P R Oikonomidou1,2, C Casu3,4, Z Yang5, B Crielaard3,6, J H Shim7, S Rivella3,8, M G Vogiatzi9,10. 1. Division of Pediatric Endocrinology, Weill Cornell Medical College, New York, NY, USA. oikonomidp@email.chop.edu. 2. Division of Hematology, Children's Hospital of Philadelphia, Abramson Research Center, 3615 Civic Center Blvd., Room 309 F, Philadelphia, PA, 19104, USA. oikonomidp@email.chop.edu. 3. Division of Pediatric Hematology/Oncology, Weill Cornell Medical College, New York, NY, USA. 4. Division of Hematology, Children's Hospital of Philadelphia, Abramson Research Center, 3615 Civic Center Blvd., Room 309 F, Philadelphia, PA, 19104, USA. 5. Department of Medicine, Cancer Center, Weill Cornell Medical College, Belfer Research Building, 413 East 69th Street, 13th Floor, New York, NY,, 10021, USA. 6. Department of Polymer Chemistry and Bioengineering, Zernike Institute for Advanced Materials, University of Groningen, Nijenborgh 4, 9747 AG, Groningen, Netherlands. 7. Department of Pathology and Laboratory medicine, Weill Cornell Medical College, 1300 York Avenue, E-904, New York, NY,, 10065, USA. 8. Division of Hematology, Children's Hospital of Philadelphia, Abramson Research Center, 3615 Civic Center Blvd., Room 316 B, Philadelphia, PA, 19104, USA. 9. Division of Pediatric Endocrinology, Weill Cornell Medical College, New York, NY, USA. 10. Division of Endocrinology, Children's Hospital of Philadelphia, 3401 Civic Center Bvld., Philadelphia, PA, 19104, USA.
Abstract
UNLABELLED: Increased fragility has been described in humans with polycythemia vera (PV). Herein, we describe an osteoporotic phenotype associated with decreased osteoblast activity in a mouse model of PV and another mouse of polycythemia and elevated circulating erythropoietin (EPO). Our results are important for patients with PV or those treated with recombinant EPO (rEPO). INTRODUCTION: PV and other myeloproliferative syndromes have been recently associated with an increased risk for fractures. However, the presence of osteoporosis in these patients has not been well documented. EPO, a hormone primarily known to stimulate erythropoiesis, has been shown recently to regulate bone homeostasis in mice. The aim of this study was to examine the bone phenotype of a mouse model of PV and compare it to that of animals with polycythemia caused by elevated circulating EPO. METHODS: Bone mass and remodeling were evaluated by micro-computed tomography and histomorphometry. The JAK2(V617F) knock-in mouse, a model of human PV, manifests polycythemia and low circulating EPO levels. Results from this mouse were compared to wild type (wt) controls and the tg6 transgenic mouse that shows polycythemia caused by increased constitutive expression of EPO. RESULTS: Compared to wt, both JAK2(V617F) and tg6 mice had a decrease in trabecular bone mass. Tg6 mice showed an additional modest decrease in cortical thickness and cortical bone volume per tissue volume (P < 0.01) suggesting a more severe bone phenotype than JAK2(V617F). Decreased osteoblast numbers and bone formation along with normal osteoclast numbers and activity were found in both mice. CONCLUSIONS: This study indicates that PV is associated with low bone mass and decreased osteoblast activity in mice. Our results support future studies of osteoporosis in affected humans. Polycythemia caused by chronically elevated circulating EPO also results in bone loss, and implications on patients treated with rEPO should be evaluated.
UNLABELLED: Increased fragility has been described in humans with polycythemia vera (PV). Herein, we describe an osteoporotic phenotype associated with decreased osteoblast activity in a mouse model of PV and another mouse of polycythemia and elevated circulating erythropoietin (EPO). Our results are important for patients with PV or those treated with recombinant EPO (rEPO). INTRODUCTION: PV and other myeloproliferative syndromes have been recently associated with an increased risk for fractures. However, the presence of osteoporosis in these patients has not been well documented. EPO, a hormone primarily known to stimulate erythropoiesis, has been shown recently to regulate bone homeostasis in mice. The aim of this study was to examine the bone phenotype of a mouse model of PV and compare it to that of animals with polycythemia caused by elevated circulating EPO. METHODS: Bone mass and remodeling were evaluated by micro-computed tomography and histomorphometry. The JAK2(V617F) knock-in mouse, a model of human PV, manifests polycythemia and low circulating EPO levels. Results from this mouse were compared to wild type (wt) controls and the tg6 transgenic mouse that shows polycythemia caused by increased constitutive expression of EPO. RESULTS: Compared to wt, both JAK2(V617F) and tg6mice had a decrease in trabecular bone mass. Tg6mice showed an additional modest decrease in cortical thickness and cortical bone volume per tissue volume (P < 0.01) suggesting a more severe bone phenotype than JAK2(V617F). Decreased osteoblast numbers and bone formation along with normal osteoclast numbers and activity were found in both mice. CONCLUSIONS: This study indicates that PV is associated with low bone mass and decreased osteoblast activity in mice. Our results support future studies of osteoporosis in affected humans. Polycythemia caused by chronically elevated circulating EPO also results in bone loss, and implications on patients treated with rEPO should be evaluated.
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