Low bone mass and strength lead to fragility fractures, for example, in elderly individuals affected by osteoporosis or children with osteogenesis imperfecta. A decade ago, rare human mutations affecting bone negatively (osteoporosis-pseudoglioma syndrome) or positively (high-bone mass phenotype, sclerosteosis and Van Buchem disease) have been identified and found to all reside in components of the canonical WNT signaling machinery. Mouse genetics confirmed the importance of canonical Wnt signaling in the regulation of bone homeostasis, with activation of the pathway leading to increased, and inhibition leading to decreased, bone mass and strength. The importance of WNT signaling for bone has also been highlighted since then in the general population in numerous genome-wide association studies. The pathway is now the target for therapeutic intervention to restore bone strength in millions of patients at risk for fracture. This paper reviews our current understanding of the mechanisms by which WNT signalng regulates bone homeostasis.

Posttranslational modifications play important roles in regulating protein structure and function. Histone deacetylase 6 (HDAC6) is a mostly cytoplasmic class II HDAC, which has a unique structure with two catalytic domains and a domain binding ubiquitin with high affinity. This enzyme was recently identified as a multisubstrate protein deacetylase that can act on acetylated histone tails, ␣-tubulin and Hsp90. To investigate the in vivo functions of HDAC6 and the relevance of tubulin acetylation/deacetylation, we targeted the HDAC6 gene by homologous recombination in embryonic stem cells and generated knockout mice. HDAC6-deficient mice are viable and fertile and show hyperacetylated tubulin in most tissues. The highest level of expression of HDAC6 is seen in the testis, yet development and function of this organ are normal in the absence of HDAC6. Likewise, lymphoid development is normal, but the immune response is moderately affected. Furthermore, the lack of HDAC6 results in a small increase in cancellous bone mineral density, indicating that this deacetylase plays a minor role in bone biology. HDAC6-deficient mouse embryonic fibroblasts show apparently normal microtubule organization and stability and also show increased Hsp90 acetylation correlating with impaired Hsp90 function. Collectively, these data demonstrate that mice survive well without HDAC6 and that tubulin hyperacetylation is not detrimental to normal mammalian development.Protein acetylation/deacetylation is involved in the regulation of protein structure and function, and therefore has potentially important roles in most cellular processes. In particular, the impact of histone N-terminal acetylation on chromatin organization and gene expression has been well documented (15). Acetylation and deacetylation of histone tails or of other proteins are catalyzed by histone acetyltransferases and histone deacetylases (HDACs), respectively. In mammals, there are 18 HDACs identified so far that can be grouped into three classes (reviewed in references 35, 36, and 39). In cells, most, if not all, class I and II HDACs are part of high-molecular-weight complexes that typically contain several HDAC polypeptides and are recruited to DNA via their interactions with sequence-specific or nonspecific DNA-binding proteins.HDAC 6 (HDAC6) was first identified through its homology to the Saccharomyces cerevisiae histone deacetylase HDA1 (9, 34). Like other class II HDACs, HDAC6 is mainly localized in the cytoplasm, but it can also shuttle between the nucleus and cytoplasm (33). This process is regulated by an N-terminally located nuclear export signal and possibly other uncharacterized mechanisms. HDAC6 has not been found in any class I or II HDAC-containing repressor complexes, which suggests it may have a unique regulation and possibly substrates different from those of other HDACs. However, it was shown biochemically and in genome-wide two-hybrid experiments to associate with the class III deacetylase SirT2 (22,26). Interestingly, HDAC6 contains two hdac catalyti...

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␤-Catenin-dependent canonical Wnt signaling plays an important role in bone metabolism by controlling differentiation of bone-forming osteoblasts and bone-resorbing osteoclasts. To investigate its function in osteocytes, the cell type constituting the majority of bone cells, we generated osteocyte-specific ␤-catenindeficient mice (Ctnnb1 loxP/loxP ; Dmp1-Cre). Homozygous mutants were born at normal Mendelian frequency with no obvious morphological abnormalities or detectable differences in size or body weight, but bone mass accrual was strongly impaired due to early-onset, progressive bone loss in the appendicular and axial skeleton with mild growth retardation and premature lethality. Cancellous bone mass was almost completely absent, and cortical bone thickness was dramatically reduced. The low-bone-mass phenotype was associated with increased osteoclast number and activity, whereas osteoblast function and osteocyte density were normal. Cortical bone Wnt/␤-catenin target gene expression was reduced, and of the known regulators of osteoclast differentiation, osteoprotegerin (OPG) expression was significantly downregulated in osteocyte bone fractions of mutant mice. Moreover, the OPG levels expressed by osteocytes were higher than or comparable to the levels expressed by osteoblasts during skeletal growth and at maturity, suggesting that the reduction in osteocytic OPG and the concomitant increase in osteocytic RANKL/OPG ratio contribute to the increased number of osteoclasts and resorption in osteocyte-specific ␤-catenin mutants. Together, these results reveal a crucial novel function for osteocyte ␤-catenin signaling in controlling bone homeostasis.The adult skeleton is continuously remodeled in a tightly regulated manner by the coupled activity of bone-resorbing osteoclasts and bone-forming osteoblasts to maintain skeletal integrity and bone homeostasis (24,46). A similar complex regulatory network of defined, but not necessarily coupled, osteoblast and osteoclast action is required during development and growth, when bone modeling ensures functional bone morphology and bone mass accrual, which in mice occurs throughout the first 3 to 4 months of life until peak bone mass is reached.Osteoblasts differentiate from mesenchymal bone marrow progenitor cells into bone-forming osteoblasts that reside on the bone surface and deposit new bone matrix. In contrast, osteoclasts are derived from hematopoietic bone marrow precursor cells that belong to the myeloid monocyte/macrophage lineage (63). However, the majority, i.e., more than 90 to 95% of all bone cells in the adult skeleton, are osteocytes (10), terminally differentiated cells of the mesenchymal osteoblast lineage residing in small lacunae found at regular intervals within the mineralized bone matrix. They extend long thin cellular protrusions or dendrites, which travel through small channels (canaliculi) inside the compact bone, but also reach the bone surface and bone marrow compartment (8,30). By forming gap junctions to neighboring cells, osteocytes are con...

Mutations in distant regulatory elements can have a negative impact on human development and health, yet because of the difficulty of detecting these critical sequences, we predominantly focus on coding sequences for diagnostic purposes. We have undertaken a comparative sequence-based approach to characterize a large noncoding region deleted in patients affected by Van Buchem (VB) disease, a severe sclerosing bone dysplasia. Using BAC recombination and transgenesis, we characterized the expression of human sclerostin (SOST) from normal (SOSTwt) or Van Buchem (SOSTvbΔ) alleles. Only the SOSTwt allele faithfully expressed high levels of human SOST in the adult bone and had an impact on bone metabolism, consistent with the model that the VB noncoding deletion removes a SOST-specific regulatory element. By exploiting cross-species sequence comparisons with in vitro and in vivo enhancer assays, we were able to identify a candidate enhancer element that drives human SOST expression in osteoblast-like cell lines in vitro and in the skeletal anlage of the embryonic day 14.5 (E14.5) mouse embryo, and discovered a novel function for sclerostin during limb development. Our approach represents a framework for characterizing distant regulatory elements associated with abnormal human phenotypes