Sari L. Alatalo

Tartrate-resistant acid phosphatase 5b : A novel serum marker of bone resorption

Human serum contains two forms of tartrate‐resistant acid phosphatase (TRAP), 5a and 5b. Of these, 5a contains sialic acid and 5b does not. We show here that antigenic properties and pH optimum of TRAP purified from human osteoclasts are identical to those of serum TRAP 5b and completely different from those of serum TRAP 5a, suggesting that 5b would be derived from osteoclasts and 5a from some other source. We developed a novel immunoassay specific for 5b using a monoclonal antibody O1A as capture antibody. O1A did not bind acid phosphatase derived from platelets and erythrocytes. Western analysis showed that O1A was specific for TRAP in both human bone and serum. We measured bound TRAP activity at pH 6.1, where 5b is highly active and 5a almost completely inactive. The immunoassay detected more than 90% of the initial TRAP 5b activity after 8‐h incubation of serum samples at 25°C and after 3 days incubation at 4°C. Serum TRAP 5b activity decreased significantly after 6 months of hormone replacement therapy (HRT) of postmenopausal women compared with the change observed in postmenopausal women receiving placebo (p < 0.0001). Instead, no significant differences were observed between the changes in the placebo and HRT groups in total serum TRAP amount. These results show that serum TRAP 5b is a specific and sensitive marker for monitoring antiresorptive treatment. Instead, total serum TRAP cannot be used for that purpose. These findings may turn out to be a significant improvement in using serum TRAP as a resorption marker.

Biochemical Markers of Bone Metabolism and Prediction of Fracture in Elderly Women

We studied the ability of various markers of bone turnover to predict fracture in 1040 randomly recruited 75‐year‐old women. A total of 178 of the women sustained at least one fracture during follow‐up (mean, 4.6 years). In elderly women, TRACP5b and urinary fragments of osteocalcin are promising new markers for prediction of fracture, in particular, vertebral fracture.

Intracellular Machinery for Matrix Degradation in Bone-Resorbing Osteoclasts†

In osteoclasts, TRACP co‐localized with cathepsin K in transcytotic vesicles and was activated by cathepsin K in vitro, suggesting that TRACP may degrade organic matrix components in transcytotic vesicles in an event regulated by cathepsin K.

Serum tartrate-resistant acid phosphatase 5b, but not 5a, correlates with other markers of bone turnover and bone mineral density.

Human serum contains two isoforms of tartrate-resistant acid phosphatase (TRACP) known as TRACP 5a and TRACP 5b with pH optima of 5.0 and 5.8, respectively. Preliminary data suggest that serum TRACP 5b is derived from osteoclasts and serum TRACP 5a from some other cells. It has been reported that heparin inhibits TRACP 5a but has no effect on the activity of TRACP 5b. Here we show that heparin has no effect on serum TRACP activity, as determined using our previously published immunoassay, suggesting that the immunoassay does not detect TRACP 5a. The change of serum TRACP 5b activity after 6 months HRT, determined by this immunoassay, correlated significantly with the changes of all markers of bone turnover determined, including serum N- and C-terminal propeptides of type I collagen and urinary-free deoxypyridinoline. Serum TRACP 5b activity was significantly elevated in patients with osteoporosis and had a significant negative correlation with bone mineral density (BMD). Serum TRACP 5a activity, determined by an immunoassay, showed no correlation with serum TRACP 5b activity, with BMD, or with any of the markers of bone turnover. These results show that serum TRACP 5b, but not 5a, reflects the bone resorption rate, and that our TRACP 5b immunoassay may be a specific method for the determination of the bone resorption rate from serum samples.

Serum TRACP 5b is a useful marker for monitoring alendronate treatment: comparison with other markers of bone turnover

We studied clinical performance of serum TRACP 5b and other bone turnover markers, including S‐CTX, U‐DPD, S‐PINP, S‐BALP, and S‐OC, for monitoring alendronate treatment. TRACP 5b had higher clinical sensitivity, area under the ROC curve, and signal‐to‐noise ratio than the other markers.

Two Different Pathways for the Maintenance of Trabecular Bone in Adult Male Mice

Androgens may regulate the male skeleton either directly via activation of the androgen receptor (AR) or indirectly via aromatization of androgens into estrogen and, thereafter, via activation of estrogen receptors (ERs). There are two known estrogen receptors, ER‐α and ER‐β. The aim of this study was to investigate the relative roles of ER‐α, ER‐β, and AR in the maintenance of trabecular bone in male mice. Seven‐month‐old male mice, lacking ER‐α (ERKO), ER‐β (BERKO), or both receptors (DERKO), were orchidectomized (orx) and treated for 3 weeks with 0.7 μg/mouse per day of 17β‐estradiol or vehicle. No reduction in trabecular bone mineral density (BMD) was seen in ERKO, BERKO, or DERKO mice before orx, showing that neither ER‐α nor ER‐β is required for the maintenance of a normal trabecular BMD in male mice. After orx, there was a pronounced decrease in trabecular BMD, similar for all groups, resulting in equal levels of trabecular BMD in all genotypes. This reduction was reversed completely in wild‐type (WT) and BERKO mice treated with estrogen, and no significant effect of estrogen was found in ERKO or DERKO mice. In summary, the trabecular bone is preserved both by a testicular factor, presumably testosterone acting via AR and by an estrogen‐induced activation of ER‐α. These results indicate that AR and ER‐α are redundant in the maintenance of the trabecular bone in male mice. In contrast, ER‐β is of no importance for the regulation of trabecular bone in male mice.

Properties and expression of human tartrate-resistant acid phosphatase isoform 5a by monocyte-derived cells

Human serum tartrate‐resistant acid phosphatase exists as two enzyme isoforms (TRACP 5a and 5b), derived by differential, post‐translational processing of a common gene product. Serum TRACP 5b is from bone‐resorbing osteoclasts (OC) and becomes elevated in diseases of increased bone resorption. TRACP 5a is secreted by macrophages (MΦ) and dendritic cells (DC) and is increased in many patients with rheumatoid arthritis. Our purpose was to fully characterize the properties of human TRACP isoforms and to produce an antibody specific to TRACP 5a for use as a biomarker in chronic inflammatory diseases. Partially purified, natural serum TRACP isoforms and recombinant TRACP 5a (rTRACP 5a) were compared with respect to specific activity and subunit structure and presence of sialic acid. Mice were immunized with rTRACP 5a, and resulting hybridomas were screened for monoclonal antibody to serum TRACP 5a. One antibody, 220, was tested for its epitope specificity and use in various immunological techniques. rTRACP 5a had properties identical to serum TRACP 5a. Antibody 220 was specific for the trypsin‐sensitive epitope in the loop peptide, present only in TRACP 5a. Antibody 220 was effective for specific immunoprecipitation, immunoassay, and immunoblot of TRACP 5a. Intact TRACP was present in MΦ, DC, and OC. TRACP 5a was the predominant isoform secreted by MΦ and DC, whereas TRACP 5b was the predominant isoform secreted by OC. TRACP isoforms 5a and 5b may have different functions inside and outside of monocyte‐derived cells. Antibody 220 is an important resource for studies of the biosynthetic relationship among TRACP isoforms and of the significance of serum TRACP 5a as a marker in diseases of bone metabolism and inflammation.

Potential function for the ROS-generating activity of TRACP.

TRACP is an enzyme with unknown biological function. It is expressed primarily in bone‐resorbing osteoclasts and activated macrophages. In addition to its phosphatase activity, TRACP is capable of generating reactive oxygen species (ROS). In resorbing osteoclasts, TRACP is localized in transcytotic vesicles transporting bone matrix degradation products from the resorption lacuna to a functional secretory domain in the basolateral membrane. ROS generated by TRACP are capable of destroying organic bone matrix components, suggesting that they may be targeted to further destroy initial matrix degradation products in the transcytotic vesicles. The transcytotic route of osteoclasts is analogous with the antigen presentation route of macrophages transporting endocytosed foreign material into cell surface for presentation to other cells of the immune system. Macrophages overexpressing TRACP have elevated levels of intracellular ROS. In alveolar macrophages, TRACP is colocalized with endocytosed Staphylococcus aureus, a pathogen whose clearance is reduced in TRACP‐deficient mice, suggesting that ROS generated by TRACP may be targeted to destroy foreign material in the antigen presentation route of macrophages. These data suggest that the ROS generating activity of TRACP may have an important role both in bone resorption and in the immune defense system.

A Novel Immunoassay for The Determination of Tartrate-Resistant Acid Phosphatase 5b From Rat Serum

Osteoclasts secrete tartrate‐resistant acid phosphatase 5b (TRACP 5b) into the circulation. We have developed an immunoassay for the determination of rat TRACP 5b activity. Intra‐assay variation of the immunoassay was 4.5%, interassay variation was 3.8%, dilution linearity was 104.6 ± 7.6%, and recovery of recombinant rat TRACP was 99.1 ± 5.8%. We studied serum TRACP 5b as a marker of bone resorption using orchidectomized (ORC) rats as a model for osteoporosis and age‐matched sham‐operated rats as controls in a 6‐month study. After the operation, trabecular bone mineral density decreased significantly more in the ORC group than in the sham group, whereas cortical bone mineral density increased similarly in both groups. Serum TRACP 5b activity was significantly elevated within the first week after ORC, returned to the control level in the third week, and was not increased above the sham level at any of the later time points. At 6 months, trabecular bone volume was 80% lower in ORC rats than in controls. Osteoclast number per trabecular bone perimeter was slightly increased, but the absolute number of osteoclasts in trabecular bone was significantly decreased. These results suggest that absolute bone resorption is increased within the first week after ORC. Later, it is decreased because there is less bone to be resorbed. However, relative bone resorption (compared with the amount of remaining bone) is still increased, leading to further bone loss. We conclude that serum TRACP 5b is a useful marker for monitoring changes in the bone resorption rate in rat ORC model.

Does Combined Gastrectomy and Ovariectomy Induce Greater Osteopenia in Young Female Rats Than Gastrectomy Alone

Osteopenia develops in experimental animals following surgical removal of the ovaries (ovariectomy. Ovx) or the stomach (gastrectomy, Gx). Though the effect of Ovx has been ascribed to estrogen deficiency, the mechanism behind the Gx-evoked osteopenia remains unknown. In order to compare Gx- and Ovx-evoked osteopenia, young female rats were subjected to Ovx, gx, the combination of ovx and Gx, or sham operation (SHAM). Serum osteoclast-derived tartrate-resistant acid phosphatase 5b was measured as an index of bone resorption, and serum osteocalcin as an index of bone formation/turnover. Bone resorption predominated over bone formation during the first 4 days after Ovx but not later. Bone resorption predominated over bone formation throughout the first 4-week period after Gx. the changes were not additive in the ovx+Gx group. Transillumination and histomorphometry of the calvariae revealed extensive osteopenia in the Gx and the Ovx+Gx groups but not in the Ovx group. Peripheral quantitative computerized tomography of the femur metaphysis showed a decrease in the trabecular bone mineral density (BMD) in all three groups although Ovx+Gx seemed to induce greater trabecular bone loss than Gx alone. However, dual energy X-ray absorptiometry (DXA) of the intact femurs revealed reduced bone mineral content (BMC) in the Gx and Ovx+Gx groups but not in the Ovx group. Indeed, cortical bone was impaired by Gx and Ovx+Gx but not by Ovx. Hence, it seems clear that the Gx-evoked osteopenia differs from that induced by Ovx but that the osteopenia induced by Ovx+Gx is only marginally greater than that induced by Gx alone.