Vaspin is a novel adipokine derived from visceral adipose tissue identified as a member of the serine protease inhibitor family that exerts insulin-sensitizing effects in obesity
[2]. Vaspin has protective effects on endothelial progenitors and anti-atherogenic properties
[3]. Evidence suggests that it could potentially ameliorate vascular complications from hyperglycemia in patients with T2D
[3]. However, knowledge of its role in regulating bone metabolism is limited but rapidly emerging.
3. Cross Talk between Adipokines and Bone
3.1. Transcriptional Factors That Modulate Adipocytes and Subsequent Effect on Osteoblastogenesis
The fate of differentiation of bone marrow MSCs, to either adipogenic or osteoblastogenic programs, plays an important role in the regulation of bone homeostasis
[54]. Studies confirmed that extracellular signaling proteins, including the adipocyte-specific peroxisome proliferator-activated receptor gamma (PPARγ) or myogenic osteoblast initiation (inhibition of PPARγ or activation of Runx2/osterix) transcription factors, can alter the differentiation of osteoblasts
[55][56][57]. Apart from Wnt1 signaling, several BMPs also stimulate osteogenesis
[58]. For example, activation of type1A BMP receptor (BMPR-1A) induces PPARγ expression and subsequent adipocyte differentiation
[59]. On the contrary, activation of the type IB BMP receptor (BMPR-IB) induces Runx2 expression and favors osteoblastogenesis
[60]. IGF1 along with insulin was reported to activate the signaling cascade of differentiation of MSCs to adipogenic or osteoblastogenic pathways in patients with obesity and diabetes
[61]. The crucial shift of MSC differentiation to adipogenic rather than osteogenic lineage is linked to reduced bone formation observed in both obese and diabetic patients. Of all factors, PPARγ remains the key driver of adipocyte differentiation by binding to the c-fos promoter of hematopoietic stem cells (HSCs), thereby abrogating myogenic and stimulating osteoclastogenic cascade. Consistent with these findings, selective deletion of osteoclastogenic PPARγ has been found to increase bone volume from reduced bone resorption
[62]. In addition, the collagen composition of the bone matrix is also believed to have an influence on MSC differentiation to myogenic lineage. This was confirmed by a study of cultured MSCs on denatured collagen which resulted in the promotion of adipogenesis
[63]. Thus, as illustrated in
Figure 1, a shift in MSC differentiation to adipogenesis may be linked to PPARγ and other transcriptional factors leading to excessive or abnormal bone resorption. The cross-talk between bone forming osteoblasts and osteoclasts, can be decoupled by number of pro-adipogenic factors leading to disruption of normal homeostasis of bone. This tight regulation might be lost/enhanced by the several adipokine derivatives that can activate osteoclastogenesis in PPARγ-dependent manner.
Figure 1. Cross-talk between different Adipocyte derived factors and bone. The above figure illustrates PPARγ inhibition or activation along with adipocyte-derived adipokines can alter or disrupt the communication between osteoblasts and osteoclasts. Adipokines; omentin visfatin and resistin enhance osteoblast differentiation and inhibit osteoclast formation. On the contrary, adipokines; leptin, chemerin, and adiponectin abrogate osteoblast formation and, thus, resulting in alterations in the homeostasis of bone
[60][61][62].
3.2. Role of Adipokine Machinery on Osteoblast Differentiation and Bone Resorption
Apart from adipocyte differentiation, in the presence of PPARγ, the release of signaling proteins NFAT2/RANKL/Cathepsin can also affect bone homeostasis
[64]. Adiponectin, the primary adipokine, has been reported to have a direct negative effect on MSC osteoblastogenesis
[65]. Recently, this finding was supported by a study in aging and postmenopausal women have confirmed an inverse relationship between serum adiponectin levels and BMD
[66]. On the contrary, the mode of action of Leptin remains unclear, whereas, in some studies, leptin acts directly on precursor cells to promote osteoblast differentiation and proliferation but in some studies, leptin was linked to reduced bone mass
[67][68][69]. Chemerin, a novel adipokine with its receptor CMKLR1, has direct interaction with PPARc and promotes MSC adipogenesis
[70]. In some other studies, simultaneous knock-out studies of CMKLR1, increased osteoblastogenesis by upregulation of osterix and suppressed osteoclast differentiation
[71][72][73], but overall, the role of chemerin in relation to bone homeostasis remains unclear.
Similarly, as demonstrated in
Figure 2, vaspin interacts with Grp78 a glucose-regulated protein, to induce intracellular signaling (PI3K/AMPK pathway) in vascular smooth muscle cells that not only improves glucose tolerance and insulin sensitivity but also enhance osteoblastogenesis in rats.
[74]. Novel adipokines of apelin with receptor APJ
[75], (angiotensin II receptor like-1), vaspin, and nesfatin-1, when bound to G-protein, coupled receptors (GPCRs) and cannabinoid receptors (CR), are known to maintain glucose tolerance
[76][77] Additionally, in some studies of obesity, vaspin levels are low along with suppression of leptin and TNF-α synthesis
[78].
Figure 2. Illustrates the role of Novel adipokines role in bone metabolism. Apelin, vaspin, and Nesfatin when bound to receptors of APJ, Grp78, and Cannabinoid receptors (CR) activate Pi3k -Akt pathway and Ras pathway for subsequent osteoblast survival and RUNX2/Osterix pathway leading to bone formation. On the other hand, lipocalin (LCN2) binds to the MC4R receptor complex on OCPs, inducing the p38 MAP kinase pathway, then binds to Sp1 sites on the RANK promoter, activating RANK expression. This in turn favors osteoclast formation and bone resorption. Thus, novel adipokines mediating the crosstalk between osteoblast and osteoclast add on a new mechanism by which Osteoblast can control bone resorption
[65][66][68][69].
However, like other adipokines, the overall functional aspect of vaspin is unknown. On the other hand, LCN2 is a glycoprotein binding to the MC4R receptor and is involved in iron homeostasis. LCN2 is abundantly expressed in WAT and is induced by inflammatory stimuli by activation of NF-Kb
[79]. Serum concentrations of this protein are positively associated with adiposity, insulin resistance hyperglycemia, insulin resistance, and CRP levels
[80]. LCN2 binds to MC4R to initiate the p38-MAPK pathway and results in the activation of osteoclast precursors
[81]. Even though most of the adipokines initiate osteoblast activation and subsequent bone formation, the perspective and role of various novel adipokines on bone metabolism need to be re-examined to better understand the pathophysiology of bone.