natriuretic-peptide--c-type and Bone-Diseases--Developmental

This review highlights how skeletal dysplasias are diagnosed and how our understanding of some of these conditions has now translated to treatment options.. The use of multigene panels, using next-generation sequence technology, has improved our ability to quickly identify the genetic etiology, which can impact management. There are successes with the use of growth hormone in individuals with SHOX deficiencies, asfotase alfa in hypophosphatasia, and some promising data for c-type natriuretic peptide for those with achondroplasia. One needs to consider that a patient with short stature has a skeletal dysplasia as options for management may be available.

Topics: Achondroplasia; Alkaline Phosphatase; Bone Diseases, Developmental; Enzyme Replacement Therapy; Genetic Testing; High-Throughput Nucleotide Sequencing; Human Growth Hormone; Humans; Hypophosphatasia; Immunoglobulin G; Natriuretic Agents; Natriuretic Peptide, C-Type; Osteochondrodysplasias; Osteogenesis Imperfecta; Radiography; Recombinant Fusion Proteins; Recombinant Proteins; Sequence Analysis, DNA; Short Stature Homeobox Protein

By using transgenic and knockout mice, we have elucidated that C-type natriuretic peptide (CNP) is a potent stimulator of endochondral bone growth. In humans, loss-of-function mutations in the gene coding for guanylyl cyclase-B (GC-B), the specific receptor for CNP, have been proved to be the cause of acromesomelic dysplasia, type Maroteaux, one form of human skeletal dysplasias. Following these results, we have started to translate the stimulatory effect of CNP on endochondral bone growth into the therapy for patients with skeletal dysplasias. We have shown that targeted overexpression of CNP in cartilage or systemic administration of CNP reverses the impaired skeletal growth of mice model of achondroplasia, the most common form of human skeletal dysplasias.

Topics: Achondroplasia; Animals; Bone Development; Bone Diseases, Developmental; Gene Expression; Growth Plate; Humans; Mice; Mice, Knockout; Mice, Transgenic; Mutation; Natriuretic Peptide, C-Type; Receptors, Atrial Natriuretic Factor

We revealed that the C-type natriuretic peptide (CNP) and its receptor guanylyl cyclase-B (GC-B) system is a potent and physiological stimulator of endochondral bone growth by using transgenic and knockout mice. In humans, one form of skeletal dysplasias, acromesomelic dysplasia, type Maroteaux, was reported to be caused by loss of function mutations in the GC-B gene. Further studies are needed for clarifying the patho-physiological roles of the CNP/GC-B system on human skeletal dysplasias. Moreover, we will have to translate this effect of the CNP/GC-B system on endochondral bone growth into skeletal dysplasias.

Topics: Animals; Bone Development; Bone Diseases, Developmental; Cartilage; Humans; Mice; Mutation; Natriuretic Peptide, C-Type; Receptors, Atrial Natriuretic Factor

Activating mutations in fibroblast growth factor receptor 3 (FGFR3) and inactivating mutations in the natriuretic peptide receptor 2 (NPR2) guanylyl cyclase both result in decreased production of cyclic GMP in chondrocytes and severe short stature, causing achondroplasia (ACH) and acromesomelic dysplasia, type Maroteaux, respectively. Previously, we showed that an NPR2 agonist BMN-111 (vosoritide) increases bone growth in mice mimicking ACH (Fgfr3Y367C/+). Here, because FGFR3 signaling decreases NPR2 activity by dephosphorylating the NPR2 protein, we tested whether a phosphatase inhibitor (LB-100) could enhance BMN-111-stimulated bone growth in ACH. Measurements of cGMP production in chondrocytes of living tibias, and of NPR2 phosphorylation in primary chondrocytes, showed that LB-100 counteracted FGF-induced dephosphorylation and inactivation of NPR2. In ex vivo experiments with Fgfr3Y367C/+ mice, the combination of BMN-111 and LB-100 increased bone length and cartilage area, restored chondrocyte terminal differentiation, and increased the proliferative growth plate area, more than BMN-111 alone. The combination treatment also reduced the abnormal elevation of MAP kinase activity in the growth plate of Fgfr3Y367C/+ mice and improved the skull base anomalies. Our results provide a proof of concept that a phosphatase inhibitor could be used together with an NPR2 agonist to enhance cGMP production as a therapy for ACH.

Topics: Achondroplasia; Animals; Bone Development; Bone Diseases, Developmental; Cartilage; Cell Differentiation; Chondrocytes; Drug Synergism; Enzyme Inhibitors; Growth Plate; Mice; Natriuretic Peptide, C-Type; Organ Size; Phosphoric Monoester Hydrolases; Phosphorylation; Piperazines; Primary Cell Culture; Receptor, Fibroblast Growth Factor, Type 3; Receptors, Atrial Natriuretic Factor; Tibia

We have previously investigated the physiological role of C-type natriuretic peptide (CNP) on endochondral bone growth, mainly with mutant mouse models deficient in CNP, and reported that CNP is indispensable for physiological endochondral bone growth in mice. However, the survival rate of CNP knockout (KO) mice fell to as low as about 70% until 10 weeks after birth, and we could not sufficiently analyze the phenotype at the adult stage. Herein, we generated CNP KO rats by using zinc-finger nuclease-mediated genome editing technology. We established two lines of mutant rats completely deficient in CNP (CNP KO rats) that exhibited a phenotype identical to that observed in mice deficient in CNP, namely, a short stature with severely impaired endochondral bone growth. Histological analysis revealed that the width of the growth plate, especially that of the hypertrophic chondrocyte layer, was markedly lower and the proliferation of growth plate chondrocytes tended to be reduced in CNP KO rats. Notably, CNP KO rats did not have malocclusions and survived for over one year after birth. At 33 weeks of age, CNP KO rats persisted significantly shorter than wild-type rats, with closed growth plates of the femur in all samples, which were not observed in wild-type rats. Histologically, CNP deficiency affected only bones among all body tissues studied. Thus, CNP KO rats survive over one year, and exhibit a deficit in endochondral bone growth and growth retardation throughout life.

Topics: Animals; Bone Development; Bone Diseases, Developmental; Dwarfism; Female; Gene Deletion; Gene Knockout Techniques; Growth Plate; Natriuretic Peptide, C-Type; Osteogenesis; Rats; Rats, Inbred F344; Rats, Transgenic

Activating mutations in the receptor for C-type natriuretic peptide (CNP), guanylyl cyclase B (GC-B, also known as Npr2 or NPR-B), increase cellular cGMP and cause skeletal overgrowth, but how these mutations affect GTP catalysis is poorly understood. The A488P and R655C mutations were compared with the known mutation V883M. Neither mutation affected GC-B concentrations. The A488P mutation decreased the EC

Topics: Adenosine Triphosphate; Allosteric Regulation; Amino Acid Substitution; Bone Diseases, Developmental; Cyclic GMP; Enzyme Inhibitors; Guanosine Triphosphate; HEK293 Cells; Humans; Kinetics; Models, Molecular; Mutagenesis, Site-Directed; Mutation; Mutation, Missense; Natriuretic Peptide, C-Type; Phosphorylation; Protein Conformation; Protein Processing, Post-Translational; Receptors, Atrial Natriuretic Factor; Recombinant Proteins

Long bone abnormality (lbab/lbab) is a strain of dwarf mice. Recent studies revealed that the phenotype is caused by a spontaneous mutation in the Nppc gene, which encodes mouse C-type natriuretic peptide (CNP). In this study, we analyzed the chondrodysplastic skeletal phenotype of lbab/lbab mice. At birth, lbab/lbab mice are only slightly shorter than their wild-type littermates. Nevertheless, lbab/lbab mice do not undergo a growth spurt, and their final body and bone lengths are only ~60% of those of wild-type mice. Histological analysis revealed that the growth plate in lbab/lbab mice, especially the hypertrophic chondrocyte layer, was significantly thinner than in wild-type mice. Overexpression of CNP in the cartilage of lbab/lbab mice restored their thinned growth plate, followed by the complete rescue of their impaired endochondral bone growth. Furthermore, the bone volume in lbab/lbab mouse was severely decreased and was recovered by CNP overexpression. On the other hand, the thickness of the growth plate of lbab/+ mice was not different from that of wild-type mice; accordingly, impaired endochondral bone growth was not observed in lbab/+ mice. In organ culture experiments, tibial explants from fetal lbab/lbab mice were significantly shorter than those from lbab/+ mice and elongated by addition of 10(-7) M CNP to the same extent as lbab/+ tibiae treated with the same dose of CNP. These results demonstrate that lbab/lbab is a novel mouse model of chondrodysplasia caused by insufficient CNP action on endochondral ossification.

Topics: Animals; Bone Development; Bone Diseases, Developmental; Growth Plate; Mice; Mice, Inbred Strains; Natriuretic Peptide, C-Type; Organ Culture Techniques; Osteogenesis; Tibia