Regulation of Runx2 Accumulation and Its Consequences

Osteoblasts are bone-forming cells and therefore they are responsible of the synthesis of type I collagen, the main component of bone matrix. However, there is an apparent disconnect between the regulation of osteoblast differentiation and bone formation since the synthesis of Type I collagen precedes the expression of Runx2, the earliest determinant of osteoblast differentiation. Recently, genetic experiments in the mouse have revealed the existence of an unexpected cross-regulation between bone and other organs. In particular this body of work has highlighted the importance of osteoblasts as endocrine cells to regulate whole-body glucose homeostasis by secretion of a hormone, osteocalcin. However, the fundamental question of why bone regulates glucose homeostasis remained to be answered. Therefore, in my thesis, considering that bone is a metabolically demanding organ that constantly renews itself, I hypothesized that characterizing the connection between the need of glucose as a main nutrient in osteoblasts and bone development will provide a key to deeper understanding of why bone regulates glucose homeostasis. My work shows here that glucose uptake through GLUT1 in osteoblasts is needed for osteoblast differentiation by suppressing the AMPK-dependent activation by phosphorylation at S148 of Smurf1 that targets Runx2 for degradation. I also uncovered the mechanism of action of Smurf1 in this setting. In a distinct but synergetic way, glucose uptake promotes bone formation by inhibiting a distinct function of AMPK. In turn, Runx2 favors Glut1 expression, and this feedforward regulation between Runx2 and Glut1 determines the onset of osteoblast differentiation during development and the extent of bone formation throughout life. Furthermore, I also identified that Smurf1 not only regulates osteoblast differentiation by targeting Runx2 for degradation but also contributes to whole-body glucose homeostasis by regulating the activation of osteocalcin by targeting the insulin receptor for degradation in vivo. These results identify Smurf1 as a determinant of osteoblast differentiation during development, of bone formation and glucose homeostasis post-natally. Most importantly, we show that these Smurf1 functions required AMPK-phosphorylation site S148 in vivo. Altogether, these results revealed the absolute necessity of glucose as a regulator of Runx2 accumulation during osteoblast differentiation and bone formation in vivo and highlight the fundamental importance of the intricate cross-talk between bone and whole-body glucose metabolism.