[21] RANKL and osteoprotegerin (OPG), which is a decoy receptor of RANKL, are relatively highly expressed in osteocytes.[21] RANKL is a membrane-bound protein and OPG is a secreted protein. OPG secreted by osteocytes passes through canaliculi and reaches the bone surface or vascular channels, but many OPG will be trapped by RANKL on the surface of osteocytes before reaching to the bone surface or vascular channels. As RANKL deletion using DMP1 Cre transgenic mice results in the increase of bone mass,[32,33] OPG secreted by osteocytes seems to play an important role in the regulation of bone mass in physiological condition.[12] As OPG expression in osteoblasts and osteocytes is unchanged in unloaded condition, however, OPG does not seem to be involved in the bone loss in unloaded condition.[21] CONCLUSION Osteocyte functions were estimated by events caused by osteocyte death, and osteocytes have been generally considered to inhibit bone resorption (Fig. 1). Using Bcl-2 transgenic mice, in which both intracellular and extracellular communication systems are disrupted, osteocyte functions have been clarified. Osteocytes stimulate osteoclastogenesis and bone resorption and inhibit osteoblast function and bone formation in physiological condition (Fig. 1). It has been also proven that osteocyte network is responsible for bone mass regulation in unloaded condition using Bcl-2 transgenic mice. Osteocyte network regulates bone mass, at least in part, through the upregulation of RANKL expression in osteoblasts and upregulation of Sost expression in osteocytes in unloaded condition. In exercise, the osteocyte network decreases the inhibitory effects on bone mass by reducing the stimulatory effect on osteoclastogenesis 58 http://e-jbm.org/ http://dx.doi.org/10.11005/jbm.2014.21.1.55

Model mice for the functional analysis of osteocytes and the inhibitory effect on osteoblast function, leading to an increase in bone mass. Indeed, additional mechanisms will be involved in the increase of bone mass by exercise and they remained to be clarified. REFERENCES 1. Manolagas SC. From estrogen-centric to aging and oxidative stress: a revised perspective of the pathogenesis of osteoporosis. Endocr Rev 2010;31:266-300. 2. Bikle DD, Halloran BP. The response of bone to unloading. J Bone Miner Metab 1999;17:233-44. 3. Marks SC, Odgren PR. Structure and development of the skeleton. In: Bilezikian JP, Raisz LG, Rodan GA, editors. Principles of bone biology. New York, NY: Academic Press; 2002. p.3-15. 4. Martin RB. Does osteocyte formation cause the nonlinear refilling of osteons? Bone 2000;26:71-8. 5. Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int 2002;13:688-700. 6. Knothe Tate ML. "Whither flows the fluid in bone?" An osteocyte's perspective. J Biomech 2003;36:1409-24. 7. Bonewald LF, Johnson ML. Osteocytes, mechanosensing and Wnt signaling. Bone 2008;42:606-15. 8. Noble BS. The osteocyte lineage. Arch Biochem Biophys 2008;473:106-11. 9. Burger EH, Klein-Nulend J. Mechanotransduction in bone- -role of the lacuno-canalicular network. FASEB J 1999;13 Suppl:S101-12. 10. Tatsumi S, Ishii K, Amizuka N, et al. Targeted ablation of osteocytes induces osteoporosis with defective mechanotransduction. Cell Metab 2007;5:464-75. 11. Bursch W. The autophagosomal-lysosomal compartment in programmed cell death. Cell Death Differ 2001;8:569-81. 12. Komori T. Functions of the osteocyte network in the regulation of bone mass. Cell Tissue Res 2013;352:191-8. 13. Firestein GS. Evolving concepts of rheumatoid arthritis. Nature 2003;423:356-61. 14. Lotze MT, Tracey KJ. High-mobility group box 1 protein (HMGB1): nuclear weapon in the immune arsenal. Nat Rev Immunol 2005;5:331-42. 15. Bivi N, Condon KW, Allen MR, et al. Cell autonomous requirement of connexin 43 for osteocyte survival: consequences for endocortical resorption and periosteal bone formation. J Bone Miner Res 2012;27:374-89. 16. Grimston SK, Goldberg DB, Watkins M, et al. Connexin43 deficiency reduces the sensitivity of cortical bone to the effects of muscle paralysis. J Bone Miner Res 2011;26: 2151-60. 17. Zhang Y, Paul EM, Sathyendra V, et al. Enhanced osteoclastic resorption and responsiveness to mechanical load in gap junction deficient bone. PLoS One 2011;6:e23516. 18. Lloyd SA, Lewis GS, Zhang Y, et al. Connexin 43 deficiency attenuates loss of trabecular bone and prevents suppression of cortical bone formation during unloading. J Bone Miner Res 2012;27:2359-72. 19. Moriishi T, Maruyama Z, Fukuyama R, et al. Overexpression of Bcl2 in osteoblasts inhibits osteoblast differentiation and induces osteocyte apoptosis. PLoS One 2011;6: e27487. 20. Ke H, Parron VI, Reece J, et al. BCL2 inhibits cell adhesion, spreading, and motility by enhancing actin polymerization. Cell Res 2010;20:458-69. 21. Moriishi T, Fukuyama R, Ito M, et al. Osteocyte network; a negative regulatory system for bone mass augmented by the induction of Rankl in osteoblasts and Sost in osteocytes at unloading. PLoS One 2012;7:e40143. 22. Noble BS, Reeve J. Osteocyte function, osteocyte death and bone fracture resistance. Mol Cell Endocrinol 2000; 159:7-13. 23. Cardoso L, Herman BC, Verborgt O, et al. Osteocyte apoptosis controls activation of intracortical resorption in response to bone fatigue. J Bone Miner Res 2009;24:597-605. 24. Emerton KB, Hu B, Woo AA, et al. Osteocyte apoptosis and control of bone resorption following ovariectomy in mice. Bone 2010;46:577-83. 25. Gu G, Mulari M, Peng Z, et al. Death of osteocytes turns off the inhibition of osteoclasts and triggers local bone resorption. Biochem Biophys Res Commun 2005;335:1095-101. 26. Qiu S, Rao DS, Palnitkar S, et al. Relationships between osteocyte density and bone formation rate in human cancellous bone. Bone 2002;31:709-11. 27. Metz LN, Martin RB, Turner AS. Histomorphometric analysis of the effects of osteocyte density on osteonal morphology and remodeling. Bone 2003;33:753-9. 28. Lazenby RA. Continuing periosteal apposition. II: The significance of peak bone mass, strain equilibrium, and agerelated activity differentials for mechanical compensation http://dx.doi.org/10.11005/jbm.2014.21.1.55 http://e-jbm.org/ 59

Toshihisa Komori in human tubular bones. Am J Phys Anthropol 1990;82: 473-84. 29. Russo CR, Lauretani F, Seeman E, et al. Structural adaptations to bone loss in aging men and women. Bone 2006; 38:112-8. 30. Hedgecock NL, Hadi T, Chen AA, et al. Quantitative regional associations between remodeling, modeling, and osteocyte apoptosis and density in rabbit tibial midshafts. Bone 2007;40:627-37. 31. Zhao W, Byrne MH, Wang Y, et al. Osteocyte and osteoblast apoptosis and excessive bone deposition accompany failure of collagenase cleavage of collagen. J Clin Invest 2000;106:941-9. 32. Nakashima T, Hayashi M, Fukunaga T, et al. Evidence for osteocyte regulation of bone homeostasis through RANKL expression. Nat Med 2011;17:1231-4. 33. Xiong J, Onal M, Jilka RL, et al. Matrix-embedded cells control osteoclast formation. Nat Med 2011;17:1235-41. 60 http://e-jbm.org/ http://dx.doi.org/10.11005/jbm.2014.21.1.55