Blocking Oxidized Phospholipids Attenuates the Age-Associated, but Not the Ovariectomy- or Unloading- Induced, Bone Loss in Mice
Authors: Palmieri Michela , Joseph Teenamol E , Warren Aaron , Gomez-acevedo Horacio , Xiong Jinhu , Witztum Joseph Lee , Manolagas Stavros C , Ambrogini Elena 
Published: May 2021

Abstract
Oxidized phospholipids (OxPL), such as oxidized phosphatidylcholine, are generated by oxidative stress (OS)-induced lipid peroxidation. E06 IgM is a natural antibody that recognizes the phosphocholine (PC) moiety of OxPLs, but not native PLs. Generation of transgenic mice expressing a single chain (scFv) form of its antigen-binding domain, “E06-scFv” mice, protects against atherosclerosis, hepatic steatosis and high fat diet-induced loss of bone mass. In addition, E06-scFv increases cancellous and cortical bone mass in both male and female adult mice fed chow diet, by increasing bone formation. Age-related bone loss is associated with increased OS and lipid peroxidation, and is characterized by a reduction in osteoblast number and bone formation. Oxidative stress is involved also in the bone loss caused by sex-steroid deficiency and elevated OS markers are found in unloading-induced bone loss, raising the possibility that an increase of OxPLs induced by OS might be contributing to the pathogenesis of these conditions as well. We aged homozygous E06-scFv transgenic female and male mice and their wild-type littermates up to 22 and 24 months respectively. Serial DXA BMD every 3 months showed that overexpression of E06-scFv attenuated the age-associated bone loss in both sexes. In addition, male and female E06-scFv transgenic mice also accumulated less fat mass than WT littermates during aging. Micro-CT analysis revealed that E06-scFv attenuated the age-associated decline in cancellous, but not cortical, bone mass. The histological analysis of the vertebrae indicated that the aged E06-scFv transgenic mice had increased osteoblasts and decreased osteoclasts compared to the WT mice. To investigate whether the beneficial effect of the E06-scFv could be seen after ovariectomy, 4.5 month old E06-scFv homozygous females and WT controls were ovariectomized (OVX). DXA and micro-CT measurements 6 weeks post- surgery indicated that, unlike aging, E06-scFv did not protect against OVX-induced bone loss in either the cancellous or the cortical compartment. Lastly, we tail-suspended 5.5 month old male mice and sacrificed them 21 days later. E06-scFv transgenic mice had similar cortical bone loss compared to WT mice. In conclusion, the E06-scFV transgene attenuates the age-associated cancellous bone loss in both female and male mice, but has no effect on the OVX- or unloading-induced bone loss. These results fully support our hypothesis that an increase in PC-OxPLs with age, caused at least in part by a decrease in natural anti-PC antibodies, contributes to the age-associated bone loss. This evidence provides proof of concept that blocking PC-OxPLs represents a therapeutic approach to countering the increase of PC-OxPLs with age and their adverse effects on age-related bone loss as well as atherosclerosis and NASH. It also confirms that the mechanisms of cancellous and cortical bone loss are distinct.