In the present study, the Akt activator SC79 promoted the maturation of multinucleated osteoclasts and the formation of intact actin rings in Ano5KI/KI BMMs cultures, suggesting that Akt activation could effectively protect Ano5KI/KI osteoclast function. Furthermore, we observed that abnormally enhanced capacity of osteoblast differentiation and matrix mineralization in Ano5KI/KI mCOB cultures were reversed by an Akt activator, which indicated that Akt signaling is closely associated with aberrant bone remodeling in GDD.
Autosomal dominant mutations in ANO5 are responsible for GDD, which is mainly characterized by enlargement of the mandible, osteomyelitis of the jaws, and cortical thickening of limb bones. In a previous study, we successfully established an Ano5Cys360Tyr knockin mouse model expressing the human mutation p.Cys360Tyr in Ano5, which significantly exhibited typical traits of patients with GDD. Furthermore, Ano5KI/KI mCOB displayed enhanced osteoblastogenesis consistent with our previous study in vitro and in another Ano5 knockout mouse model [19, 20, 28]. The phenotype of impaired osteoclast differentiation and bone resorption in Ano5KI/KI mice is highly correlated with the other Ano5 knockout mice reported by the X, Li group. However, it is currently unclear how ANO5 dominant mutations lead to the bone disorder of GDD.
Increasing evidence in recent years has indicated that ANO5 is closely associated with osteoclast differentiation and maturation. Consistent with the fact that Ano5 overexpression regulates osteoclast maturation through Akt signaling [7], our previous research indicated that the p.Cys360Tyr mutation in Ano5 significantly inhibited Akt activation. To further determine the association between Akt signaling and abnormal osteoclastogenesis in GDD, SC79 was utilized and rescued the inhibition of TRAP−positive multinucleated osteoclast formation in Ano5KI/KI BMMs cultures. The transcription level of Trap was also increased with SC79 stimulation. Importantly, enhanced expression of Nftac1, a vital transcription factor for osteoclastogenesis, was also observed after Akt activation. The classic NFATc1 activation pathway requires an elevation of the intracellular calcium concentration, which then activates calcium/calmodulin-dependent protein phosphatase calcineurin and in turn leads to robust nuclear translocation of NFATC1 [29]. Furthermore, a recent study highlighted that Ano5 deletion in mice significantly diminished calcium oscillations in osteoclasts, which resulted in reduced RANKL-NFATc1 signaling [8]. Similarly, we found that the free calcium levels in the cytoplasm of Ano5KI/KI osteoclasts were lower than those of wild-type osteoclasts and were surprisingly upregulated by SC79 stimulation, which may be attributed to reciprocal feedback between Akt activation and calcium signaling. Our functional evidence further indicated that inhibited osteoclasts differentiation in GDD is closely related with diminished calcium/Nfatc1 cascade pathway that is regulated by inactive Akt signaling.
In the process of osteoclastic bone absorption, multinucleated osteoclasts undergo rearrangements of the actin cytoskeleton to constitute intact actin rings to form a sealed compartment between the bone surface and basal membrane [26]. Our in vitro data revealed the inhibitory effects of the p.Cys360Tyr mutation on F-actin formation was rescued by Akt activation as well, which was validated by upregulation of Atp6v0d2 and Dc-stamp. Furthermore, the expression of Mmp9 and Ctsk, responsible for the degradation of bone matrix, was enhanced after SC79 stimulation. These results underscored that inhibition of Akt signaling is a crucial molecule in the abnormal osteoclastogenesis of GDD.
Bone homeostasis also relies on osteoblasts mediating bone formation, and Akt signaling plays a critical role in cell viability, inhibiting apoptosis, and cell differentiation [15]. Consistent with the change in osteoclasts, the phosphorylation level of Akt was decreased in mature osteoblasts from Ano5KI/KI mice. Meanwhile, our results suggested that SC79 inhibited the ALP activity and mineralized nodules formation of Ano5KI/KI osteoblasts, implying that it is crucial for both the early and late stages of osteogenesis. Furthermore, Akt activation obviously suppressed the expression of Runx2, a crucial regulator for the proliferation of osteoblast progenitors and their differentiation into osteoblasts and involved in inducing the transcription of Ocn and Col1a1, which closely take part in the process of bone matrix formation [30].
Canonical AKT signaling is involved in promoting osteoblast proliferation and differentiation through mTOR and Gsk3β/β-catenin cascades [31]. Nevertheless, the levels of Gsk3β and downstream β-catenin were comparable between Ano5KI/KI and Ano5+/+ mCOBs in our study (Fig. S1, Additional File 1), which indicates that the decrease in Akt phosphorylation regulated osteogenesis by means other than interference of the Gsk3β/β-catenin pathway. Several studies have yielded similar findings to ours and showed that inhibition of Akt phosphorylation with imatinib stimulates osteogenesis in MSCs, but the reason is not well understood [32]. Surprisingly, Akt/mTOR signaling could inhibit the autophagy process that is required to maintain osteoblast differentiation and bone matrix secretion. Studies have pointed out that intracellular components of crystal-like structures in the cytoplasm are mainly located in autophagosome-like vesicles, and more convincingly, the apatite crystal components in the vesicles have been identified [33, 34]. We hypothesized that increased osteogenesis caused by the mutation may be due to the reinforcement of autophagic activity. However, our in vitro data showed that the p.Cys360Tyr mutation in Ano5 had no relevant effect on the protein level of LC3II, one of the widely used markers for autophagy, which was further confirmed by comparable levels of Atg5, Atg7, Atg12, and Beclin-1 (Fig. S2, Additional File 1). The enhanced osteoblastogenesis in Ano5KI/KI mCOBs is independent of autophagy and Gsk3β signaling, while specific factors mechanically contributing to excessive osteoblast differentiation and bone matrix secretion mediated by reduced Akt phosphorylation in the GDD disorder model need to be further explored.