Abstract C110: Abstract B: Hedgehog pathway inhibition in young mice results in severe bone defects

Abstract

Current treatment for the most common pediatric brain tumor, medulloblastoma (MB) compromises neurological and endocrine development, particularly in younger patients. Mutations in Patched (PTCH1), the receptor for Hedgehog (Hh) proteins, cause MB in approximately 30% of patients. Loss of PTCH1 leads to constitutive activation of Smoothened (SMO) and increased expression of downstream target genes such as GLI1. Previously, we investigated the use of the SMO inhibitor, HhAntag, in a mouse model of MB. Treatment of Ptch1+/−p53−/− mice with HhAntag completely eliminates spontaneous and transplanted tumors. However, treatment of young mice with HhAntag results in permanent defects in bone structure. Histological analyses of long bones from these mice showed a significant reduction in proliferating chondrocytes and an increase in the number of hypertrophic chondrocytes. In our current study, we have further characterized the bone toxicities caused by HhAntag treatment and are testing potential molecules that might lessen the severity of these toxicities. We treated P10-old mice for 4 or 6 days and analyzed their limbs at 0, 2, or 4 days after HhAntag treatment. We found that the severity of bone defects increases with the length of time the mice are treated with HhAntag. MicroCT and MRI analysis showed that exposure to HhAntag for as little as 4 days caused premature growth plate fusion and an increase in bone mineral density. In an effort to protect proliferating chondrocytes from the toxicities caused by HhAntag, we have identified several candidate molecules that have been shown to alter developing bone. One candidate, Parathyroid Hormone-Related Protein (PTHrP), is a downstream effector of the Hh pathway. Hh signaling activates the expression of PTHrP, which then signals to proliferating chondrocytes, preventing them from differentiating. Previous studies show that overexpression of PTHrP in developing bones delays chondrocyte hypertrophy. Therefore, exogenous PTHrP may offset the premature differentiation evident in HhAntag treated animals. We have identified a physiologically relevant dose of PTHrP that is sufficient to mediate a change in bone morphology. We are currently treating mice simultaneously with PTHrP and HhAntag, in an effort to reduce the HhAntag associated bone toxicities. Another candidate is the proteasome inhibitor, bortezomib. Bortezomib has been shown to alter Hh pathway activity and therefore may also reduce the toxicities associated with HhAntag treatment. We are currently establishing the proper dosing strategy appropriate for bortezomib treatment of young mice. We have shown that treatment of young mice with HhAntag leads to severe bone defects and are currently employing a multi-drug approach to lessen the severity of these defects. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):C110.