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Fracture healing requires proliferation of callus cells at early and mature stages of osteoblast differentiation
Nicole R. Gould, Andre F. Coello, Jennifer A. McKenzie, Mariam Obaji, Tiandao Li, Katherine R. Hixon, Leyi Chen, Kristen Barwick, Tiffany Lee, Bo Zhang, David Ornitz, Matthew J. Silva
Nicole R. Gould, Andre F. Coello, Jennifer A. McKenzie, Mariam Obaji, Tiandao Li, Katherine R. Hixon, Leyi Chen, Kristen Barwick, Tiffany Lee, Bo Zhang, David Ornitz, Matthew J. Silva
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Research Article Bone biology Cell biology

Fracture healing requires proliferation of callus cells at early and mature stages of osteoblast differentiation

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Abstract

Fractures heal by rapid formation of mineralized callus, a process requiring periosteal cell proliferation and differentiation. Our objective was to dissect the contribution of proliferating osteoblast-lineage cells to fracture callus formation. First, mice expressing thymidine kinase (TK) in 3.6Col1a1-lineage cells were treated with ganciclovir (GCV) to ablate proliferating osteolineage cells for 5 or 10 days. Immunostaining demonstrated that this approach specifically depleted TK+ proliferating cells in the bony regions of the callus, while sparing other proliferating cells. Single-cell RNA-seq of callus cells revealed that GCV-treated Col1-TK mice had fewer osteoblasts and chondrocytes than controls, with more myofibroblasts and immune cells, consistent with fibrous nonunion. In controls, 15%–30% of callus cells expressing the early osteoblast marker Osterix (Osx, Sp7) and the late marker osteocalcin (Ocn, Bglap) were in the cell cycle. Next, we targeted proliferating osteolineage cells at different stages of differentiation by crossing Osx-CreERT2, Ocn-Cre, and Dmp1-CreERT2 mice with ROSA-TK mice. Following fracture, each Cre ROSA-TK mouse line exhibited decreased callus bone volume and a shift from callus bone to fibrous tissue. Therefore, during fracture repair, proliferation of callus cells at early and mature stages of osteoblast differentiation is critical to the formation of a mineralized callus that is essential for healing.

Authors

Nicole R. Gould, Andre F. Coello, Jennifer A. McKenzie, Mariam Obaji, Tiandao Li, Katherine R. Hixon, Leyi Chen, Kristen Barwick, Tiffany Lee, Bo Zhang, David Ornitz, Matthew J. Silva

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Figure 4

Ablation of proliferating Osterix-expressing cells during fracture healing impairs callus bridging and mineralization.

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Ablation of proliferating Osterix-expressing cells during fracture heali...
(A) Mice were treated with TMX starting at 10 weeks of age, followed by femur fracture at 12 weeks, followed by 2 weeks GCV treatment. Healing was assessed at 14 DPF. Genotype controls were mice lacking either Osx-CreERT2 (Cre–) or ROSA-TK (TK–) alleles; experimental mice had both alleles (Cre+TK+) (n = 6). (B) TK+ mice were treated with GCV (Cre–) or water (Cre+) for TK IHC, which shows robust TK expression in callus woven bone only in Cre+ mice (green dashed line, callus periphery; WoB, woven bone; Mu, muscle). (C) Left: Representative radiographs. Right: Quantification of radiographic healing. (D) Histological analysis of PSRAB-stained sections to assess callus size and composition. (E) Callus bone volume was quantified by micro-CT. Statistical differences were determined by χ2 test (C) or by 2-way ANOVA with Holm-Šidák post hoc test (D and E). *P < 0.05, **P < 0.01, ***P < 0.001. Groups with different letters are significantly different (P < 0.05). Scale bars: TK, 0.25 mm; PSRAB, 1 mm; micro-CT, 1 mm.

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