Inhibition of phosphatidylinositol 3-kinase α (PI3Kα) prevents heterotopic ossification

EMBO Mol Med. 2019 Sep;11(9):e10567. doi: 10.15252/emmm.201910567. Epub 2019 Aug 2.

Abstract

Heterotopic ossification (HO) is the pathological formation of ectopic endochondral bone within soft tissues. HO occurs following mechanical trauma, burns, or congenitally in patients suffering from fibrodysplasia ossificans progressiva (FOP). FOP patients carry a conserved mutation in ACVR1 that becomes neomorphic for activin A responses. Here, we demonstrate the efficacy of BYL719, a PI3Kα inhibitor, in preventing HO in mice. We found that PI3Kα inhibitors reduce SMAD, AKT, and mTOR/S6K activities. Inhibition of PI3Kα also impairs skeletogenic responsiveness to BMPs and the acquired response to activin A of the Acvr1R206H allele. Further, the efficacy of PI3Kα inhibitors was evaluated in transgenic mice expressing Acvr1Q207D . Mice treated daily or intermittently with BYL719 did not show ectopic bone or cartilage formation. Furthermore, the intermittent treatment with BYL719 was not associated with any substantial side effects. Therefore, this work provides evidence supporting PI3Kα inhibition as a therapeutic strategy for HO.

Keywords: PI3K; bone; bone morphogenetic protein; fibrodysplasia ossificans progressiva; heterotopic ossification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activin Receptors, Type I / genetics
  • Activin Receptors, Type I / metabolism
  • Activins / metabolism
  • Animals
  • Bone Morphogenetic Proteins / metabolism
  • Class I Phosphatidylinositol 3-Kinases / antagonists & inhibitors
  • Class I Phosphatidylinositol 3-Kinases / genetics
  • Class I Phosphatidylinositol 3-Kinases / metabolism*
  • Humans
  • Mice
  • Ossification, Heterotopic / enzymology*
  • Ossification, Heterotopic / genetics
  • Ossification, Heterotopic / prevention & control*
  • Phosphoinositide-3 Kinase Inhibitors / administration & dosage*
  • Thiazoles / administration & dosage

Substances

  • Bone Morphogenetic Proteins
  • Phosphoinositide-3 Kinase Inhibitors
  • Thiazoles
  • activin A
  • Alpelisib
  • Activins
  • Class I Phosphatidylinositol 3-Kinases
  • Pik3ca protein, mouse
  • Activin Receptors, Type I