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The IFITM5 mutation in osteogenesis imperfecta type V is associated with an ERK/SOX9-dependent osteoprogenitor differentiation defect
Ronit Marom, I-Wen Song, Emily C. Busse, Megan E. Washington, Ava S. Berrier, Vittoria C. Rossi, Laura Ortinau, Youngjae Jeong, Ming-Ming Jiang, Brian C. Dawson, Mary Adeyeye, Carolina Leynes, Caressa D. Lietman, Bridget M. Stroup, Dominyka Batkovskyte, Mahim Jain, Yuqing Chen, Racel Cela, Alexis Castellon, Alyssa A. Tran, Isabel Lorenzo, D. Nicole Meyers, Shixia Huang, Alicia Turner, Vinitha Shenava, Maegen Wallace, Eric Orwoll, Dongsu Park, Catherine G. Ambrose, Sandesh C.S. Nagamani, Jason D. Heaney, Brendan H. Lee
Ronit Marom, I-Wen Song, Emily C. Busse, Megan E. Washington, Ava S. Berrier, Vittoria C. Rossi, Laura Ortinau, Youngjae Jeong, Ming-Ming Jiang, Brian C. Dawson, Mary Adeyeye, Carolina Leynes, Caressa D. Lietman, Bridget M. Stroup, Dominyka Batkovskyte, Mahim Jain, Yuqing Chen, Racel Cela, Alexis Castellon, Alyssa A. Tran, Isabel Lorenzo, D. Nicole Meyers, Shixia Huang, Alicia Turner, Vinitha Shenava, Maegen Wallace, Eric Orwoll, Dongsu Park, Catherine G. Ambrose, Sandesh C.S. Nagamani, Jason D. Heaney, Brendan H. Lee
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Research Article Bone biology Genetics

The IFITM5 mutation in osteogenesis imperfecta type V is associated with an ERK/SOX9-dependent osteoprogenitor differentiation defect

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Abstract

Osteogenesis imperfecta (OI) type V is the second most common form of OI, distinguished by hyperplastic callus formation and calcification of the interosseous membranes, in addition to the bone fragility. It is caused by a recurrent, dominant pathogenic variant (c.-14C>T) in interferon-induced transmembrane protein 5 (IFITM5). Here, we generated a conditional Rosa26-knockin mouse model to study the mechanistic consequences of the recurrent mutation. Expression of the mutant Ifitm5 in osteo-chondroprogenitor or chondrogenic cells resulted in low bone mass and growth retardation. Mutant limbs showed impaired endochondral ossification, cartilage overgrowth, and abnormal growth plate architecture. The cartilage phenotype correlates with the pathology reported in patients with OI type V. Surprisingly, expression of mutant Ifitm5 in mature osteoblasts caused no obvious skeletal abnormalities. In contrast, earlier expression in osteo-chondroprogenitors was associated with an increase in the skeletal progenitor cell population within the periosteum. Lineage tracing showed that chondrogenic cells expressing the mutant Ifitm5 had decreased differentiation into osteoblastic cells in diaphyseal bone. Moreover, mutant IFITM5 disrupted early skeletal homeostasis in part by activating ERK signaling and downstream SOX9 protein, and inhibition of these pathways partially rescued the phenotype in mutant animals. These data identify the contribution of a signaling defect altering osteo-chondroprogenitor differentiation as a driver in the pathogenesis of OI type V.

Authors

Ronit Marom, I-Wen Song, Emily C. Busse, Megan E. Washington, Ava S. Berrier, Vittoria C. Rossi, Laura Ortinau, Youngjae Jeong, Ming-Ming Jiang, Brian C. Dawson, Mary Adeyeye, Carolina Leynes, Caressa D. Lietman, Bridget M. Stroup, Dominyka Batkovskyte, Mahim Jain, Yuqing Chen, Racel Cela, Alexis Castellon, Alyssa A. Tran, Isabel Lorenzo, D. Nicole Meyers, Shixia Huang, Alicia Turner, Vinitha Shenava, Maegen Wallace, Eric Orwoll, Dongsu Park, Catherine G. Ambrose, Sandesh C.S. Nagamani, Jason D. Heaney, Brendan H. Lee

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Figure 7

Expression of the mutant Ifitm5 allele leads to altered spatiotemporal expression of SOX9.

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Expression of the mutant Ifitm5 allele leads to altered spatiotemporal e...
(A) RPPA in the transgenic Ifitm5c.-14C > T mouse model. SOX9 RPPA signal intensity was increased in calvaria protein extract from mice overexpressing mutant Ifitm5, as compared with mice overexpressing wild type Ifitm5, and nontransgenic littermates (n = 8 per group, **P < 0.001, by 1-way ANOVA with Tukey’s post hoc tests, all comparisons were with the mutant Ifitm5 [MUT Tg] group). (B) Western blot for SOX9 in representative RPPA samples. (C) Representative IHC images of proximal tibia of control (top) and mutant (Rosa26mIfitm5/+ Prx1-Cre/–, bottom) mice at 2 weeks of age, showing increased intensity and altered distribution of SOX9+ cells in the growth plate. In the mutant mice, SOX9+ cells are seen throughout the growth plate including the hypertrophic zone (which is reduced compared with littermate controls). Scale bar: 200 μm. Original magnification, ×20 (insets). See supplemental Figure 10 for the staining control (secondary antibody).

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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