Sclerostin
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Sclerostin | |||||||||
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Identifiers | |||||||||
Symbol | Sclerostin | ||||||||
Pfam | PF05463 | ||||||||
InterPro | IPR008835 | ||||||||
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Sclerostin is a protein that in humans is encoded by the SOST gene.[2][3]
Sclerostin is a secreted glycoprotein with a C-terminal cysteine knot-like (CTCK) domain and sequence similarity to the DAN (differential screening-selected gene aberrative in neuroblastoma) family of bone morphogenetic protein (BMP) antagonists. Sclerostin is produced by the osteocyte and has anti-anabolic effects on bone formation.[4]
Contents
Structure
The sclerostin protein, with a length of 213 residues, has a dssp secondary structure that is 28% beta sheet (6 strands; 32 residues).[1]
Function
Sclerostin, the product of the SOST gene, located on chromosome 17q12–q21 in humans,[5] was originally believed to be a non-classical bone morphogenetic protein (BMP) antagonist.[6] More recently sclerostin has been identified as binding to LRP5/6 receptors and inhibiting the Wnt signaling pathway.[7][8] The inhibition of the Wnt pathway leads to decreased bone formation.[7] Although the underlying mechanisms are unclear, it is believed that the antagonism of BMP-induced bone formation by sclerostin is mediated by Wnt signaling, but not BMP signaling pathways.[9][10] Sclerostin is expressed in osteocytes and some chondrocytes and it inhibits bone formation by osteoblasts.[11][12][13]
Sclerostin production by osteocytes is inhibited by parathyroid hormone,[13][14] mechanical loading[15] and cytokines including prostaglandin E2,[16] oncostatin M, cardiotrophin-1 and leukemia inhibitory factor.[17] Sclerostin production is increased by calcitonin.[18] Thus, osteoblast activity is self regulated by a negative feedback system.[19]
Clinical significance
Mutations in the gene sclerostin are associated with disorders associated with high bone mass, sclerosteosis and van Buchem disease.[5] Sclerosteosis is an autosomal recessive disorder characterized by bone overgrowth. It was first described in 1958[20][21] but given the current name in 1967.[22] Excessive bone formation is most prominent in the skull, mandible and tubular bones.[20] It can cause facial distortion and syndactyly.[20] Increased intracranial pressure can cause sudden death in patients.[20] It is a rare disorder that is most prominent in the Afrikaner population in South Africa (40 patients), but there have also been cases of American and Brazilian families.[20]
van Buchem disease is also an autosomal recessive skeletal disease characterized by bone overgrowth.[22] It was first described in 1955 as "hyperostosis corticalis generalisata familiaris", but was given the current name in 1968.[22][23] Excessive bone formation is most prominent in the skull, mandible, clavicle, ribs and diaphyses of long bones and bone formation occurs throughout life.[22] It is a very rare condition with about 30 known cases in 2002.[22] In 1967 van Buchem characterized the disease in 15 patients of Dutch origin.[22] Patients with sclerosteosis are distinguished from those with van Buchem disease because they are often taller and have hand malformations.[20]
An antibody for sclerostin is being developed because of the protein’s specificity to bone.[11] Its use has increased bone growth in preclinical trials in osteoporotic rats and monkeys.[24][25] In a Phase I study, a single dose of anti-sclerostin antibody from Amgen (Romosozumab) increased bone density in the hip and spine in healthy men and postmenopausal women and the drug was well tolerated.[26] In a Phase II trial, one year of the antibody treatment in osteoporotic women increased bone density more than bisphosphonate and teriparatide treatment; it had mild injection side effects.[12][27] A Phase II trial of a monoclonal human antibody to sclerostin from Eli Lilly had positive effects on post-menopausal women. Monthly treatments of the antibody for one year increased the bone mineral density of the spine and hip by 18 percent and 6 percent, respectively, compared to the placebo group.[28]
The Amgen drug is expected to be on the market in 2017 and is predicted to be the gold standard in osteoporosis treatment by 2021.[29] In addition, OsteoGeneX is developing small molecule inhibitors of sclerostin.[30]
References
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Further reading
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External links
- ↑ 1.0 1.1 PDB: 2KD3; Lua error in package.lua at line 80: module 'strict' not found.
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- ↑ http://users.telenet.be/zeldzame.ziekten/List.o/Pmenoposteo.htm
- ↑ 20.0 20.1 20.2 20.3 20.4 20.5 Lua error in package.lua at line 80: module 'strict' not found.
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