Background Fibrous dysplasia is characterized by intense marrowfibrosis and increased rates of bone turnover. The lesions offibrous dysplasia resemble those described in the long bonesof transgenic mice overexpressing the c-fos proto-oncogene.Activating mutations in the subunit of the stimulatory guanine-nucleotidebindingprotein (Gs) linked to adenylate cyclase have recently beendescribed in bone cells from patients with the McCuneAlbrightsyndrome and fibrous dysplasia.
Methods We used in situ hybridization to determine the levelof expression of c-fos in bone-biopsy specimens from two normalsubjects, eight patients with fibrous dysplasia, and six patientswith other bone disorders characterized by high rates of boneturnover. The probe used corresponded to the fourth exon ofthe c-fos gene.
Results High levels of c-fos expression were detected in thebone lesions from all eight patients with fibrous dysplasia.No expression of c-fos was detected in bone specimens from thenormal subjects or from specimens of normal bone obtained frompatients with fibrous dysplasia. The cells that expressed c-fosin the dysplastic lesions were fibroblastic and populated themarrow space. A very low level of c-fos expression was detectedin the biopsy specimens from the patients with other bone diseases.One patient with polyostotic fibrous dysplasia and one patientwith the McCuneAlbright syndrome were tested for thepreviously described Gs gene mutations and were found to expressthese mutations in bone.
Conclusions Increased expression of the c-fos proto-oncogene,presumably a consequence of increased adenylate cyclase activity,may be important in the pathogenesis of the bone lesions inpatients with fibrous dysplasia.
Source Information
From the Genetics Unit, Shriners Hospital (J.P.), and the Departments of Surgery (G.A.C., F.H.G., R.S.) and Human Genetics (F.H.G., R.S.), McGill University both in Montreal.
Address reprint requests to Dr. St.-Arnaud at the Genetics Unit, Shriners Hospital, 1529 Cedar Ave., Montreal, QC H3G 1A6, Canada.
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