Rare diseases can provide critical insight into fundamental cellular mechanisms. One such disease, progressive osseous heteroplasia (POH), is a genetic disorder in which the body produces bone in skin, fat and skeletal muscle. Disorders of osteogenesis such as POH provide the opportunity to gain valuable information about the regulation of bone formation by revealing gene mutations that alter multi-potential precursor cells to promote osteoblast differentiation. We discovered that one of two copies of the GNAS gene is mutated in POH, establishing that inactivating GNAS mutations can alter cell fate to induce bone formation in inappropriate locations. The major product of the GNAS gene is Gs?, a G protein subunit that transmits signals from cell surface receptors to activate cAMP. Heterotopic (extra-skeletal) bone formation in POH patients often initiates within subcutaneous fat, suggesting common progenitor cells and a relationship, perhaps reciprocal, between osteogenesis and adipogenesis. Our investigations have shown that Gs? mRNA and protein expression and cAMP activity are reduced in cells from patients with POH and that decreased expression of GNAS and cAMP are associated with enhanced osteogenesis, while increased activation of cAMP signaling inhibits osteogenesis and favors adipogenesis. Our studies have demonstrated that GNAS plays a complex role in cell fate decisions and have directed us to further investigate the cellular and molecular mechanisms of osteogenic and adipogenic regulation by GNAS. In order to gain insight into this very complex process and based on our preliminary data, we will focus this proposal on investigations of cAMP signaling as a critical entry point to downstream signaling through GNAS/Gs? in regulating cell fate decisions. We hypothesize that cAMP signaling regulates early stage cell fate decisions that direct osteogenesis and adipogenesis. We propose three Specific Aims:
Aim 1. Identify the roles and stages of GNAS and cAMP signaling in regulating cell fate decisions and tissue development using in vitro and in vivo assays.
Aim 2. Examine interactions between cAMP and other signaling pathways in response to GNAS inactivation, focusing on cAMP crosstalk with the BMP pathway.
Aim 3. Investigate the identity of progenitor cells that are recruited to form heterotopic bone and adipose tissue in response to GNAS inactivation through in vivo lineage tracing experiments. This proposal will provide new insights into the molecular pathways that regulate osteogenesis and adipogenesis under normal and pathological conditions, will delineate factors that control the differentiation of pluripotent stem cells in the musculoskeletal system into different lineages, and will provide an important foundation for the design of molecular diagnostic and treatment strategies for a wide range of human disorders of bone and adipose tissue.

Public Health Relevance

Rare genetic disorders can provide valuable insight into fundamental cellular mechanisms that impact more common conditions. POH, a disease which forms extra-skeletal bone, is caused by gene mutations that regulate pluripotent stem cell differentiation in the musculoskeletal system. Our studies will investigate specific effects of the mutated POH gene on cell differentiation as well as identify progenitor cells and signaling pathways that regulate bone and fat formation. These studies will provide new insights leading to diagnostic and treatment strategies for a wide range of human disorders of bone and adipose tissue.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR046831-13
Application #
8904603
Study Section
Skeletal Biology Structure and Regeneration Study Section (SBSR)
Program Officer
Chen, Faye H
Project Start
2000-09-01
Project End
2017-08-31
Budget Start
2015-09-01
Budget End
2017-08-31
Support Year
13
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Orthopedics
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Ramaswamy, Girish; Fong, John; Brewer, Niambi et al. (2018) Ablation of Gs? signaling in osteoclast progenitor cells adversely affects skeletal bone maintenance. Bone 109:86-90
Amalfitano, Matthew; Fyfe, Billie; Thomas, Sumi V et al. (2018) A case report of mesenteric heterotopic ossification: Histopathologic and genetic findings. Bone 109:56-60
Loro, Emanuele; Ramaswamy, Girish; Chandra, Abhishek et al. (2017) IL15RA is required for osteoblast function and bone mineralization. Bone 103:20-30
Ramaswamy, Girish; Kim, Hyunsoo; Zhang, Deyu et al. (2017) Gs? Controls Cortical Bone Quality by Regulating Osteoclast Differentiation via cAMP/PKA and ?-Catenin Pathways. Sci Rep 7:45140
Convente, Michael R; Wang, Haitao; Pignolo, Robert J et al. (2015) The immunological contribution to heterotopic ossification disorders. Curr Osteoporos Rep 13:116-24
Pignolo, Robert J; Ramaswamy, Girish; Fong, John T et al. (2015) Progressive osseous heteroplasia: diagnosis, treatment, and prognosis. Appl Clin Genet 8:37-48
Regard, Jean B; Malhotra, Deepti; Gvozdenovic-Jeremic, Jelena et al. (2013) Activation of Hedgehog signaling by loss of GNAS causes heterotopic ossification. Nat Med 19:1505-12
Cairns, Dana M; Pignolo, Robert J; Uchimura, Tomoya et al. (2013) Somitic disruption of GNAS in chick embryos mimics progressive osseous heteroplasia. J Clin Invest 123:3624-33
Liu, Jan-jan; Russell, Elizabeth; Zhang, Deyu et al. (2012) Paternally inherited gs? mutation impairs adipogenesis and potentiates a lean phenotype in vivo. Stem Cells 30:1477-85
Shore, Eileen M (2012) Fibrodysplasia ossificans progressiva: a human genetic disorder of extraskeletal bone formation, or--how does one tissue become another? Wiley Interdiscip Rev Dev Biol 1:153-65

Showing the most recent 10 out of 22 publications