Expression of osteoblastic and osteoclastic genes during spontaneous regeneration and autotransplantation of goldfish scale: a new tool to study intramembranous bone regeneration.

Complementary DNA of osteoblast-specific genes (dlx5, runx2a, runx2b, osterix, RANKL, type I collagen, ALP, and osteocalcin) was cloned from goldfish (Carassius auratus) scale. Messenger RNA expressions were analyzed during spontaneous scale regeneration. Dlx5 had an early peak of expression on day 7, whereas osterix was constantly expressed during days 7-21. Runx2, a major osteoblastic transcription factor in mammalian bone, did not show any significant expression. The expressions of two functional genes, type I collagen and ALP, continually increased after day 7, while that of osteocalcin increased on day 14. As for osteoclastic markers, in addition to the cloning of two functional genes, TRAP and cathepsin K, in our previous study, we here cloned the transcription factor NFATc1 to use as an early osteoclastic marker. Using these bone markers, we investigate the signal key that controls the onset of scale resorption and regeneration by performing intra-scale-pocket autotransplantation of five groups of modified scales, namely, 1) methanol-fixed scale, 2) proteinase K-treated cell-free scale, 3) polarity reversal (upside-down) scale, 4) U-shape trimmed scale, and 5) circular-hole perforated scale. In this autotransplantation, each ontogenic scale was pulled out, modified, and then re-inserted into the same scale pocket. At post-transplant, inside the pockets of all modified transplant groups, new regenerating scales formed, attaching to the ongoing resorbed transplants. Autotransplantation of methanol-fixed scale, proteinase K-treated cell-free scale, and polarity reversal (upside-down) scale triggered scale resorption and scale regeneration. These two processes of scale resorption and regeneration occurred in accordance with osteoclastic and osteoblastic marker gene expressions. These results were microscopically confirmed using TRAP and ALP staining. Regarding the autotransplantation of U-shape trimmed and circular-hole perforated scales, new scales regenerated and grew at the trimmed/perforated part of each transplant, while scale resorption occurred apparently only around the trimmed/perforated area. In contrast, no scale resorption or regeneration was detected in sham transplantations. Our finding suggests that loss of correct cell-to-cell contact between the scale-pocket lining cells and the scale cortex cells is the key to switch on the onset of scale resorption and regeneration. Overall, the present study shows that goldfish scale regeneration shares similarities in gene expression with intramembranous bone regeneration. Improved understanding of goldfish scale regeneration will help elucidate the process of intramembranous bone regeneration and make goldfish scale a possible new tool to study bone regeneration.

Parathyroid hormone 1 (1-34) acts on the scales and involves calcium metabolism in goldfish.

The effect of fugu parathyroid hormone 1 (fugu PTH1) on osteoblasts and osteoclasts in teleosts was examined with an assay system using teleost scale and the following markers: alkaline phosphatase (ALP) for osteoblasts and tartrate-resistant acid phosphatase (TRAP) for osteoclasts. Synthetic fugu PTH1 (1-34) (100pg/ml-10ng/ml) significantly increased ALP activity at 6h of incubation. High-dose (10ng/ml) fugu PTH1 significantly increased ALP activity even after 18h of incubation. In the case of TRAP activity, fugu PTH1 did not change at 6h of incubation, but fugu PTH1 (100pg/ml-10ng/ml) significantly increased TRAP activity at 18h. Similar results were obtained for human PTH (1-34), but there was an even greater response with fugu PTH1 than with human PTH. In vitro, we demonstrated that both the receptor activator of the NF-κB ligand in osteoblasts and the receptor activator NF-κB mRNA expression in osteoclasts increased significantly by fugu PTH1 treatment. In an in vivo experiment, fugu PTH1 induced hypercalcemia resulted from the increase of both osteoblastic and osteoclastic activities in the scale as well as the decrease of scale calcium contents after fugu PTH1 injection. In addition, an in vitro experiment with intramuscular autotransplanted scale indicated that the ratio of multinucleated osteoclasts/mononucleated osteoclasts in PTH-treated scales was significantly higher than that in the control scales. Thus, we concluded that PTH acts on osteoblasts and osteoclasts in the scales and regulates calcium metabolism in goldfish.

Severe protein losing enteropathy with intractable diarrhea due to systemic AA amyloidosis, successfully treated with corticosteroid and octreotide.

This report concerns two patients with severe protein losing enteropathy and refractory diarrhea due to AA amyloidosis who were successfully treated with corticosteroid and octreotide. In these patients, biopsied tissues from the gastrointestinal (GI) tract showed extensive deposition of AA amyloid, which was caused by rheumatoid arthritis in one case and was of unidentified etiology in the other. Both patients manifested severe diarrhea unresponsive to conventional treatment with hypoproteinemia, and protein leakage from the small intestine to the ascending colon was confirmed by 99mTc-diethylene triamine pentaacetic acid human serum albumin (HSA-D) scintigraphy. Soon after starting a long-acting somatostatin analogue, octreotide, with co-administration of oral prednisolone, their general status improved in parallel with a rapid decrease in the volume of watery diarrhea and an increase in serum levels of albumin and IgG. Also on 99mTc-HSA-D scintigraphy protein leakage from the GI tract was apparently decreased in both patients. Combination therapy with a somatostatin analogue and corticosteroid may be effective for protein losing enteropathy with intractable diarrhea ascribable to GI amyloidosis. Because of the lack of specific therapies in this serious clinical situation, the described therapy should actively be considered as a therapeutic option not only in AA amyloidosis, but also in other types of systemic amyloidosis.