2. Results
2.1. Cytotoxicity of Cu2+ towards PBMC and Osteoclasts
Osteoclasts are more sensitive to Cu
2+ than mesenchymal stroma cells, which tolerate Cu
2+ concentrations up to 250 µM without any decrease in cell number [
11]. To ensure, that the investigations on osteoclast formation and functionality will be performed in a non-cytotoxic range, viability studies with PBMC and mature osteoclasts were conducted () PBMC showed significant loss of viability at Cu
2+ concentration of 12 µM and above. In the presence of 30 µM Cu
2+ the number of viable cells was reduced to 20.3 +/− 3.6%. Interestingly, mature osteoclasts tolerated Cu
2+ much better. Only at Cu
2+ concentrations of 20 µM and above a significantly reduced number of viable cells were detected and with 30 µM the number of viable cells was 43.9 +/−9.3 % (). The following investigations were performed with Cu
2+ in concentrations between 0 and 8 µM.
Figure 1. Cell viability of human PBMC and mature human osteoclasts after treatment with Cu2+. Luminescence-based CellTiterGlo® assay was used to determine the ATP content, which correlates with the number of metabolically active cells. Cells of two donors with each n = 3 (n = 6 in total per group) were included into the experiments. Statistic differences were calculated by one-way ANOVA, followed by Tukey’s test for multiple comparisons * p < 0.05, *** p < 0.001, ****p < 0.0001.
2.2. Effect of Cu2+ on Osteoclast Number and Activity of Osteoclast-Specific Enzymes
PBMC were differentiated under stimulation with M-CSF and RANKL to osteoclasts in the presence of 4 and 8 µM Cu2+. Multinucleated TRAP positive cells were formed in all groups () however with increasing copper concentration the number of osteoclasts decreased significantly (A). As already found in our preliminary investigations, activity of TRAP significantly increased in the presence of Cu2+ (B), while the activities of cathepsin K and CAII activity remained on the same level (C,D).
Figure 2. Osteoclasts were differentiated from PBMC for 14 days in the presence of MCSF and RANKL and without Cu2+ (control) as well as under the addition of 4 and 8 µM Cu2+, light microscopy after staining of TRAP (pink) and nuclei (blue), scale bars represent 100 µm.
Figure 3. (A) Number of multinucleated TRAP positive osteoclasts differentiated from human PBMC after 14 days of cultivation, counted from light microscopic images (cells of two donors, xx images per condition) Statistic differences were calculated by one-way ANOVA, followed by Tukey’s test for multiple comparisons (B) TRAP activity, (C) CTSK activity and (D) CAII activity of osteoclasts differentiated from human PBMC after 14 days of cultivation. Data of 7 different donors (each n = 5) were included into the calculation. (n = 35 in total). Statistical differences were calculated using Kruskal Wallis Test **** p < 0.0001.
2.3. Effects of Cu2+ on Gene Expression of Osteoclast Markers
Gene expression of osteoclast markers ACP5 (TRAP), CTSK and CAII was analyzed when osteoclasts were differentiated in the presence of MSCF/RANKL and Cu2+. While TRAP and CA2 expression were not affected by Cu2+, CTSK expression was slightly reduced in the presence of Cu2+ ().
Figure 4. Expression of osteoclast marker genes in PBMC derived osteoclasts after 14 days of differentiation. Fold changes were calculated by the ΔΔCT method and related to the samples without Cu2+. Samples of three different PBMC donors were used (each n = 3, n = 9 in total per group), mean ± upper/lower limit. Statistical differences were calculated from DCT values. ** p < 0.01.
Control values without addition of Cu
2+ displayed high variances between the cells of the three different donors (see
Supplemental Figure S1).
2.4. Effects of Cu2+ on Resorption
Resorption of dentin slices was not changed when osteoclasts were cultivated in the presence of Cu2+ (). Nevertheless, TRAP activity of the osteoclasts on dentin slices was again significantly higher in the presence of Cu2+ (data not shown).
Figure 5. Representative SEM images of resorption pits after 14 days cultivation of PBMC derived osteoclasts on dentine slices (
A,
D) control, (
B,
E) 8 µM Cu
2+, (
F,
G) without cells, scale bar represent 100 µm (
A–
C) and 20 µm (
D–
F). (
G) Open source Fiji software was used to calculate resorbed area of dentin slices (cells of two PBMC donors, 24 images per group). For details see
Supplemantary Figure S2. Mann-Whitney did not reveal significant differences between 0 and 8 µM Cu
2+.
In contrast, resorption of mineralized extracellular bone matrix was significantly reduced when osteoclasts were differentiated in the presence of Cu2+ ().
Figure 6. (a) Representative images of osteoblast-derived ECM after osteoclastic resorption in the presence of 6 µM Cu2+ compared to a copper-free control. SaOS-2 osteoblasts were cultivated for 4 weeks until a closed layer of mineralized extracellular matrix was formed in the dishes. After removal of the osteoblasts, PBMC (two donors, each n = 4 per group) were seeded and cultivated for 14 days under stimulation with M-CSF and RANKL with and without addition of Cu2+. After fixing with 4% formaldehyde, von Kossa staining was performed to stain the remaining mineralized matrix after osteoclastic resorption. Images were recorded with a Leica stereomicroscope and represent the whole area of a 48- well dish (12 mm diameter). (b) Resorbed area of all samples was calculated applying the open source software Fiji using the threshold function. Eight samples were imaged for each condition and shown as mean +/− standard deviation. Significant differences were calculated by two-tailed unpaired t-test with p < 0.001.
2.5. Effect of Cu2+ on Mature Osteoclasts
We were interested to find out, whether the TRAP activity increasing effect of Cu2+ was also detectable, when the ion was applied to cultures of already differentiated osteoclasts. Mature osteoclasts (after 10–11 days of differentiation) were detached from the surfaces, were the PBMC were originally seeded and further cultivated in the presence of MCSF, RANKL and Cu2+. Interestingly, the number of TRAP positive osteoclasts did not decrease in the presence of Cu2+ ( and A) Furthermore, no significant increase of TRAP activity was detected. ().
Figure 7. Osteoclasts were differentiated from PBMC for 10 days in the presence of MCSF and RANKL, detached and cultivated for further 4 days without Cu2+ (control) as well as under the addition of 4 and 8 µM Cu2+, light microscopy after staining of TRAP (pink) and nuclei (blue), scale bars represent 100 µm.
Figure 8. (A) Number of multinucleated TRAP positive osteoclasts counted from light microscopic images (cells of two donors, 4 images per condition) Statistic differences were calculated by one-way ANOVA, followed by Tukey’s test for multiple comparisons (B) TRAP activity and (C) CTSK activity of mature osteoclasts cultivated in the presence of 0, 4 and 8 µM Cu2+. Data of four different donors were included into the calculation with each n = 3 replicates per group (average +/− standard deviation). TRAP and CTSK activities were normalized to the copper free control, since the enzyme activity levels between the different donors showed high variances. Statistical significant differences were calculated by one way ANOVA followed by Tukey’s test to perform multiple comparisons. * p < 0.05 compared to the control.
Resorption of osteoblast mineral matrix by mature osteoblasts was not changed in the presence of Cu2+ ().
Figure 9. (a) Representative images of osteoblast-derived ECM after osteoclastic resorption in the presence of 8 µM Cu2+ compared to a copper-free control. SaOS-2 osteoblasts were cultivated for 4 weeks until a closed layer of mineralized extracellular matrix was formed in the dishes. After removal of the osteoblasts, mature osteoclasts, detached from suspension dishes (two donors, each n = 3 per group) were seeded and cultivated for 4 days under further stimulation with M-CSF and RANKL with and without addition of 8 µM Cu2+. After fixing with 4% formaldehyde, von Kossa staining was performed to stain the remaining mineralized matrix after osteoclastic resorption. Images were recorded with a Leica stereomicroscope and represent the whole area of a 48- well dish (12 mm diameter). (b) Resorbed area of all samples was calculated applying the open source software Fiji using the threshold function. Six samples were imaged for each condition and are shown as mean +/− standard deviation. Two-tailed unpaired t-test did not show significant differences between 0 and 8 µM Cu2+.
2.6. Effect of Cu2+ on Glutathione Levels
The following experiments were performed to find out, whether oxidative stress, which was induced due to the presence of Cu2+ might be in correlation to the increased TRAP activity. For this reason both differentiating PBMC and already differentiated mature osteoclasts were treated again with 4 and 8 µM Cu2+ and the glutathione levels of the cells were determined using the monochlorbimane (MCB) assay ().
Figure 10. Glutathione levels of PBMC during osteoclastic differentiation (A) and of mature osteoclasts (B) in the presence of 4 and 8 µM Cu2+ compared to a copper-free control. Data of three different PBMC donors (each n = 3; n = 9 in total per group and time point) were included into the calculations. Statistically significant differences were calculated by 2-way ANOVA followed by Tukey’s multiple comparisons test * p < 0.05, ** p < 0.01, *** p < 0.001, **** p < 0.0001.
Glutathione levels of both osteoclasts and PBMC were significantly reduced in the presence of Cu2+. The highest reduction was detected for PBMC after one day of cultivation. This reduction cannot be attributed to the reduction in osteoclast number, since it was decreased only in differentiating osteoclasts (A) and stayed stable in mature osteoclasts in the presence of Cu2+ (A).
Interestingly, mature osteoclasts, which did not increase their TRAP activity in the presence of Cu2+, nevertheless showed a significant reduction of glutathione levels.
3. Discussion
The present study analyses the effect of Cu
2+ on the activity of osteoclast-specific enzymes, their gene expression and on osteoclastic resorption. Cytotoxicity studies revealed a higher sensitivity of PBMC compared to mature osteoclasts towards Cu
2+. Löffler and co-workers investigated the effect of metal ions on monocytes and macrophages. They postulated that macrophages might be better equipped against the destructive effects of metal ions, since they keep closer contact to metal ions during phagocytosis. Accordingly, Löffler et al. could show significantly higher metabolic activities of macrophages compared to monocytes at low Co
2+ concentrations (Cu
2+ was not included into this study) [
22]. Similar effects might be conceivable for monocytes and osteoclasts in the presence of the metal ion Cu
2+.
We demonstrated a significantly increased TRAP activity, when PBMC were differentiated into osteoclasts in the presence of 4 and 8 µM Cu
2+ and this effect was consistently found for PBMC of more than 15 different donors. In contrast, gene expression of TRAP (ACP5) as well as osteoclastic resorption was not increased in the presence of Cu
2+; resorption was even slightly inhibited by the ion. To rule out an influence of Cu
2+ on the fluorimetric TRAP assay, we tested the assay with cell lysates, which were obtained from PBCM derived osteoclasts and added 10 µM Cu
2+ directly to the assay. However, the TRAP activity was not increased in the presence of Cu
2+, it was even decreased to around 70% compared to samples without copper (data not shown). Furthermore, our results show that TRAP gene expression was not increased, when PBMC were differentiated into osteoclasts in the presence of 4 and 8 µM Cu
2+. There are not many investigations on the influence of Cu
2+ on osteoclastogenesis and osteoclastic resorption in the literature. As early as 1981 Wilson and co-workers cultivated mouse calvaria tissue in the presence and absence of Cu
2+ and showed a dose-dependent decrease of osteoclastic resorption [
23]. In 2002 Zhang et al. demonstrated an inhibition of resorption, when rabbit osteoclasts were cultivated on bone slices in the presence of 1 µM Cu
2+ [
24]. Finally, the group of Pamela Habibovic deposited different elements, including copper to calcium phosphate films in a biomimetic approach. They demonstrated a significantly reduced resorption when primary rabbit osteoclasts were cultivated on copper-containing films [
25]. All these studies did not analyse TRAP activity, however, a reduced resorption in the presence of Cu
2+ was also demonstrated in our study, but only in the case of osteoclasts, which were treated with Cu
2+ during osteoclastogenesis from PBMC and only towards extracellular bone matrix (). Besides differentiating osteoclasts, which were formed from PBMC, also mature osteoclasts were involved. In a previous study [
26] we compared different surfaces for the detachment of osteoclasts, which generally resulted in relatively low yields of detached osteoclasts. Heinemann and co-workers also report difficulties in detaching osteoclasts, which were formed in vitro on commonly used cell culture surfaces and propose special temperature-sensitive dishes for osteoclast detachment [
27]. In the present study, we tried ultra-low attachment cell culture flasks for formation and detachment of osteoclasts. Both differentiation time and osteoclast yield were considerably increased on these surfaces compared to other cell culture surfaces. PMBC were able to attach loosely to the surfaces, which might have promoted their ability to migrate and fuse. After being formed, the multinucleated osteoclasts could be easily detached just by adding low concentrations of buffered EDTA without using a cell scraper. Interestingly, in our study the resorption was less affected, when Cu
2+ was added to mature osteoclasts, indicating an effect of Cu
2+ on osteoclast formation rather than osteoclast function. However, the above cited study of Yang et al. also used mature osteoclasts, directly isolated from bone and found a significantly decreased osteoclastic resorption.
The central questions of this study are how Cu
2+ affects TRAP activity and why both TRAP gene expression and osteoclastic resorption are not increased in the same way. TRAP activity is regulated in a redox dependent pathway: the active centre contains two ferric ions, and the enzyme is active, when one of them is in a reduced state [
28]. Copper as redox active metal ion is able to generate reactive oxygen species, which could change the redox state of TRAP and therefore activate this enzyme. This would be in line with the unchanged TRAP mRNA expression in the presence of Cu
2+, indicating a regulation on protein level. However, it has been shown that copper is a potent inhibitor of TRAP activity with a Ki of 6.8 µM [
29] which is in line with our observation of a reduced TRAP activity when copper ions are added directly to the assay (see above). It has been shown in numerous studies that copper can induce oxidative stress in biological systems [
30,
31]. Intracellular antioxidant substances protect cells from highly reactive oxygen species (ROS) generated by different redox reactions. The most prevalent cellular protective antioxidant is the thiol-containing tripeptide glutathione, which is present in all cells in high concentration [
32]. Different methods were proposed to quantify the level of reduced glutathione (GSH) in cells. Among these, the fluorometric monochlorbimane assay [
33], which was optimized by Capek, and co-workers is a useful method since the reagent is able to penetrate through the cell membrane and to directly react with intracellular GSH [
34]. We demonstrated a significant reduction of GSH levels in both PBMC and mature osteoclasts, indicating, that the cells suffered from oxidative stress in the presence of low concentrations of Cu
2+. It has been early postulated, that increased ROS levels support osteoclastogenesis and TRAP activity [
35,
36]. Later, different groups reported an elevation of intracellular ROS level during stimulation of monocytes with RANKL and reduced osteoclast formation when the cultures were treated with antioxidants [
37,
38]. ROS generated through the presence of Cu
2+ could therefore have increased TRAP activity in our experiments. However, why did the increased TRAP activity not imply an increased osteoclastic resorption? It has been shown before, that TRAP activity does not necessarily correlate with osteoclastic resorption. The function of TRAP in osteoclasts is proposed to further degrade collagen fragments, which were initially digested by cathepsin K, and it was shown, that the enzyme itself is able of producing ROS for these degradation processes [
39]. It has been shown, that TRAP activity is rather a marker for osteoclast number than for osteoclast resorptive activity [
40,
41]. In addition, our own investigations displayed a strong dependency of TRAP activity from the composition of the resorbed material [
21]. In the case of Cu
2+ or Cu
2+ containing biomaterials it can be concluded that the highly significant increase of TRAP activity is not reflected by an increased osteoclastic activity. Quite the opposite, a reduction of resorptive activity of osteoclasts in vitro was observed in the presence of Cu
2+ for osteoclast, differentiated from PBMC in the presence of extracellular bone matrix (). The reduced number of osteoclasts in this experimental setup ( and A) can explain this effect. In contrast, the addition of Cu
2+ to already differentiated osteoclasts did decrease neither osteoclast number nor resorptive activity (A and ).
Consequently, Cu
2+ released from potential implant materials in concentrations below 10 µM does not induce increased osteoclastic resorption. As shown in our study, higher concentrations of Cu
2+ are cytotoxic to osteoclasts and PBMC in any case, while mesenchymal stromal cells were shown to tolerate Cu
2+ concentrations up to 250 µM [
11]. Therefore, doping of bone graft materials with low amounts of Cu
2+ could shift the equilibrium between bone formation and bone resorption around the implant.
In a conclusion, Cu2+ has a substantial influence on the formation of osteoclasts from PBMC. While considerably less multinucleated osteoclasts are formed in the presence of even low amounts of Cu2+ (4 and 8 µM), the activity of the most specific osteoclastic enzyme, TRAP, is significantly increased. In this study, we could show that this increased TRAP activity is neither based on an increased gene expression nor contributed to an increased osteoclastic resorption. We hypothesized, that ROS, generated by Cu2+ induced the detected high TRAP activity. In contrast to PBMC mature osteoclasts are less sensitive to Cu2+. Higher Cu2+ concentrations were necessary to reduce cell viability of mature osteoclasts and low Cu2+ concentrations did not trigger the activity of TRAP.