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(The FASEB Journal. 1999;13:2179-2185.)
© 1999 FASEB

The glutamate receptor antagonist MK801 modulates bone resorption in vitro by a mechanism predominantly involving osteoclast differentiation

NICKY M. PEET1, PETER S. GRABOWSKI, IRA LAKETIC-LJUBOJEVIC and TIM M. SKERRY

Department of Biology, University of York, York, YO10 5YW, U.K.

1Correspondence: Department of Biology, University of York, PO Box 373, York, YO10 5YW, U.K. E-mail nmp2{at}york.ac.uk


   ABSTRACT
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Recent identification in bone of transporters, receptors, and components of synaptic signaling suggests a role for glutamate in the skeleton. We investigated effects of glutamate and its antagonist MK801 on osteoclasts in vitro. Glutamate applied to patch clamped osteoclasts induced significant increases in whole-cell membrane currents (P<0.01) in the presence of the coagonist glycine. Agonist-elicited currents were significantly decreased after application of MK801 (100 µM, P<0.01), but MK801 had no effect on actin ring formation necessary for osteoclast polarization, attachment, and resorption. In cocultures of bone marrow cells and osteoblasts in which osteoclasts develop, MK801 inhibited osteoclast differentiation and reduced resorption of pits in dentine (3 to 100 µM; P<0.001). MK801 added early in the culture (for as little as 2–4 days) was as effective as addition for the entire culture period. Addition of MK801 for any time after day 7 of culture was ineffective in reducing osteoclast activity. Using rat and rabbit mature osteoclasts cultured on dentine or explants of mouse calvariae prelabeled with 45Ca, we could not detect significant effects of MK801 on osteoclastic resorption. These data show clearly that glutamate receptor function is critical during osteoclastogenesis and suggest that glutamate is less important in regulating mature osteoclast activity.—Peet, N. M., Grabowski, P. S., Laketic-Ljubojevic, I., Skerry, T. M. The glutamate receptor antagonist MK801 modulates bone resorption in vitro by a mechanism predominantly involving osteoclast differentiation.


Key Words: osteoclast • differentiation • electrophysiology • glutamate receptor • MK801 maleate (Dizocilpine)


   INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
INTERCELLULAR COMMUNICATION IS crucial in the integration of tissue responses. In bone, the orchestration of activity of the cells responsible for information sensing, formation, and resorption governs the amount of bone at each site in the skeleton, and therefore the likelihood of fracture. In bone pathologies, profound effects on bone mass have been shown to be caused by the alterations of hormonal signaling after the menopause (1) or in individuals with aberrant PTH receptor function. (2) . The effects of the numerous paracrine agents on bone mass also demonstrate the importance of local intercellular communication (3) . Identification by us, and subsequently by others, of glutamate transporters (4) and receptors (5 6 7) in bone suggests that paracrine signaling in bone cells may mimic synaptic transmission between neurons.

Glutamate is the major excitatory neurotransmitter in the central nervous system (CNS) and is released in a quantal manner by presynaptic cells to bind to clustered specific cell surface receptors on the postsynaptic cell (8) . These receptors are divided into ionotropic receptors (three subgroups of glutamate-gated ion channels) and 7-transmembrane domain-containing metabotropic receptors that signal via G-proteins (9) . The ionotropic receptors are divided according to their sensitivity to pharmacological ligands N-methyl-D-aspartate (NMDA), AMPA, and kainate. In response to glutamate binding, ionotropic receptors open to allow influx of ions into the cell, regulating subsequent processes. In this report, we focus on the function of NMDA receptors in osteoclasts, as immunocytochemical localizations show that human and laboratory animal osteoclasts possess NMDA receptors (6 , 7) .

Naturally the implication of this is that the receptors play a role in the process of bone resorption, and in this study we have used electrophysiological techniques as well as in vitro resorption assays to investigate that role. Patch clamping is the method of choice for characterizing membrane ion channel activity and allows accurate definition of specific responses to both agonists and antagonists in single cells. This is a significant goal, since differences between CNS and bone glutamate receptors could point toward divergence in ligand specificity that would have profound implications on drug targeting. Longer term in vitro assays, such as the ones we use here, have been available for the study of osteoclastogenesis and bone resorption for a considerable period of time and the methods are well characterized (10 11 12) . We show here that although mature osteoclasts possess NMDA receptors and respond acutely to ligand stimulation, the role of glutamate appears to be predominantly to control osteoclastogenesis, since the effects of NMDA antagonists are greater by far in cultures where osteoclasts develop than in cultures where mature cell function is investigated.


   MATERIALS AND METHODS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Chemicals and media were obtained from Gibco BRL (Grand Island, N.Y.) unless otherwise stated.

Isolation of mature rabbit osteoclasts
Osteoclasts were isolated from 2- to 3-day-old neonatal rabbits as described previously (13) . Briefly, for each experiment, femora and tibiae from a single rabbit were curetted into minimal essential medium containing 10% fetal calf serum and penicillin/streptomycin (medium). Cells were settled in medium onto 10 mm diameter glass coverslips at 37°C, 5% CO2, and nonadherent cells were removed after 45 min by vigorous washing in phosphate-buffered saline (PBS). The coverslips were transferred to 4 ml pre-equilibrated medium and maintained at 37°C in humidified 95% air, 5% CO2 for 3 h prior to use.

Patch clamp studies
To assist patching, coverslips with adherent osteoclasts were placed at 4°C for 30 min, causing the osteoclasts to round up (D. Ypey, personal communication). The coverslips were then rinsed in external solution before use. The cell preparation was placed in a recording chamber mounted on an inverted microscope. Experiments were performed in the whole-cell patch clamp configuration (14) using an L/M-EPC7 amplifier and CED patch/voltage clamp software. Pipettes (2–10 M{Omega}) were pulled from unfilamented borosilicate Kovar glass (Corning 7052) and heat polished. Experiments were performed at room temperature (20–26°C). Seal resistance ranged from 5 to 10 G{Omega}. Cells were held at 0 mV and stepped to test potentials between -140 and 140 mV for 800 ms in 20 mV steps. To investigate the membrane currents before and after addition of glutamate [100–300 µM] and MK801 (Tocris) [100 µM], we used nearly symmetrical solutions on each side of the membrane. The NMDA receptor coagonist glycine [30 µM] was used in conjunction with each application of glutamate or NMDA. Intracellular solutions contained [mM]: 140 CsCl, 10 HEPES, 5 glucose, 5 K2ATP; pH 7.2. The extracellular solution was Mg2+ and Na+ free and contained [mM]: 140 CsCl, 2 CaCl2, 5 HEPES, 10 glucose; pH 7.3. All solutions were filtered prior to use (pore diameter 0.2 µM). Compounds were added to the extracellular compartment via a pipette. In between the experiments, the bath was perfused continuously with extracellular solution. Results are displayed as typical traces and representative current/voltage relationships. Statistical significance was determined by Student’s t test.

Coculture
Osteoclasts were generated from cocultures of osteoblasts and marrow leukocytes essentially as described previously (10) . To extract primary osteoblasts, neonatal mouse calvariae were dissected free of loose tissues and washed in Hanks’ buffered salts solution with magnesium and calcium ions (Hanks’+), then digested for 15 min with collagenase type I (crude) at 1 mg/ml in Hanks’+ (collagenase), when the solution was aspirated and discarded. The calvariae were then digested for 30 min in 3 ml collagenase and washed twice with 3 ml of phosphate-buffered saline without magnesium and calcium ions (PBS-). The collagenase suspension and the washes were combined and the cells were collected by centrifugation at 1000 x g for 3 min, suspended in medium ({alpha}-MEM with 10% fetal calf serum and penicillin/streptomycin, and kept on ice. The calvariae were treated with EDTA at 4 mM in PBS- for 15 min and washed twice with Hanks’+. The cells were collected as before; the calvariae were digested with collagenase for another 60 min and the cells were collected. All three fractions of cells were pooled and cultured in 15 ml of medium in a 75 cm2 flask. Three hours later, the medium was aspirated and the cells were gently washed once with Hanks’+. The cells were then maintained in medium without disturbance for up to a week. They were usually used for coculture within 3 days.

Bone marrow leukocytes were extracted from adult mouse tibiae and femora. The bones were dissected and placed in Hanks’+. The muscle tissue was scraped away and the epiphyses were cut off to gain access to the marrow cavity. The marrow tissue was ejected from the shafts with Hanks’+ with 10% fetal calf serum using a syringe and a 25 gauge needle. It was then converted to a fine cell suspension by sequential passage through 19, 21 and 25 gauge needles and layered onto Ficoll. The leukocyte fraction was recovered from the top of the Ficoll after 25 min centrifugation at 600 x g and washed once in Hanks’+.

To set up the coculture, 10 mm diameter coverslips or elephant ivory wafers (6 mm diameter) were placed in 48-well plates and covered with 200 µl of medium with 10-8m 1,25 dihydroxy vitamin D3 (D3 medium). Freshly extracted leukocytes and previously prepared osteoblasts were counted and suspended in D3 medium so that addition of 100 µl of mixture yielded 2 x 104 osteoblasts and 4 x 105 leukocytes per well. Drugs or vehicle were diluted to 4x final concentration with D3 medium and added to the wells in 100 µl, bringing the total volume per well to 400 µl. Wells at the edge of each plate were not used but were filled with PBS. The D3 medium was refreshed on days 4 and 7 by preparing fresh D3 medium with a 2x final concentration of the drug or vehicle, then adding 400 µl dropwise to the wells and waiting 20 min before removing 400 µl.

To analyze osteoclast morphology and activity 11 days later, cells on coverslips were fixed in 4% paraformaldehyde in PBS and stained for tartrate-resistant acid phosphatase (TRAP; 15 ). Ivory wafers were placed in distilled water for 15 min and then rubbed gently with lint-free tissue to remove cells. A Leica Quantimet image analysis system was used to measure areas of TRAP staining and resorption lacunae (16).

The area of TRAP-stained osteoclasts was measured in eight geometrically predetermined fields and the measured area was extrapolated to represent the whole area of the coverslip. Resorption lacunae area was measured at five geometrically predetermined fields and similarly extrapolated to the whole area of the wafer. Data from coculture studies were transformed logarithmically to normalize distributions, and differences between control and experimental cultures were analyzed by one-way analysis of variance and Dunnett’s test.

Mature osteoclast resorption assay
Rat and rabbit osteoclasts were studied to determine the role of glutamate in the bone resorption by mature cells. Osteoclasts from neonatal rats (3–5 days old) were prepared and cultured according to the method of Arnett and Spowage (11) . Briefly, for each experiment, femora and tibiae pooled from four 3-day-old Wistar rats were curetted into minimal essential medium containing 10% fetal bovine serum and penicillin/streptomycin, acidified with 82 µl concentrated HCl per 100 ml (MEM). Rabbit osteoclasts were prepared as described in the first section of Materials and Methods. Cells were settled in MEM onto 6 mm diameter wafers of elephant ivory at 37°C, 5% CO2 and nonadherent cells were removed after 45 min by vigorous washing in PBS. Experimental media containing MK801 were prepared from 100x aqueous stock solutions and control experimental medium included a 1/100th volume of sterile water. The ivory wafers were transferred to 4 ml pre-equilibrated experimental media, with or without MK801, in 12-well tissue culture plates (four wafers per well) and cultured for 26 h at 37°C, 5% CO2. At the end of the incubation period, the cells and pits were visualized and measured as before.

Calvarial explant assay
The effect of MK801 on bone resorption in calvarial explants was assessed by measuring the release of 45Ca from prelabeled neonatal mouse calvariae as described previously (12) . Briefly, neonatal (1 to 2 days old) mice were injected subcutaneously with 1 µCi 45Ca chloride (Amersham, Little Chalfont, U.K.) in 50 µl of physiological saline. After 4 days, the animals were killed and the calvarial bones were excised and divided into equal halves along the sagittal suture. Half-calvariae were preincubated at 37°C, 5% CO2 on stainless steel grids in 12-well tissue culture plates in 1 ml of phenol red free BGJ culture medium (ICN Flow, High Wycombe, U.K.) containing 5% fetal bovine serum and penicillin/streptomycin. After an 18 h preincubation period, the medium was replaced with experimental medium to which MK801 was added from concentrated 100x aqueous stock solutions. Control experiments included a 1/100th volume of sterile water. After a 48 h culture period, the experiment was terminated and bones were dissolved in 50% trichloroacetic acid. An aliquot of the medium and an aliquot of the dissolved bone were analyzed for 45Ca by liquid scintillation counting and the percentage of 45Ca released from each bone was calculated. Differences between control and experimental cultures were assessed by one-way analysis of variance.

Visualization of actin rings in osteoclasts
Rabbit osteoclasts were prepared as described above and settled onto 10 mm glass coverslips for 45 min. After rinsing vigorously in PBS, the coverslips were transferred to MEM and preincubated for 3 h at 37°C, 95% air, 5% CO2. The coverslips were then transferred to fresh MEM with or without MK801 (at 30 or 100 µM) and incubated for an additional 3 h at 37°C, 95% air, 5% CO2. Cells were fixed in 4% formaldehyde in PBS for 5 min, then washed three times with PBS. F-actin was stained at room temperature in the dark with 10-7 M rhodamine-conjugated phalloidin (Sigma, St. Louis, Mo.) and visualized by fluorescence microscopy.


   RESULTS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Patch clamp studies
In the presence of the coagonist glycine, 300 µM glutamate induced currents in mature osteoclasts that were significantly increased above control currents in cells stepped to the same potentials (P<0.01) (Fig. 1a, b ). The NMDA receptor antagonist MK801 did not completely block glutamate-induced currents, but the reduction was significant (P<0.01). Glutamate-induced currents were also blocked to a similar extent by 1 mM magnesium (data not shown). Application of MK801 alone did not cause significant changes in control currents (not shown).



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Figure 1. MK801 blocks glutamate-elicited currents. a) Representative traces: control currents, currents induced by 300 µM glutamate + 30 µM glycine, and glutamate-induced currents after addition of 100 µM MK801 (P<0.01). Traces are representative of three independent experiments at a stepping potential of -80 mV. b) Current/voltage (I/V) relationship showing the effect of glutamate (300 µM+30 µM glycine) on currents in the absence and presence of MK801 (100 µM) at different membrane potentials. Traces are representative of three independent experiments.

Coculture
MK801 produced consistent reductions in osteoclast size, nuclearity, TRAP expression, and resorptive activity. Specifically, in control cultures, cells were large, with up to 20 nuclei visible in each cell (Fig. 2a, b ), whereas after exposure to MK801, most cells that stained positive for TRAP were small and either mono- or binucleate (Fig. 2c, d ). The effect of MK801 on the TRAP-positive cell area was investigated at nine different concentrations between 3 and 100 µM and shown to be concentration dependent and significant above 50 µM (P<0.05 at 60 µM increasing to P<0.001 at 80 µM and above) (Fig. 3 ).



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Figure 2. MK801 reduces osteoclast formation in cocultures. Representative photomicrographs of cocultures stained for TRAP activity after 11 days. a, b) Control; c, d) MK801, 100 µM. a, c) Bar = 250 µM; b, d) Bar = 20 µM.



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Figure 3. MK801 inhibits osteoclastogenesis concentration-dependently in cocultures. Filled symbols are means (± SE, n=4) of the area of coverslips covered by TRAP-positive osteoclasts. *P<0.05; {dagger}P<0.01; {ddagger}P<0.001.

Pits in ivory wafers from control cultures were linked in trails and overlapped (Fig. 4a ), sometimes covering up to 80% of the surface of the dentine, whereas those exposed to MK801 were smaller, less overlapping, and less continuous, forming isolated patches (Fig. 4b ). The addition of MK801 for short periods at different times revealed that addition early during the culture (days 2–4 or 2–7) was as effective in inhibiting osteoclast formation and resorption of dentine as was treatment with MK801 for the entire experiment. However, addition at any time after day 7 did not have a significant effect in reducing resorbing activity (Fig. 5 ).



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Figure 4. MK801 reduces osteoclastic resorption of dentine in cocultures. Representative photomicrographs of resorption lacunae in ivory wafers visualized by incident light. a) Control; b) MK801, 100 µM. Bar = 200 µM.



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Figure 5. MK801 inhibits osteoclastogenesis in cocultures at early time points. MK 801 was included in culture medium during the days shown on the abscissa. Bars are mean (± SE, n=4) area of resorption lacunae in ivory wafers. {dagger}P<0.01; {ddagger}P<0.001.

Mature osteoclast assay
Routinely, the area resorbed in control cultures of disaggregated neonatal rat osteoclasts was greater than 25 x 103 µm2. In three independent experiments, we observed no significant effect of MK801 (10–100 µM) on resorption. The area of resorption in control cultures of one representative study was 45 x 103 µm2) SD 12, n=4), or 0.03% of the total area of dentine, compared with 38 x 103 µm2SD 10 n=4, NS) in cultures containing 100 µM MK801.

Rabbit osteoclasts were similarly unresponsive to the effects of MK801, and there was no significant difference between the resorption area or TRAP activity in control and MK801-treated cultures at any of the concentrations tested.

Calvarial explant assay
Between 12 and 22% of the calcium label in mouse calvarial bones in control cultures was released into the medium over 48 h in culture. In three replicate experiments, MK801 (10–100 µM) had no significant effect on calvarial resorption. In controls, 17.6% (± SE 3.2%) of the incorporated label was released into the medium compared with 17.7% (± SE 3%) in cultures treated with 10 µM MK801 and 14.5% (± SE 3%) after treatment with 100 µM MK801 (Fig. 6 ).



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Figure 6. Effect of MK801 on 45Ca release from calvarial explants cultured for 48 h. Data are shown as mean (±SD, n=4) 45Ca recovered in culture medium as a percentage of the total 45Ca recovered from prelabeled calvaria, calculated individually for each bone. Results are representative of three separate explant studies. n.s. = not significantly different to control.

Actin rings in osteoclasts
There was no detectable difference between F-actin ring formation in osteoclasts treated with MK801 at 30 µM or 100 µM compared with vehicle-treated controls (Fig. 7 ).



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Figure 7. Effect of MK801 on actin ring formation in rabbit osteoclasts. Representative photomicrographs all at 3 h after treatment: a) control, b) MK801 [100 µM], and c) MK801 [30 µM]. Bars = 5 µM.


   DISCUSSION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
These data show clearly that glutamate is capable of regulating membrane currents in osteoclasts and that osteoclastogenesis in vitro is inhibited by the NMDA receptor antagonist MK801. This suggests that osteoclastogenesis is highly dependent on constitutive glutamate signaling in the cultures. As a whole, these findings are not surprising in view of our previous demonstration of NMDA receptor mRNA and protein expression by osteoclasts (5) . Furthermore, in studies some years ago, it was shown that glutamate induced chemotactic responses in cells of the macrophage/monocyte lineage, including osteoclasts, although at that time the mechanism for such an effect was unknown (17) .

Our electrophysiological studies provide direct evidence that receptors expressed by osteoclasts are functional. However, an interesting feature of this report is that the effect of the antagonist MK801 occurs predominantly during the earlier phase of osteoclastogenesis and is less or nonexistent in mature rat, mouse, or rabbit osteoclasts in cocultures, explant models, and disaggregated osteoclasts. This result contrasts with other studies (7) that showed inhibition of bone resorption by preparations of isolated rabbit osteoclasts similar to the ones we used. To clarify this point, we investigated the effect of MK801 on actin ring formation, since it is well known that this process is pivotal in polarization, attachment, and resorption activity of osteoclasts (18 19 20 21) . The lack of effect of MK801 in disrupting actin rings in mature rabbit osteoclasts seems to support the lack of significant effect of the agent on bone resorption except in the coculture model, in which we show regulation of osteoclast differentiation.

It is hard to reconcile the presence of receptors on osteoclasts and the effects of ligands and antagonists on membrane currents with a lack of effect on resorption of antagonists on isolated mature cells in culture. Our data suggest, therefore, that glutamate mediated changes in membrane currents are not involved in regulation of resorption in mature osteoclasts, but may be involved in other intracellular processes.

Whether or not MK801 affects mature osteoclast function, from our studies it is clear that its effects on osteoclastogenesis are of greater magnitude than those on mature cells. This raises a further question, namely, whether the effects under those circumstances are mediated by receptors on osteoclast precursors or on the osteoblasts that are necessary to induce their fusion and activity. We have demonstrated the expression of glutamate receptors on osteoblasts and characterized their properties extensively (5 , 22) . It is therefore possible that effects of glutamate and/or antagonists on osteoclastogenesis are mediated indirectly through osteoblasts. Direct contact between hematopoietic progenitor cells and osteoblasts/stromal cells is required for osteoclastogenesis, and an osteoblastic membrane-associated factor has recently been described that fulfills the role of osteoclast differentiation factor [ODF, also known as tumor necrosis factor-related, activation-induced cytokine (TRANCE) and receptor activator of nuclear factor {kappa}B ligand (RANKL)]. ODF/TRANCE/RANKL interacts with the RANK receptor on osteoclast precursors to drive osteoclastogenesis (23) . Studies of the effects of MK801 on osteoclastogenesis driven by RANKL in cultures in the presence or absence of osteoblasts would discriminate between direct and/or indirect effects of glutamate signaling on osteoclasts.

The concentrations of MK801 we have used [3–100 µM] are well within the range considered to be selective in neuroscience studies. However, it is not completely clear that the channel characteristics of osteoclast NMDA receptors are identical to those expressed in the CNS. One reason for this may be connected with the heteromeric nature of the receptors. NMDA receptors are made up of four or five NMDAR1 and NMDAR2 subunits (24) . The NMDAR2 subunits are divided into 2A, B, C, and D. CNS type receptors are predominantly composed of 1/2A heteromers, whereas in bone we have shown that NMDA receptors are the much less well-characterized 1/2C or 1/2D type, which are known to have gating characteristics that are different from the 1/2A receptors (9) .

Although the effects of NMDA receptor antagonists on osteoclastic bone resorption are therefore clear in vitro, they are not well characterized in vivo. Several knockout mice exist with deletions of single glutamate receptors, but the NMDAR1 knockout does not exhibit a profound skeletal phenotype and is not osteopetrotic (25) (Fig. 8 ). Perhaps it is not surprising given the expression of numerous different receptor subtypes by all the bone cells we have studied, which would suggest redundancy in the system. Such redundancy would be consistent with many other paracrine systems in bone. In a different glutamate receptor transgenic animal, in which editing of the GluRB subunit of an AMPA receptor abrogates its function, there is a mild skeletal phenotype with reduced bone growth and kyphosis (26) . Since we have detected expression of this receptor in bone, the phenotype may be directly linked to glutamate signaling in bone, in which there may be less redundancy.



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Figure 8. Cryosections of metaphysis (a), diaphysis (b) of proximal phalanx from neonatal NMDAR1[minus/- mouse, stained with toluidine blue, displaying typical histology. a) Bar = 100 µm. b) Bar = 30 µm.

Although it is not surprising that the glutamate receptors expressed in bone would be functional, there are only a small number of tissues in which glutamate signaling has been characterized outside of the CNS. In addition to earlier demonstrations of expression of functional glutamate receptors in the adrenal gland, pancreas, lung, and some regions of the gut (27 28 29 30) , we have recently shown that glutamate receptors are present in megakaryocytes and basal layer keratinocytes (31 , 32) , implicating excitatory amino acid signaling in platelet formation and wound healing. There is now an increasing body of evidence for neurotransmitter actions on bone (33 34 35 36) . These data therefore add to the possibility that excitatory amino acids in particular, and neurotransmitters in general, are probably more ubiquitously functional than previously thought. A parallel may be drawn between this possibility and the growth in understanding of the multiple functions of cytokines, which were initially thought to be involved solely in signaling within the immune system where they were discovered.

The ultimate implication of studies of neurotransmitter function in the musculoskeletal system is the possibility of manipulating bone mass by drug targeting those signaling systems in vivo. The blood–brain barrier may provide a useful way to engineer compounds that will act on the skeleton without affecting brain function.


   ACKNOWLEDGMENTS
 
Funding for this work was provided by the Nuffield Foundation Oliver Bird Fund (N.M.P.) and Smith and Nephew (P.S.G. and I.L.-L.). Dr. Paul Genever advised us on the actin staining technique and prepared Fig. 8 from bones generously donated by Drs. Tom Curran and Michi Yuzaki from the St. Jude Children’s Research Hospital in Memphis.


   FOOTNOTES
 
Received for publication February 24, 1999. Revised for publication August 4, 1999.


   REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 

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