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Icariin stimulates differentiation of bone marrow-derived mesenchymal stem cells (BM-MSCs) through activation of cAMP/PKA/CREB

Abstract

Icariin, a prenylated flavonol glycoside isolated from Epimedium, has been considered as a potential alternative therapy for osteoporosis. The present study aimed to clarify the detailed molecular mechanisms of action of icariin on osteoblast function, using bone marrow-derived mesenchymal stem cells (BM-MSCs). BM-MSCs were first stimulated by icariin. Then, gene and protein expression of cAMP/PKA/CREB signaling molecules were analyzed by RT-PCR and western blotting (WB), and alkaline phosphatase (ALP) was analyzed in cell lysates by ELISA. MTT assays indicated that icariin did not have significant effects on cell viability up to 1 µM. Icariin showed a dose-dependent effect on the alkaline phosphatase activity of BM-MSCs. WB analysis showed that icariin treatment of BM-MSCs significantly enhanced the protein expression of protein kinase A (PKA) and cAMP-responsive element binding protein (CREB), while RT-PCR results showed that icariin dose-dependently increased the mRNA levels of PKA and CREB. Icariin induced BM-MSC differentiation by BMP2, Smad1, and Runx2. RT-PCR and WB results indicated that icariin significantly increased the expression of BMP2, Smad1, and Runx2 in BM-MSCs. These results suggest that icariin is an agonist of the cAMP/PKA/CREB pathway in BM-MSC differentiation, raising the possibility that it could be used in the treatment of osteoporosis.

Keywords:
Icariin/molecular mechanisms; BM-MSCs; cAMP; PKA; CREB


INTRODUCTION

Osteoporosis is characterized by low bone mineral density (BMD) and loss of the structural and biomechanical properties that are required to maintain bone homeostasis (Ivanova et al., 2015Ivanova S, Vasileva L, Ivanova S, Peikova L, Obreshkova D. Osteoporosis: therapeutic options. Folia Med. 2015;57(3-4):181-90.). Icariin is the main active flavonoid glucoside of Epimedium pubescens, which has been reported to enhance bone healing and reduce the incidence of osteoporosis (Hsieh et al., 2010Hsieh TP, Sheu SY, Sun JS, Chen MH, Liu MH. Icariin isolated from Epimedium pubescens regulates osteoblasts anabolism through BMP-2, SMAD4, and Cbfa1 expression. Phytomedicine. 2010;17(6):414-23. ). Icariin restores the osteogenic differentiation and bone formation of bone marrow stromal cells in a rat model of estrogen deficiency-induced osteoporosis (Luo et al., 2015Luo Z, Liu M, Sun L, Rui F. Icariin recovers the osteogenic differentiation and bone formation of bone marrow stromal cells from a rat model of estrogen deficiency-induced osteoporosis. Mol Med Rep. 2015;12(1):382-8.). In the ovariectomized (OVX) calvarial defect model, icariin loaded on CPC scaffolds enhanced both osteogenesis and angiogenesis, while a system of local sustained release of icariin combined with systemic administration achieved a better effect on bone defect regeneration (Wu et al., 2017Wu Y, Cao L, Xia L, Wu Q, Wang J, Wang X, et al. Evaluation of osteogenesis and angiogenesis of icariin in local controlled release and systemic delivery for calvarial defect in ovariectomized rats. Sci Rep. 2017;7(1):5077.).

Osteoblasts, osteocytes and osteoclasts are the three types of bone cells that are in direct contact with all the cellular elements in the bone marrow (Carrington, 2005Carrington JL. Aging bone and cartilage: cross-cutting issues. Biochem Biophys Res Commun. 2005;328(3):700-8.). Mesenchymal stem cells (MSCs) are a promising source of cells for use in cell-based therapeutics and regenerative medicine due to their ability to self-renew and differentiate into a number of functional cell types. To date, bone marrow-derived mesenchymal stem cells (BM-MSCs) have been the most widely-studied family of stem cells (Li et al., 2016Li X, Xu Z, Bai J, Yang S, Zhao S, Zhang Y, et al. Umbilical cord tissue-derived mesenchymal stem cells induce t lymphocyte apoptosis and cell cycle arrest by expression of indoleamine 2, 3-Dioxygenase. Stem Cells Int. 2016;2016:7495135.). BM-MSCs have been estimated to represent 0.01-0.0001% of the nucleated cells in adult human bone marrow (Dazzi et al., 2006Dazzi F, Ramasamy R, Glennie S, Jones SP, Roberts I. The role of mesenchymal stem cells in haemopoiesis. Blood Rev. 2006;20(3):161-71.). BM-MSCs are progenitors of skeletal tissue components such as bone, cartilage, the hematopoiesis-supporting stroma, and adipocytes (Bianco, Riminucci, Gronthos, 2001Bianco P, Riminucci M, Gronthos S, Robery PG. Bone marrow stromal stem cells: nature, biology, and potential applications. Stem Cells. 2001;19(2):180-92.). Bone morphogenesis protein-2 (BMP-2), a member of the BMP family, is one of the best-characterized inducers of osteochondrogenesis and can increase the expression of markers of both osteo- and chondrogenic lineage differentiation of progenitor cells, such as MSCs. It has recently been shown that protein kinase A (PKA) activation also forms an important component of the mechanism by which BMP-2 mediates MSC differentiation. Once activated, PKA usually phosphorylates its prototypical downstream transcription factor, cAMP-responsive element binding protein (CREB), which is associated with a number of important physiological functions including osteochondrogenic differentiation (Zhao, Li, Zhou, 2009Zhao L, Li G, Zhou GQ. SOX9 directly binds CREB as a novel synergism with the PKA pathway in BMP-2-induced osteochondrogenic differentiation. J Bone Miner Res. 2009;24(5):826-36.).

Icariin has been shown to have an anti-osteoporotic effect by regulating the bidirectional differentiation of BM-MSCs through the canonical Wnt signaling pathway (Huang et al., 2017Huang JM, Bao Y, Xiang W, Jing XZ, Guo JC, Yao XD, et al. Icariin regulates the bidirectional differentiation of bone marrow mesenchymal stem cells through canonical Wnt signaling pathway. Evid-Based Compl Alt Med. 2017;2017:8085325.). Icariin is also a bone anabolic agent that may exert its osteogenic effects through the induction of BMP-2 and NO synthesis, subsequently regulating expression of Cbfa1/Runx2, OPG, and RANKL. This effect may contribute to its effect on the induction of osteoblast proliferation and differentiation, resulting in bone formation (Hsieh et al., 2010Hsieh TP, Sheu SY, Sun JS, Chen MH, Liu MH. Icariin isolated from Epimedium pubescens regulates osteoblasts anabolism through BMP-2, SMAD4, and Cbfa1 expression. Phytomedicine. 2010;17(6):414-23. ). In this study, we clarified the detailed molecular mechanisms of action of icariin on the osteoblastic function of BM-MSCs. The results demonstrate that icariin induces osteoblast differentiation via BMP2, through activation of cAMP/PKA/CREB signaling in osteoblasts.

MATERIAL AND METHODS

Material and reagents

Icariin was obtained from Sigma-Aldrich (St. Louis, MO, USA) and the purity of the compound was more than 99%. Stock solutions of icariin were prepared in dimethyl sulfoxide (DMSO) (Sigma-Aldrich). In all studies, the final concentration of DMSO was 0.1% (v/v). The icariin stock solutions were stored at -20 ºC.

Cell culture

BM-MSCs were purchased from Saiye Biological Technology Co., Ltd. (Guangzhou, China). BM-MSCs were cultured in 25 cm2 flasks in complete medium (DermaLife® K Medium Kit, Lifeline Cell Technology, Frederick, MD, USA) consisting of DMEM, 10% fetal bovine serum (FBS), and 100 U/mL penicillin and streptomycin. Cells were trypsinized and passaged at 80-90% confluence. The cells were reseeded into 96-well plates or 6-well plates at a density of 1 × 104 or 1 × 106 cells/well, respectively, and cultured in a humidified atmosphere of 5% CO2 and 95% air, at 37ºC.

Cell viability assay

BM-MSCs were plated into 96-well plates at a density of 1 × 104 per well. After 2 days, cells were stimulated with icariin at concentrations of 0, 0.001, 0.01, 0.1, 1 or 10 µM for 24 h. Cell proliferation was investigated using the 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. To perform the assay, 20 µL of MTT was added to every well, and the plates were placed into a 5% CO2-humidified incubator at 37ºC for 4 h. After incubation, supernatants were removed from the plates and 100 µL of DMSO solution was added for 15 min. The plates were read on a micro-plate reader at a wavelength of 492 nm.

RNA preparation and RT-PCR analysis

BM-MSCs were seeded into 6-well plates at a density of 1 × 106 cells per well. Total RNA was extracted from the cells using TRIzol® reagent according to the manufacturer’s instructions (Life Technologies, Carlsbad, CA, USA) after stimulation. First strand cDNA was synthesized using a Reverse Transcription System Kit (Tiangen Biotech, Beijing, China). RNA was reverse transcribed into cDNA and analyzed by RT-PCR using an ABI PRISM® 7000 sequence detector (Applied Biosystems, Foster City, CA, USA). CREB, PKA, BMP2, Smad1, and Runx2 mRNA levels were detected by real-time PCR in a reaction mixture of 20 µL total volume containing 10 µL of 2 × SYBR® TransStar Green PCR Super Mix, 0.6 µL sense and antisense primers, and 50 ng RT product. The utilized primer sequences are shown in Table I.

TABLE I
Primer for real-time PCR assays

Western blot analysis

Cells were lysed with lysis buffer (20 mM Tris-HCl, pH 8.0, 120 mM NaCl, 1% [v/v] Triton™ X-100, 10 mM ethylenediaminetetraacetic acid, 1 mM ethylene glycol tetraacetic acid, 0.05% [v/v] 2-mercaptoethanol, and 1 × protease inhibitor solution). Cell debris was removed by centrifugation at 14,000 × g for 15 min, and equal amounts of protein extracted from each sample were heat denatured and subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) on a 10% (v/v) polyacrylamide gel. After electrophoresis, proteins were electrotransferred onto polyvinylidene difluoride membranes. The membranes were blocked with 5% (w/v) skimmed milk at room temperature for 2 h and probed with primary antibody at 4°C overnight. The primary antibodies used were CREB, PKA, BMP2, Smad1, and RUNX2. After washing, membranes were incubated with the appropriate secondary antibody in 5% (w/v) skimmed milk/Tris-buffered saline containing 0.05% Tween® 20 for 1 h at 4°C. Proteins were detected using SignalFire™ ECL Reagent (Cell Signaling Technology, Danvers, MA, USA).

Enzyme-linked immunosorbent assay (ELISA) analysis

Supernatants from BM-MSC cell culture were harvested at 24 h after stimulation, and centrifuged at 1000 × g for 20 min. The supernatants were analyzed for ALP by ELISA following the manufacturers’ instructions (Nanjing Jiancheng Bioengineering Institute).

Statistical analysis

Data are expressed as the mean ± SD of three independent determinations, and significance was analyzed using the t-test and one-way ANOVA. *P < 0.05 was considered statistically significant. All analyses were performed using the Statistical Package for the Social Sciences (SPSS) statistical software for Windows, Version 18.0 (SPSS Inc., Chicago, IL, USA).

RESULTS

Effect of icariin on cell viability

The effect of icariin on cell viability of BM-MSCs was determined by MTT assay. As shown in Figure 1, 0.001 µM icariin had no significant effect on the proliferation of BM-MSCs. However, icariin at 0.01, 0.1, or 1 µM promoted MSC proliferation (P < 0.01), and showed a quantitative relationship. Meanwhile, 10 µM of icariin showed a certain cytotoxicity, significantly inhibiting the proliferation of BM-MSCs (P < 0.05).

FIGURE 1
Effects of different concentrations of icariin on the proliferation of BM-MSCs at 24 h. vs. treatment with 0 μM, *P < 0.05, **P < 0.01.

Assessment of ALP activity under different treatment conditions

BM-MSCs were treated with different concentrations of icariin for 24 h. the groups treated with 0.01, 0.1, or 1 µM icariin showed a significant increase in ALP activity compared with the control group (P< 0.05, Figure 2 A).

FIGURE 2
Icariin actives the cAMP/PKA/CREB signaling pathway in BM-MSCs. (A) Icariin showed a dose-dependent effect on alkaline phosphatase (ALP) activity in BM-MSCs. (B) WB analysis showed that icariin treatment of BM-MSCs significantly enhanced protein expression of PKA and CREB. (C)(D) RT-PCR results showed that icariin dose-dependently increased the mRNA levels of PKA and CREB in BM-MSCs. vs. treatment with 0 μM, *P < 0.05, **P < 0.01.

Icariin administration enhanced BM-MSC gene and protein expression via the cAMP/PKA/CREB signaling pathway

The cAMP/PKA/CREB signaling pathway has been shown to play an important role in differentiation of BM-MSCs. To determine the mechanism of icariin on BM-MSC differentiation, we examined the effect of icariin on the expression of components of the cAMP/PKA/CREB signaling pathway. Our qPCR data showed that icariin significantly enhanced mRNA expression of CREB and PKA in BM-MSCs. As shown in Figure 2, treatment with icariin at a concentration of 1 µM induced the most significant effect with a 1.9-fold increase in expression of CREB and a 1.6-fold increase in PKA, compared to the blank group (0 µM). The effect of icariin on BM-MSC mRNA expression showed a dose-response relationship (Figure 2. C, D). Finally we examined the effect of icariin on protein expression of PKA/CREB signaling molecules, and found that icariin stimulation of BM-MSCs showed a dose-response relationship. Expression of PKA/CREB was significant increased after treatment with icariin at the concentration of 1 µM, including both mRNA and protein levels (Figure 2 B). Taken together, these results demonstrate that icariin may regulate BM-MSC differentiation through activation of the cAMP/PKA/CREB signaling pathway.

Icariin induced BMP2, Smad1, and RUNX2 mRNA and protein expression in BM-MSCs

The CREB receptors BMP2, Smad1, and Runx2 were constitutively expressed on BM-MSCs (Figure 3). The mRNA and protein levels of BMP2, Smad1, and Runx2 were analyzed after treatment of BM-MSCs with icariin to determine whether icariin increased BMP2, Smad1, and Runx2 expression. Analysis by RT-PCR showed that BM-MSCs treated with icariin exhibited a significant and dose-dependent increase in the mRNA expression of BMP2, Smad1, and Runx2, compared with untreated cells (Figure 3 A-C). The effect of icariin on BMP2, Smad1, and Runx2 protein expression was also dose-dependent. Meanwhile, the mRNA and protein expression of BMP2, Smad1, and RUNX2 showed a significantly greater sensitivity to icariin (1 µM) stimulation than untreated cells (all P < 0.01).

FIGURE 3
Icariin induced BM-MSC differentiation by BMP2, Smad1, and Runx2. RT-PCR and WB results indicated that icariin significantly increased the expression of BMP2, Smad1, and Runx2 in BM-MSCs. vs. treatment with 0 μM; *P < 0.05, **P < 0.01

DISCUSSION

The herb Epimedium has long been used in traditional Chinese medicine to treat bone fractures and prevent osteoporosis. Researchers believe that the flavonoids contained in the herb are the effective component responsible for this activity. Icariin should be an effective agent for bone-strengthening activity, and one of its mechanisms is to stimulate the proliferation and enhance the osteogenic differentiation of MSCs (Chen et al., 2005Chen KM, Ge BF, Ma HP, Liu XY, Bai MH, Wang Y. Icariin, a flavonoid from the herb Epimedium enhances the osteogenic differentiation of rat primary bone marrow stromal cells. Pharmazie. 2005;60(12):939-42.). Icariin has been shown to increase osteogenic differentiation and mineralization of BMSCs and osteoblasts, and to inhibit osteoclast formation and bone resorption activity (Zhang et al., 2011Zhang J, Li Y, Sun J, Liu C, Zhang D. Synergistic or antagonistic effect of MTE plus TF or icariin from Epimedium koreanum on the proliferation and differentiation of primary osteoblasts in vitro. Biol Trace Element Res. 2011;143(3):1746-57.; Ma et al., 2014Ma HP, Ma XN, Ge BF, Zhen P, Zhou J, Gao YH, et al. Icariin attenuates hypoxia-induced oxidative stress and apoptosis in osteoblasts and preserves their osteogenic differentiation potential in vitro. Cell Proliferat. 2014;47(6):527-39.; Zhang et al., 2016Zhang D, Fong C, Jia Z, Cui L, Yao X, Yang M. Icariin stimulates differentiation and suppresses adipocytic transdifferentiation of primary osteoblasts through estrogen receptor-mediated pathway. Calcified Tissue Int. 2016;99(2):187-98.). In this paper, we found that low concentrations (0.01, 0.1, 1 µM) of icariin stimulated BM-MSC proliferation (P < 0.01), but that 10 µM icariin had a certain cytotoxicity, and significantly inhibited the proliferation of BM-MSCs (P < 0.05).

Hormones that stimulate the synthesis of cAMP regulate many cell type-specific processes including gene transcription, cell proliferation, differentiation, and survival. These processes are mediated, in part, by the MAP (mitogen-activated protein) kinase (or ERK; extracellular signal response kinase) cascade in a wide range of diverse cell types including pancreatic islet cells, bone cells, pituitary cells, thyroid cells, neuronal cells and others (Li et al., 2016Li Y, Dillon TJ, Takahashi M, Earley KT, Stork PJ. Protein kinase A-independent ras activation cooperates with Rap1 to mediate activation of Extracellular signal-regulated kinases (ERK) by cAMP. J Bio Chem. 2016;291(41):21584-21595.). In this study, we found that cAMP consistently enhanced the expression of the osteogenesis marker ALP. The results of cell proliferation assay demonstrated that icariin stimulated BM-MSC proliferation. These results indicated that icariin treatment at different concentrations promoted proliferation of BM-MSCs through the cAMP/PKA/CREB pathway. Further, we sought to examine the effect of icariin on expression of PKA/CREB mRNA and protein, by analyzing the mRNA and protein levels of PKA/CREB after treatment of BM-MSCs. Analysis using RT-PCR and WB showed that BM-MSCs treated with icariin exhibited a dose-dependent increase in the mRNA and protein expression of PKA/CREB, compared with untreated cells. Several previous studies have evaluated the role of the PKA pathway in osteogenic differentiation of hMSCs, and reported that pretreatment of human MSCs with a cAMP analog or forskolin enhanced bone formation. cAMP is a pivotal intracellular signaling molecule, the main function of which is to activate cAMP-dependent PKA (Yang et al., 2008Yang DC, Tsay HJ, Lin SY, Chiou SH, Li MJ, Chang TJ, et al. cAMP/PKA regulates osteogenesis, adipogenesis and ratio of RANKL/OPG mRNA expression in mesenchymal stem cells by suppressing leptin. Plos One. 2008;3(2):e1450.). Adenylate cyclase is activated through dissociation of G-proteins, causing the conversion of adenosine triphosphate into cAMP. Subsequently, cAMP activates PKA, which in turn phosphorylates CREB protein, and this translocates into the nucleus where it activates transcription of target genes (Kim et al., 2013Kim JM, Choi JS, Kim YH, Jin SH, Lim S, Jang HJ, et al. An activator of the cAMP/PKA/CREB pathway promotes osteogenesis from human mesenchymal stem cells. J Cell Physiol. 2013;228(3):617-26.; Chen et al., 2016Chen B, Lin T, Yang X, Li Y, Xie D, Cui H. Intermittent parathyroid hormone (1-34) application regulates cAMP-response element binding protein activity to promote the proliferation and osteogenic differentiation of bone mesenchymal stromal cells, via the cAMP/PKA signaling pathway. Exp Ther Med. 2016;11(6):2399-406. ). However, precisely how the administration of icariin regulates osteogenic differentiation of BM-MSCs by the cAMP/PKA/CREB signaling pathway requires further elucidation. In the current study, cell proliferation assays, osteogenic gene expression testing, and ALP activity detection were used in order to determine the underlying molecular mechanism by which icariin administration modulates the cAMP/PKA/CREB signaling pathway.

Previous studies have shown that activation of the PKA pathway synergistically participates in BMP-2-induced osteoblastic differentiation, possibly by mediating the CREB and/or Ras/MAPK pathways, and activation of the PKA pathway may be one of the key BMP-2-activated signaling events that lead to osteogenic differentiation (Zhao et al., 2006Zhao L, Yang S, Zhou GQ, Yang J, Ji D, Sabatakos G, et al. Downregulation of cAMP-dependent protein kinase inhibitor gamma is required for BMP-2-induced osteoblastic differentiation. Int J Biochem Cell B. 2006;38(12):2064-73.). Based on these findings, we also tested the mRNA and protein expression of BMP2, Smad1, and Runx2 in BM-MSCs stimulated with icariin to investigate whether the administration of icariin regulates osteogenic differentiation of BM-MSCs via the cAMP/PKA/CREB signaling pathway. BMP/Smad signals are mediated by BMP receptors (type I and II). Smad1, 5, and 8 are phosphorylated by the BMP receptors and form a complex with Smad4, following which the complex is translocated into the nucleus. Within the nucleus, the phosphorylated Smads interact with other transcription factors such as Runx2 to initiate transcription of osteogenic-related genes (Xu et al., 2015Xu L, Liu Y, Hou Y, Wang K, Wong Y, Lin S, et al. U0126 promotes osteogenesis of rat bone-marrow-derived mesenchymal stem cells by activating BMP/Smad signaling pathway. Cell Tissue Res. 2015;359(2):537-45.). We focused on signaling pathways involved in icariin-mediated BMP2, Smad1, and Runx2 expression in BM-MSCs according to previous reports (Guo et al., 2016Guo C, Li C, Yang K, Kang H, Xu X, Xu X, et al. Increased EZH2 and decreased osteoblastogenesis during local irradiation-induced bone loss in rats. Sci Rep. 2016;6:31318.; Su et al., 2015Su X, Liao L, Shuai Y, Jing H, Liu S, Zhou H, et al. MiR-26a functions oppositely in osteogenic differentiation of BMSCs and ADSCs depending on distinct activation and roles of Wnt and BMP signaling pathway. Cell Death Dis. 2015;6:e1851.). Analysis by RT-PCR and WB showed that BMP2, Smad1, and Runx2 were activated by icariin in BM-MSCs (Figure 3). Taken together, our results indicate that icariin regulates the expression of BMP2 in BM-MSCs through the cAMP/PKA/CREB signaling pathway.

ACKNOWLEDGMENTS

The authors are grateful to the National Natural Science Foundation of China (31370764) for their support of this work.

REFERENCES

  • Bianco P, Riminucci M, Gronthos S, Robery PG. Bone marrow stromal stem cells: nature, biology, and potential applications. Stem Cells. 2001;19(2):180-92.
  • Carrington JL. Aging bone and cartilage: cross-cutting issues. Biochem Biophys Res Commun. 2005;328(3):700-8.
  • Chen B, Lin T, Yang X, Li Y, Xie D, Cui H. Intermittent parathyroid hormone (1-34) application regulates cAMP-response element binding protein activity to promote the proliferation and osteogenic differentiation of bone mesenchymal stromal cells, via the cAMP/PKA signaling pathway. Exp Ther Med. 2016;11(6):2399-406.
  • Chen KM, Ge BF, Ma HP, Liu XY, Bai MH, Wang Y. Icariin, a flavonoid from the herb Epimedium enhances the osteogenic differentiation of rat primary bone marrow stromal cells. Pharmazie. 2005;60(12):939-42.
  • Dazzi F, Ramasamy R, Glennie S, Jones SP, Roberts I. The role of mesenchymal stem cells in haemopoiesis. Blood Rev. 2006;20(3):161-71.
  • Guo C, Li C, Yang K, Kang H, Xu X, Xu X, et al. Increased EZH2 and decreased osteoblastogenesis during local irradiation-induced bone loss in rats. Sci Rep. 2016;6:31318.
  • Hsieh TP, Sheu SY, Sun JS, Chen MH, Liu MH. Icariin isolated from Epimedium pubescens regulates osteoblasts anabolism through BMP-2, SMAD4, and Cbfa1 expression. Phytomedicine. 2010;17(6):414-23.
  • Huang JM, Bao Y, Xiang W, Jing XZ, Guo JC, Yao XD, et al. Icariin regulates the bidirectional differentiation of bone marrow mesenchymal stem cells through canonical Wnt signaling pathway. Evid-Based Compl Alt Med. 2017;2017:8085325.
  • Ivanova S, Vasileva L, Ivanova S, Peikova L, Obreshkova D. Osteoporosis: therapeutic options. Folia Med. 2015;57(3-4):181-90.
  • Kim JM, Choi JS, Kim YH, Jin SH, Lim S, Jang HJ, et al. An activator of the cAMP/PKA/CREB pathway promotes osteogenesis from human mesenchymal stem cells. J Cell Physiol. 2013;228(3):617-26.
  • Li X, Xu Z, Bai J, Yang S, Zhao S, Zhang Y, et al. Umbilical cord tissue-derived mesenchymal stem cells induce t lymphocyte apoptosis and cell cycle arrest by expression of indoleamine 2, 3-Dioxygenase. Stem Cells Int. 2016;2016:7495135.
  • Li Y, Dillon TJ, Takahashi M, Earley KT, Stork PJ. Protein kinase A-independent ras activation cooperates with Rap1 to mediate activation of Extracellular signal-regulated kinases (ERK) by cAMP. J Bio Chem. 2016;291(41):21584-21595.
  • Luo Z, Liu M, Sun L, Rui F. Icariin recovers the osteogenic differentiation and bone formation of bone marrow stromal cells from a rat model of estrogen deficiency-induced osteoporosis. Mol Med Rep. 2015;12(1):382-8.
  • Ma HP, Ma XN, Ge BF, Zhen P, Zhou J, Gao YH, et al. Icariin attenuates hypoxia-induced oxidative stress and apoptosis in osteoblasts and preserves their osteogenic differentiation potential in vitro. Cell Proliferat. 2014;47(6):527-39.
  • Su X, Liao L, Shuai Y, Jing H, Liu S, Zhou H, et al. MiR-26a functions oppositely in osteogenic differentiation of BMSCs and ADSCs depending on distinct activation and roles of Wnt and BMP signaling pathway. Cell Death Dis. 2015;6:e1851.
  • Wu Y, Cao L, Xia L, Wu Q, Wang J, Wang X, et al. Evaluation of osteogenesis and angiogenesis of icariin in local controlled release and systemic delivery for calvarial defect in ovariectomized rats. Sci Rep. 2017;7(1):5077.
  • Xu L, Liu Y, Hou Y, Wang K, Wong Y, Lin S, et al. U0126 promotes osteogenesis of rat bone-marrow-derived mesenchymal stem cells by activating BMP/Smad signaling pathway. Cell Tissue Res. 2015;359(2):537-45.
  • Yang DC, Tsay HJ, Lin SY, Chiou SH, Li MJ, Chang TJ, et al. cAMP/PKA regulates osteogenesis, adipogenesis and ratio of RANKL/OPG mRNA expression in mesenchymal stem cells by suppressing leptin. Plos One. 2008;3(2):e1450.
  • Zhang D, Fong C, Jia Z, Cui L, Yao X, Yang M. Icariin stimulates differentiation and suppresses adipocytic transdifferentiation of primary osteoblasts through estrogen receptor-mediated pathway. Calcified Tissue Int. 2016;99(2):187-98.
  • Zhang J, Li Y, Sun J, Liu C, Zhang D. Synergistic or antagonistic effect of MTE plus TF or icariin from Epimedium koreanum on the proliferation and differentiation of primary osteoblasts in vitro. Biol Trace Element Res. 2011;143(3):1746-57.
  • Zhao L, Li G, Zhou GQ. SOX9 directly binds CREB as a novel synergism with the PKA pathway in BMP-2-induced osteochondrogenic differentiation. J Bone Miner Res. 2009;24(5):826-36.
  • Zhao L, Yang S, Zhou GQ, Yang J, Ji D, Sabatakos G, et al. Downregulation of cAMP-dependent protein kinase inhibitor gamma is required for BMP-2-induced osteoblastic differentiation. Int J Biochem Cell B. 2006;38(12):2064-73.

Publication Dates

  • Publication in this collection
    20 Dec 2019
  • Date of issue
    2019

History

  • Received
    20 Apr 2018
  • Accepted
    21 June 2018
Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Av. Prof. Lineu Prestes, n. 580, 05508-000 S. Paulo/SP Brasil, Tel.: (55 11) 3091-3824 - São Paulo - SP - Brazil
E-mail: bjps@usp.br