Lung adenocarcinoma is the most common and aggressive type of lung cancer with the highest incidence of bone metastasis. Epidermal growth factor‐like domain multiple 6 (EGFL6) is an exocrine protein, and the expression of EGFL6 is correlated with survival of patient with lung adenocarcinoma. However, the association between EGFL6 expression in lung adenocarcinoma and bone metastasis has not been investigated. In this study, we found that EGFL6 levels in lung adenocarcinoma tissues correlate with bone metastasis and TNM stages in surgical patients. In vitro, overexpression of EGFL6 in lung adenocarcinoma cells promoted their proliferation, migration, and invasion ability compared with control by enhancing EMT process and activating Wnt/β-catenin and PI3K/AKT/mTOR pathways. In the nude mouse model, overexpression of EGFL6 enhanced tumor growth and caused greater bone destruction. Moreover, the exocrine EGFL6 of human lung adenocarcinoma cells increased osteoclast differentiation of bone marrow mononuclear macrophages (BMMs) of mice via the NF-κB and c-Fos/NFATc1 signaling pathways. However, exocrine EGFL6 had no effect on osteoblast differentiation of bone marrow mesenchymal stem cells (BMSCs). In conclusion, high expression of EGFL6 in tumor tissue of lung adenocarcinomas is associated with bone metastasis in surgical patients. The underlying mechanism may be the increased metastatic properties of lung adenocarcinoma cells with high EGFL6 level and the enhanced osteoclast differentiation and bone resorption by exocrine EGFL6 from tumors. Therefore, EGFL6 is a potential therapeutic target for the treatment of bone metastasis from lung adenocarcinoma.

Lung adenocarcinoma is the most common and aggressive type of lung cancer with the highest incidence of bone metastasis. Epidermal growth factor-like domain multiple 6 (EGFL6) is an exocrine protein, and the expression of EGFL6 is correlated with survival of patient with lung adenocarcinoma. However, the association between EGFL6 expression in lung adenocarcinoma and bone metastasis has not been investigated. In this study, we found that EGFL6 levels in lung adenocarcinoma tissues correlate with bone metastasis and TNM stages in surgical patients. In vitro, overexpression of EGFL6 in lung adenocarcinoma cells promoted their proliferation, migration, and invasion ability compared with control by enhancing EMT process and activating Wnt/β-catenin and PI3K/AKT/mTOR pathways. In the nude mouse model, overexpression of EGFL6 enhanced tumor growth and caused greater bone destruction.Moreover, the exocrine EGFL6 of human lung adenocarcinoma cells increased osteoclast differentiation of bone marrow mononuclear macrophages (BMMs) of mice via the NF-κB and c-Fos/NFATc1 signaling pathways. However, exocrine EGFL6 had no effect on osteoblast differentiation of bone marrow mesenchymal stem cells (BMSCs). In conclusion, high expression of EGFL6 in tumor tissue of lung adenocarcinomas is associated with bone metastasis in surgical patients. The underlying mechanism may be the increased metastatic properties of lung adenocarcinoma cells with high EGFL6 level and the enhanced osteoclast differentiation and bone resorption by exocrine EGFL6 from tumors. Therefore, EGFL6 is a potential therapeutic target for the treatment of bone metastasis from lung adenocarcinoma.

Human osteoclast-stimulating factor (OSF) induces osteoclast formation and bone resorption in osteoporosis by recruiting multiple signaling complexes with downstream partners. Protein contains a peptide-recognition Src homology 3 (SH3) domain that can recognize and bind class II linear motif [Formula: see text] to its partner proteins. The motif is defined by two prolines at positions [Formula: see text]1 and [Formula: see text]2, which are the primary anchor residues required for the domain recognition, and a positively charged amino acid at position [Formula: see text]4, which is the secondary anchor residue and determines the binding orientation of the motif peptides on the domain surface. In this study, we systematically examined the intermolecular interaction of OSF SH3 domain with a high-affinity decapeptide segment derived from its partner protein Sam68 at structural and energetic levels. It was found that, in addition to the primary and secondary anchor residues, the residue at peptide position [Formula: see text]1 is also important, which can form a [Formula: see text]-stacking system (consisting of multiple cation-[Formula: see text] or [Formula: see text]–[Formula: see text] stacking interactions) with its vicinal aromatic residues Phe23, Trp49 and Tyr65 of OSF SH3 domain, thus, largely stabilizing the domain–peptide complex. Here, we assigned the position [Formula: see text]1 as the third anchor residue and investigated the stacking effect by systematically substituting the position [Formula: see text]1 residue with six charged/aromatic amino acids (Arg, Lys, His, Phe, Tyr and Trp) and one neutral amino acid (Ala), as well as their impacts on the domain–peptide binding. A strong stacking effect was observed in association with charged/aromatic substitutions relative to neutral substitution, conferring substantial stability to the complex formation. A further fluorescence-based assay also substantiated the computational findings; the lysine and tyrosine substitutions ([Formula: see text] and [Formula: see text]) were observed to significantly and moderately improve peptide affinity by 4.7-fold and 1.4-fold relative to wild-type Sam68 decapeptide ([Formula: see text]), respectively.

Objectives The extension of diffuse idiopathic skeletal hyperostosis (DISH) from the low thoracic spine to the lumbar spine result in adjustment of spinal sagittal alignment in surgical patients. The aim of this study was to investigate changes in sagittal alignment and back pain in the thoracolumbar spine in nonsurgical DISH and control participants selected from a radiological database. Methods Participants in the DISH and the control group were selected by searching for “DISH or degenerative changes in the thoracic spine” in the radiology database of Taizhou Hospital between 2018 and 2021 using Resnick and Niwayama’s criteria. The subjects with spinal tumors, previous spinal surgery, vertebral fractures, inflammatory diseases, poor-quality radiographs, or loss of follow-up were excluded. Demographic and clinical characteristics were recorded retrospectively via the hospital information system and telephone follow-up. Segmental disc angles (SDAs), lumbar lordosis (LL), and bridge scores were analyzed using images of three-dimensional CT. Results The final participants consisted of 51 individuals with DISH (DISH group) and 102 individuals without DISH (control group). Depending on the presence of thoracolumbar pain, the DISH group was divided into the DISH group with thoracolumbar pain (DISH+Pain) and the DISH group without thoracolumbar pain (DISH-Pain). The LL and SDAs of T11-T12 and T12-L1 were significantly greater in the DISH group than in the control group. In addition, the SDA of L1-L2 was significantly smaller in the DISH+Pain group than in the DISH-Pain group, whereas there was no significant difference in lumbar lordosis between the DISH+Pain group and the DISH-Pain group. The bridge scores in DISH+Pain group was larger in T10-T11 (p = 0.01) and L1-L2 (p < 0.01) spine segments than those in DISH-Pain group. Conclusion The extension of DISH from thoracic to lumbar spine may increase lumbar lordosis and SDAs in the thoracolumbar spine. The DISH patients with more bony bridging and small L1-L2 SDA may be more likely have thoracolumbar pain. Adjustment of sagittal alignment of the spine in the development of DISH may be of clinical importance.

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