Bone is a remarkable dynamic tissue which is involved in a variety of roles besides providing structural support. Bone exhibits endocrine, immune, mineral storage, growth factor, organ protection and repair functions
[1][2][3]. Most of these functions can be attributed to the presence of three distinct major cell types, the osteoblast (OB), the osteoclast (OC) and the osteocytes. Osteoblasts are derived from mesenchymal stem cells during embryogenesis, and are responsible for the secretion of a proteinaceous matrix, including growth factors, which becomes mineralized
[1][4]. OBs are found lining the bone surface and also become encased in the mineralized matrix, where they differentiate into osteocytes
[5][6]. Osteocytes communicate with each other and other cell types via canaliculi found in bone. Osteocytes are capable of detecting stresses on the skeleton, and are able to activate OBs lining the bone surface, as well as OCs to start the repair process
[7]. Osteoclasts have been thought to arise from hematopoietic cells exclusively; however, recent lineage tracing studies using mice have shown that there is also an extraembryonic component to this
[8][9]. Cells derived from erythromyeloid-progenitors (EMP) in the embryonic yolk sac are the first wave of OC to differentiate, followed later by a distinct second wave derived from hematopoietic stem cells (HSCs). These two stem cell populations occupy two different niches in the adult, with the EMP homing to the spleen while the HSCs seed the bone marrow
[8][9]. OCs are capable of resorbing bone via their ability to secrete acid to dissolve the mineral component and proteinases in order to digest the now exposed proteinaceous matrix
[10][11]. This is a highly organized process that involves pre-OC cells fusing with each other, the formation of a sealed bone compartment underneath the now multinucleated OC sequestered by the sealing zone, and the formation of a ruffled membrane contained within the sealing zone
[12][13][14]. The ruffled border acts as the gateway for the secretion of the acid and proteinases, and allows for the uptake of the dissolved mineral and digested proteins, which are mostly transcytosed by vesicles to the apical cell membrane for eventual disposal via the circulation
[15]. Experiments performed in RAW 264 cells showed that the formation of an actin ring redirects intracellular vesicles, mostly secretory lysosomes, to transport large quantities of proteinases (e.g., Cathepsin K, alkaline phosphatase) and the acid generating machinery (made up from chloride channel 7 and the V-ATPase) to the OC plasma membrane adjacent to the bone surface
[16][17]. Bone remodeling is a highly coordinated process that involves constant communication between OBs and OCs, and any interference with this can lead to disease
[10][18][19]. V-ATPases are involved in pre-pro-protein processing (including glycosylation)
[20], secretion
[21], the internalization and degradation of molecules
[22], vesicle transport and fusion
[23][24], modulate signaling complexes, participate in distinct signalosomes
[25], and promote cell migration in cancer
[26]. To this end, mutations that interfere with V-ATPase function underlie diseases affecting a number of organ systems.