Osterix Facilitates Osteocytic Communication by Targeting Connexin43

Reviewer #1 (Public review):

The manuscript "Osterix Facilitates Osteocytic Communication by Targeting Connexin43" investigates the role of Osterix (Osx) in osteocytes using a Col1α1-CreER;Osxfl/fl mouse model and cultured cells. The study reveals that Osx is expressed in osteocytes, and its deletion in vitro leads to a significant reduction in osteocyte dendrite formation, highlighting its critical role in maintaining cellular communication. Through ChIP-seq analysis, the authors identified Connexin43 (Cx43) as a direct downstream target of Osx. Moreover, treatment with all-trans retinoic acid (ATRA), a known agonist of Cx43, was able to rescue the dendritic network in osteocytes, restoring their communication capabilities in vitro.

This research provides valuable insights into the molecular mechanisms by which Osx influences osteocyte function, particularly through its regulation of Cx43. However, despite these findings, the study does not fully elucidate all the mechanisms involved in Osx-mediated osteocytic communication. Several conclusions, particularly those related to the broader signaling pathways, require additional experimental evidence and further investigation to be fully substantiated. This study provides a new aspect in understanding the complex role of Osx in bone biology but leaves open questions regarding the intricacies of its regulatory network.

Major Comments:

(1) In the Col1a1-CreER;tdTomato mice, the number of tdTomato+ cells in the cortical bone appears lower compared to Osx+ cells. The overlap between tdTomato+ and Osx+ cells in Figure 1 is limited. Could this affect the knockout efficiency? Can the authors provide data on Osx knockout efficiency in vivo? While immunostaining of Osx is shown in both control and mutant mice in Figure 2A, the Osx expression pattern differs from Figure 1A. Osx expression is relatively low in the bone marrow in Figure 1A, but much stronger in Figure 2A.

Additionally, Osx+ cells in Figure 1A seem confined to the bone surface, whereas Figure 2A shows a broader distribution. What developmental stage of mice was used in Figure 1? Could the authors also provide co-staining with other osteocyte markers alongside Osx?

(2) The authors mentioned using both siRNA and Lenti-Osx to modulate Osx expression. What was the specific purpose of these experiments? If the authors aim to demonstrate that Osx plays a critical role in osteocytes, they should provide data on downstream targets or markers relevant to osteocyte function. Additionally, did these treatments affect processes like differentiation or cell viability in osteocytes? The current results only demonstrate that siRNA and Lenti-Osx can successfully modulate Osx expression in vitro, but further evidence is needed to support broader functional conclusions.

(3) Osx knockout mice exhibited a decreased osteocyte dendritic network both in vivo and in vitro. To better understand how this affects overall bone health, could the authors provide additional parameters, such as bone thickness, bone strength, and other relevant metrics? Furthermore, to determine whether these phenotypes are primarily due to defects in the osteocyte dendritic network or a reduction in osteocyte numbers, the authors should also assess the number of osteocytes in the knockout mice Figure 2.

(4) Regarding the Lucifer Yellow Dye Transfer Assay in Figure 3, the authors should provide data on cell density and cell viability for both control and mutant groups. Additionally, although less dye is observed in the mutant group, the migration distance appears comparable to the control group. Could the authors explain this result? Furthermore, how was transmission speed between the groups evaluated in Figure 3D? More details on the method used to assess transmission speed would be helpful.

(5) For a more comprehensive and unbiased analysis of Osx function in osteocytes, the authors should present a full analysis of differentially expressed genes, rather than focusing solely on integrins. Additionally, it would be beneficial to include an analysis of the knockdown group alongside the other groups, considering the animal model used in this study involves knockout mice.

(6) In the immunofluorescence staining of integrin αvβ1 in the si-Osx and Lenti-Osx groups, the cellular localization of integrin αvβ1 appears altered. Unlike the control group, where it is mainly localized in the cytoplasm, positive signals are observed in the nucleus of the si-Osx and Lenti-Osx groups. Additionally, since integrin αvβ1 is a membrane protein, shouldn't it primarily be observed on the cell membrane rather than in the cytoplasm? Could the authors clarify this observation?

(7) The results regarding Cx43 expression after Lenti-Osx treatment are questionable. It appears that the images for the Lenti-GFP and Lenti-Osx groups have been misrepresented. The merged images for the Lenti-GFP control group seem to belong to the Lenti-Osx group, and vice versa. If the images were presented in their correct order, the conclusions would contradict the authors' claims. This issue needs to be addressed to ensure an accurate interpretation of the data.

(8) The authors demonstrated that ATRA treatment elevates Cx43 protein levels in the control group, where Osx function is normal. However, can ATRA also restore Cx43 protein levels in the si-Osx treated group, where Osx transcriptional function is impaired? Theoretically, Cx43 protein levels should not be restored in the si-Osx group. Could the observed rescue phenotype be due to effects downstream of Cx43? This possibility should be considered and clarified.

(9) Does the Cx43 mutation of knockout cause similar phenotypes in the animal model? Can restoration of Cx43 rescue the bone phenotype?

Reviewer #2 (Public review):

This study shows that Osx plays a pivotal role in the dendritic network and intercellular communication of Col1α1-positive osteocytes via targeting Connexin43 (Cx43). It provides solid evidence to broaden our understanding of Osx's roles during bone homeostasis. This work will be of interest to investigators studying bone diseases involving osteocytes, such as delayed fracture healing or osteoporosis.

Comments:

(1) In Figure 1, it appears that the Osx- and Col1α1-positive cells may not be exclusively expressed by osteocytes. Possibly periosteum cells and osteoblasts are also included. This could potentially impact the interpretation of results. The authors should provide a clearer analysis to distinguish the cell types precisely.

(2) Jialiang S. Wang et al. (Nat Commun. 2021 Nov 1;12(1):6274.) have previously reported on the direct role of Osx in osteocytes. In light of this prior research, it is essential for the authors to thoroughly discuss how this study differs from previous findings.

(3) In the methods section, it is crucial to provide detailed information about the manufacturer and country of origin of reagents, like ATRA.

(4) The morphology of osteocytes in cortical bone can vary between the metaphysis site and the middle shaft site of long bones. For SEM data of osteocytes in Figure 2, it is necessary to address this issue. The authors should clarify whether morphological difference was observed between these sites and, if so, how these differences might impact the interpretation of the data.

(5) In the bone research field, two different Col1α1 - CreER mice were used. The authors should specify which type of Col1α1 - CreER mice were utilized in this research.

(6) A more detailed description of the statistical method used in Figure 2G - I is required, particularly with regard to quantifying the number of osteocyte dendritic processes.

(7) In Figure 6C and Figure 6D, while the legend indicates N = 3, there are five data points presented in the statistical graph.

Reviewer #3 (Public review):

Summary:

This study investigated the expression of Osterix (Osx) not only in osteoblasts but also significantly in osteocytes. Through Osx knockout, the osteocytic dendritic network was damaged, leading to communication disruption. This study investigated the regulatory role of Osx on osteoblast dendrites through Cx43.

Strengths:

This paper provides a good explanation of the role of Osx in osteocyte synapse and cell communication, enriching the understanding of Osx's functional significance. The results of the experiment support the conclusions of the study. This is an interesting study with a clear logical structure.

Weaknesses:

Some experimental results need to be supplemented, and there are still some details and errors in the text that need to be revised.