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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 2

Ablation of proliferating 3.6Col1a1-lineage cells for 5 days after fracture depletes callus osteoblasts and chondrocytes and alters callus composition.

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Ablation of proliferating 3.6Col1a1-lineage cells for 5 days after fract...
(A) After femur fracture at 12 weeks of age, Col1-TK mice were treated with water (Control, n = 3) or GCV (Exptl, n = 3) for 5 days. Cells isolated from whole-fracture callus were subjected to scRNA-seq. (B) UMAP plot of total callus cells with annotated cell cluster identities based on canonical gene expression and bioinformatic analysis. (C) Mesenchymal cells were selected in silico and reclustered. (D) Expression of representative differentially expressed genes for each of 9 clusters projected on UMAPs and displayed as violin plots. (E) Mesenchymal cells were identified by treatment group, and the percentage of cells in each cluster was quantified (n = 3). (F) Histological sections of callus at 5 DPF from Control (n = 8; WT + GCV, or Col1-TK + water) and Exptl (n = 5; Col1-TK + GCV) were stained with Picrosirius red and Alcian blue (PSRAB) and used to determine total callus area, and percentage area of woven bone (red), cartilage (blue), fibrous (F)/other tissue, and periosteum. (G) High-power fields (from F) of TK IHC of Control (Col1-TK + water) and Experimental (Col1-TK + GCV) mice (white dashed line, callus periphery; green dashed line, woven bone area; Mu, muscle; Cg, cartilage; Ct, cortical bone; WoB, woven bone). Statistical differences were determined by 2-way ANOVA with Holm-Šidák post hoc test (E) or 2-tailed t test (F); *P < 0.05, **P < 0.01, ****P < 0.0001. Scale bars: PSRAB, 0.5 mm; TK, 1 mm.

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