Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption

Aims: The physiological function of sclerostin remains unknown. Sclerostin is synthesized by osteocytes and operates by inhibiting the Wnt/β-catenin pathway. Similarly, it is well established that low levels of sclerostin lead to enhanced bone formation and reduced calciuria, and that high levels o...

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Main Authors: María Encarnacion Rodríguez-Ortiz, Juan Miguel Díaz-Tocados, Ana Isabel Torralbo, Karen Valdés-Díaz, Antonio Rivas-Domínguez, Fátima Guerrero, Irene Reina-Alfonso, Manuel Naves-Díaz, Cristina Alonso-Montes, Cristian Rodelo-Haad, Mariano Rodríguez, Juan Rafael Muñoz-Castañeda, IMIBIC Nephrology Group
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2025-05-01
Series:Bone & Joint Research
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Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.145.BJR-2024-0227.R1
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author María Encarnacion Rodríguez-Ortiz
Juan Miguel Díaz-Tocados
Ana Isabel Torralbo
Karen Valdés-Díaz
Antonio Rivas-Domínguez
Fátima Guerrero
Irene Reina-Alfonso
Manuel Naves-Díaz
Cristina Alonso-Montes
Cristian Rodelo-Haad
Mariano Rodríguez
Juan Rafael Muñoz-Castañeda
IMIBIC Nephrology Group
author_facet María Encarnacion Rodríguez-Ortiz
Juan Miguel Díaz-Tocados
Ana Isabel Torralbo
Karen Valdés-Díaz
Antonio Rivas-Domínguez
Fátima Guerrero
Irene Reina-Alfonso
Manuel Naves-Díaz
Cristina Alonso-Montes
Cristian Rodelo-Haad
Mariano Rodríguez
Juan Rafael Muñoz-Castañeda
IMIBIC Nephrology Group
author_sort María Encarnacion Rodríguez-Ortiz
collection DOAJ
description Aims: The physiological function of sclerostin remains unknown. Sclerostin is synthesized by osteocytes and operates by inhibiting the Wnt/β-catenin pathway. Similarly, it is well established that low levels of sclerostin lead to enhanced bone formation and reduced calciuria, and that high levels of sclerostin are associated with osteoporosis. Methods: The impact of high levels of recombinant sclerostin on bone and mineral metabolism parameters was analyzed in this study. In male healthy rats, the effects of three elevated doses of sclerostin over a 14-day period were studied, involving bone histomorphometry, micro-CT (μCT), immunohistochemistry, and analysis of mineral metabolism parameters. Results: Although there was increased bone formation, high doses of sclerostin led to a higher reduction in trabecular bone volume due to a significant increase in bone resorption through the direct activation of osteoclastogenesis. In vitro, sclerostin promoted the differentiation of bone marrow stem cells into osteoclasts. Bone resorption, as measured by tartrate-resistant acid phosphatase (TRAP) activity, was excessive in trabecular, cortical, and subchondral bone. Similarly, high doses of sclerostin increased the number of hypertrophic chondrocytes, consequently expanding the growth plate area. At the cortical level, positive TRAP staining could be observed, suggestive of osteocytic osteolysis and trabecularization of cortical bone. The increased bone resorption resulted in a substantial rise in the urinary excretion of phosphorus and calcium, accompanied by elevated levels of FGF23 and a significant decrease in parathyroid hormone (PTH). Conclusion: These findings suggest that elevated levels of sclerostin promote bone resorption through the activation of osteoclasts and the generation of osteocytic osteolysis, resulting in increased calciuria, phosphaturia, and changes in mineral metabolism. Cite this article: Bone Joint Res 2025;14(5):448–462.
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spelling doaj-art-cf03f0b805484da1a9d32cd11705a3142025-08-20T03:46:00ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582025-05-0114544846210.1302/2046-3758.145.BJR-2024-0227.R1Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruptionMaría Encarnacion Rodríguez-Ortiz0Juan Miguel Díaz-Tocados1Ana Isabel Torralbo2Karen Valdés-Díaz3Antonio Rivas-Domínguez4Fátima Guerrero5Irene Reina-Alfonso6Manuel Naves-Díaz7Cristina Alonso-Montes8Cristian Rodelo-Haad9Mariano Rodríguez10Juan Rafael Muñoz-Castañeda11IMIBIC Nephrology Group Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Córdoba, Spain Health Results-Oriented Cooperative Research Network RICORS2040 (Kidney Disease), Institute of Health Carlos III, Madrid, Spain Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofia, University of Cordoba, Córdoba, Spain Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofia, University of Cordoba, Córdoba, Spain Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofia, University of Cordoba, Córdoba, Spain Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofia, University of Cordoba, Córdoba, Spain Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofia, University of Cordoba, Córdoba, Spain Health Results-Oriented Cooperative Research Network RICORS2040 (Kidney Disease), Institute of Health Carlos III, Madrid, Spain Health Results-Oriented Cooperative Research Network RICORS2040 (Kidney Disease), Institute of Health Carlos III, Madrid, Spain Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Córdoba, Spain Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Córdoba, Spain Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Córdoba, Spain Aims: The physiological function of sclerostin remains unknown. Sclerostin is synthesized by osteocytes and operates by inhibiting the Wnt/β-catenin pathway. Similarly, it is well established that low levels of sclerostin lead to enhanced bone formation and reduced calciuria, and that high levels of sclerostin are associated with osteoporosis. Methods: The impact of high levels of recombinant sclerostin on bone and mineral metabolism parameters was analyzed in this study. In male healthy rats, the effects of three elevated doses of sclerostin over a 14-day period were studied, involving bone histomorphometry, micro-CT (μCT), immunohistochemistry, and analysis of mineral metabolism parameters. Results: Although there was increased bone formation, high doses of sclerostin led to a higher reduction in trabecular bone volume due to a significant increase in bone resorption through the direct activation of osteoclastogenesis. In vitro, sclerostin promoted the differentiation of bone marrow stem cells into osteoclasts. Bone resorption, as measured by tartrate-resistant acid phosphatase (TRAP) activity, was excessive in trabecular, cortical, and subchondral bone. Similarly, high doses of sclerostin increased the number of hypertrophic chondrocytes, consequently expanding the growth plate area. At the cortical level, positive TRAP staining could be observed, suggestive of osteocytic osteolysis and trabecularization of cortical bone. The increased bone resorption resulted in a substantial rise in the urinary excretion of phosphorus and calcium, accompanied by elevated levels of FGF23 and a significant decrease in parathyroid hormone (PTH). Conclusion: These findings suggest that elevated levels of sclerostin promote bone resorption through the activation of osteoclasts and the generation of osteocytic osteolysis, resulting in increased calciuria, phosphaturia, and changes in mineral metabolism. Cite this article: Bone Joint Res 2025;14(5):448–462.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.145.BJR-2024-0227.R1sclerostinbone resorptionbone turnovermineral metabolismtrap activityrat modeltrap-stainingosteoclastscortical bonetrabecular bonechondrocytescalciumgrowth plateosteocytes
spellingShingle María Encarnacion Rodríguez-Ortiz
Juan Miguel Díaz-Tocados
Ana Isabel Torralbo
Karen Valdés-Díaz
Antonio Rivas-Domínguez
Fátima Guerrero
Irene Reina-Alfonso
Manuel Naves-Díaz
Cristina Alonso-Montes
Cristian Rodelo-Haad
Mariano Rodríguez
Juan Rafael Muñoz-Castañeda
IMIBIC Nephrology Group
Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
Bone & Joint Research
sclerostin
bone resorption
bone turnover
mineral metabolism
trap activity
rat model
trap-staining
osteoclasts
cortical bone
trabecular bone
chondrocytes
calcium
growth plate
osteocytes
title Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
title_full Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
title_fullStr Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
title_full_unstemmed Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
title_short Impact of elevated sclerostin levels on bone resorption: unravelling structural changes and mineral metabolism disruption
title_sort impact of elevated sclerostin levels on bone resorption unravelling structural changes and mineral metabolism disruption
topic sclerostin
bone resorption
bone turnover
mineral metabolism
trap activity
rat model
trap-staining
osteoclasts
cortical bone
trabecular bone
chondrocytes
calcium
growth plate
osteocytes
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.145.BJR-2024-0227.R1
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