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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">BR</journal-id>
<journal-title-group>
<journal-title>Biomedical Reports</journal-title>
</journal-title-group>
<issn pub-type="ppub">2049-9434</issn>
<issn pub-type="epub">2049-9442</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/br.2018.1128</article-id>
<article-id pub-id-type="publisher-id">BR-0-0-1128</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title><italic>PLXNA2</italic> identified as a candidate gene by genome-wide association analysis for mandibular prognathism in human chondrocytes</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Kajii</surname><given-names>Takashi S.</given-names></name>
<xref rid="af1-br-0-0-1128" ref-type="aff">1</xref>
<xref rid="c1-br-0-0-1128" ref-type="corresp"/></contrib>
<contrib contrib-type="author"><name><surname>Oka</surname><given-names>Akira</given-names></name>
<xref rid="af2-br-0-0-1128" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author"><name><surname>Hatta</surname><given-names>Mitsutoki</given-names></name>
<xref rid="af3-br-0-0-1128" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Yamazaki</surname><given-names>Jun</given-names></name>
<xref rid="af3-br-0-0-1128" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Yamashita</surname><given-names>Junro</given-names></name>
<xref rid="af4-br-0-0-1128" ref-type="aff">4</xref></contrib>
<contrib contrib-type="author"><name><surname>Iida</surname><given-names>Junichiro</given-names></name>
<xref rid="af5-br-0-0-1128" ref-type="aff">5</xref></contrib>
</contrib-group>
<aff id="af1-br-0-0-1128"><label>1</label>Section of Orthodontics, Department of Oral Growth and Development, Fukuoka Dental College, Fukuoka 814-0913, Japan</aff>
<aff id="af2-br-0-0-1128"><label>2</label>Institute of Medical Science, Tokai University, Kanagawa 259-1193, Japan</aff>
<aff id="af3-br-0-0-1128"><label>3</label>Section of Cellular and Molecular Regulation, Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka 814-0913, Japan</aff>
<aff id="af4-br-0-0-1128"><label>4</label>Section of Fixed Prosthodontics, Department of Oral Rehabilitation, Fukuoka Dental College, Fukuoka 814-0913, Japan</aff>
<aff id="af5-br-0-0-1128"><label>5</label>Department of Orthodontics, Division of Oral Functional Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan</aff>
<author-notes>
<corresp id="c1-br-0-0-1128"><italic>Correspondence to</italic>: Dr Takashi S. Kajii, Section of Orthodontics, Department of Oral Growth and Development, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0913, Japan, E-mail: <email>takkajii@mac.com</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>09</month>
<year>2018</year></pub-date>
<pub-date pub-type="epub">
<day>11</day>
<month>07</month>
<year>2018</year></pub-date>
<volume>9</volume>
<issue>3</issue>
<fpage>253</fpage>
<lpage>258</lpage>
<history>
<date date-type="received"><day>23</day><month>02</month><year>2018</year></date>
<date date-type="accepted"><day>03</day><month>07</month><year>2018</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2018, Spandidos Publications</copyright-statement>
<copyright-year>2018</copyright-year>
</permissions>
<abstract>
<p>In a previous genome-wide association study, plexin A2 (<italic>PLXNA2</italic>) was suggested as one of the candidate genes for mandibular prognathism. <italic>PLXNA2</italic> encodes plexin A2, a member of the plexin-A family of semaphorin co-receptors. Semaphorin 3A (sema3A) exerts an osteoprotective effect. However, to the best of our knowledge, there have been no previous studies examining the role of sema3A or plexin A2 on human chondrocytes. The objectives of the present study were to examine the function of sema3A and its receptor, plexin A2, in human chondrocytes. Normal human chondrocytes were cultured in media with either a high (100 ng/ml) or a low (1 ng/ml) concentration of sema3A, or without sema3A as a control. Cells and extracellular matrices were assayed for concentrations of protein and parathyroid hormone-related peptide receptor 1 (PTH-R1) using a bicinchoninic acid assay and an enzyme immunoassay, respectively. At culture day 7, the high and low concentrations of exogenous sema3A significantly increased the protein content compared with the control (P=0.0008 and 0.00002, respectively). At culture day 14, a high concentration of exogenous sema3A significantly increased the protein content and decreased the concentration of PTH-R1 compared with the control (P=0.002). The present study revealed novel results that exogenous sema3A suppresses the expression of PTH-R1 in human proliferative chondrocytes and suggested that sema3A may affect human chondrocytes via its receptor, plexin A2.</p>
</abstract>
<kwd-group>
<kwd>mandibular prognathism</kwd>
<kwd>candidate genes</kwd>
<kwd>plexin A2</kwd>
<kwd>semaphorin 3A</kwd>
<kwd>chondrocytes</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>It is evident that mandibular prognathism (Online Mendelian Inheritance in Man #176700) is a multifactorial phenotype (<xref rid="b1-br-0-0-1128" ref-type="bibr">1</xref>,<xref rid="b2-br-0-0-1128" ref-type="bibr">2</xref>). To identify the susceptibility loci of mandibular prognathism, the first genome-wide association study (GWAS) was performed using microsatellites in Japanese patients including 240 individuals with mandibular prognathism and 360 individuals who were healthy (<xref rid="b3-br-0-0-1128" ref-type="bibr">3</xref>,<xref rid="b4-br-0-0-1128" ref-type="bibr">4</xref>). This previous GWAS (<xref rid="b4-br-0-0-1128" ref-type="bibr">4</xref>) suggested that six loci [1p22.3, 1q32.2 (<xref rid="tI-br-0-0-1128" ref-type="table">Table I</xref>), 3q23, 6q23.2, 7q11.22 and 15q22.22] were identified as susceptibility regions of mandibular prognathism. The mutations of synovial sarcoma, X breakpoint 2 interacting protein, plexin A2 (<italic>PLXNA2</italic>) (<xref rid="tII-br-0-0-1128" ref-type="table">Table II</xref>), Ras p21 protein activator 2, transcription factor 21, calneuron 1 and RAR (retinoic acid receptor)-related orphan receptor &#x03B1; genes were suggested as candidate genes, respectively.</p>
<p>PLXNA2 gene is located on chromosome 1q32.2 and encodes plexin A2, a member of the plexin-A family of semaphorin co-receptors (<xref rid="b5-br-0-0-1128" ref-type="bibr">5</xref>). Semaphorins are a large family of secreted or membrane-bound proteins that mediate repulsive effects on axon path finding during nervous system development (<xref rid="b5-br-0-0-1128" ref-type="bibr">5</xref>). Semaphorin 3A (sema3A) is a secreted protein and expressed by osteoblasts, whereas sema3A is not detected in osteoclasts (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>). Sema3A exerts an osteoprotective effect by suppressing osteoclastic bone resorption and promoting osteoblastic bone formation. Plexin A2 is expressed in osteoblasts, and it is suggested that sema3A and plexin A2 binding stimulates osteoblast differentiation (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>). Yoshida <italic>et al</italic> (<xref rid="b7-br-0-0-1128" ref-type="bibr">7</xref>) reported that sema3A may induce cell migration, proliferation and the odontoblastic differentiation of human dental pulp stem cells. However, human mandibular growth consists of a periosteal growth of cortical bone and an endochondral growth of the mandibular condyle (<xref rid="b8-br-0-0-1128" ref-type="bibr">8</xref>). Active mandibular growth occurs in an endochondral growth of the condyle (<xref rid="b8-br-0-0-1128" ref-type="bibr">8</xref>). Gomez <italic>et al</italic> (<xref rid="b9-br-0-0-1128" ref-type="bibr">9</xref>) reported that sema3A and plexin A2 mRNA are expressed in mouse chondrogenic cell line MC 615. However, to the best of our knowledge, there have been no previous studies on the role of sema3A or plexin A2 in human chondrocytes.</p>
<p>The objectives of the present study were to examine the function of sema3A and its receptor, plexin A2, in human chondrocytes.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Cell culture</title>
<p>Normal human chondrocytes (PromoCell GmbH, Heidelberg, Germany) were seeded into a T25 culture vessel (10,000&#x2013;20,000 cells/cm<sup>2</sup>) and grown in commercial medium (Chondrocyte Growth Medium; PromoCell GmbH) containing 10&#x0025; fetal calf serum (PromoCell GmbH). Cultures were maintained at 37&#x00B0;C in a humidified atmosphere of 5&#x0025; CO<sub>2</sub> and 95&#x0025; air, and the medium was changed every 2&#x2013;3 days. Subcultures were obtained by removing the cells from the dish using 0.025&#x0025; trypsin in 2-[4-(2-Hydroxyethyl)-1-piperazinyl] ethanesulfonic acid (HEPES) buffered saline solution containing 0.01&#x0025; ethylenediaminetetraacetic acid (EDTA) (PromoCell GmbH).</p>
<p>Cells were seeded into 100 mm diameter culture plates. After 1 day, they were exposed to new media with either: i) A 100 ng/ml concentration, the concentration determined in a previous study (<xref rid="b7-br-0-0-1128" ref-type="bibr">7</xref>), of recombinant human sema3A (R&#x0026;D Systems, Inc., Minneapolis, MN, USA; high); ii) A 1 ng/ml concentration of sema3A (low); or iii) without sema3A (control). The effects of sema3A were analyzed at days 7 and 14 of culturing, and representative data were obtained from five culture plates of each group.</p>
</sec>
<sec>
<title>Protein assay and type II collagen and human parathyroid hormone-related peptide (PTHrP) receptor 1 (PTH-R1) concentration determination</title>
<p>Cells and extracellular matrices were assayed for concentrations of PTH-R1 on days 7 and 14 of culturing using an Enzyme-linked Immunosorbent assay kit (cat no. SEC743Hu; Cloud-Clone Corp., Houston, TX, USA) as previously described (<xref rid="b10-br-0-0-1128" ref-type="bibr">10</xref>). Cells and extracellular matrices were detached with 0.025&#x0025; trypsin in HEPES buffered saline solution containing 0.01&#x0025; EDTA, collected by centrifugation (220 &#x00D7; g for 3 min at 4&#x00B0;C), washed three times, resuspended in 1&#x00D7; PBS, subject to ultrasonication, and centrifuged (1,500 &#x00D7; g for 10 min at 4&#x00B0;C) to remove cellular debris in accordance with the manufacturer&#x0027;s protocol.</p>
<p>The cells and extracellular matrices were also assayed for concentrations of type II collagen using an enzyme immunoassay kit (Type II Collagen Detection kit; Chondrex, Inc., Redmond, WA, USA) as previously described (<xref rid="b11-br-0-0-1128" ref-type="bibr">11</xref>,<xref rid="b12-br-0-0-1128" ref-type="bibr">12</xref>). In accordance with the manufacturer&#x0027;s protocol, the cells and extracellular matrices were solubilized by pepsin digestion (at 4&#x00B0;C for 24 h) and elastase digestion (at 4&#x00B0;C for 24 h) prior to with the assay. Culture media were also assayed for concentrations of type II collagen. Protein content of the cells and extracellular matrices were measured using a bicinchoninic acid assay reagent kit (Thermo Fisher Scientific, Waltham, MA, USA) as previously described (<xref rid="b13-br-0-0-1128" ref-type="bibr">13</xref>,<xref rid="b14-br-0-0-1128" ref-type="bibr">14</xref>). Bovine serum albumin was used as the control. All assays were performed according to the manufacturer&#x0027;s protocol.</p>
</sec>
<sec>
<title>Statistical methods</title>
<p>The data were represented as the mean &#x00B1; standard deviation. Representative data were obtained from five culture plates of each group. Parametric tests were used in the present study as the distribution of the concentrations of type II collagen, PTH-R1 and the protein expression levels of control, low and high sema3A groups were normally distributed. One-way analysis of variance was used to compare the protein content and concentrations of type II collagen and PTH-R1 among three groups. Post hoc multiple comparisons were performed using Bonferroni&#x0027;s test. Statistical analyses were performed using SPSS version 23.0 statistical package (IBM Corporation, Armonk, NY, USA). P&#x003C;0.05 was considered to indicate a statistically significant difference.</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Evaluation of human chondrocytes response to sema3A treatment</title>
<p><xref rid="f1-br-0-0-1128" ref-type="fig">Fig. 1</xref> reveals the effect of recombinant human sema3A on the morphology of human chondrocytes. At culture day 7, the cells were polygonal, and low and high concentrations of exogenous sema3A appeared to promote the growth of chondrocytes compared with the control. At culture day 14, the cells remained polygonal in the three groups.</p>
<p><xref rid="f2-br-0-0-1128" ref-type="fig">Fig. 2</xref> demonstrates the mean &#x00B1; standard deviation of the protein content, in accordance with cell growth and accumulation of extracellular matrices, of human chondrocytes. At culture day 7, high and low concentrations of exogenous sema3A significantly increased the protein content of chondrocytes (0.044&#x00B1;0.010 and 0.051&#x00B1;0.006 mg/ml, respectively) compared with the control (0.017&#x00B1;0.005 mg/ml) (P=0.0008 and 0.00002, respectively). At culture day 14, a high concentration of sema3A significantly increased the protein content of chondrocytes (0.174&#x00B1;0.020 mg/ml) compared with the control (0.124&#x00B1;0.014 mg/ml) (P=0.002).</p>
</sec>
<sec>
<title>Effect of sema3A on type II collagen expression in human chondrocytes</title>
<p><xref rid="f3-br-0-0-1128" ref-type="fig">Fig. 3</xref> presents the mean &#x00B1; standard deviation of concentrations of type II collagen in the culture medium of human chondrocytes. At culture day 7, exogenous sema3A dose-dependently decreased the concentrations of type II collagen in the culture medium of chondrocytes, although the differences were not statistically significant among the three groups. At culture day 14, the concentration of type II collagen in the culture medium of chondrocytes was not detected in the three groups. Concentrations of type II collagen in cells and extracellular matrices were not also detected in the three groups.</p>
</sec>
<sec>
<title>Effects of sema3A on PTH-R1 expression in human chondrocytes</title>
<p><xref rid="f4-br-0-0-1128" ref-type="fig">Fig. 4</xref> presents the mean &#x00B1; standard deviation of concentrations of PTH-R1 in human chondrocytes. At culture day 7, neither high nor low concentrations of exogenous sema3A significantly influenced the concentration of PTH-R1 of chondrocytes (0.241&#x00B1;0.036 and 0.242&#x00B1;0.029 ng/ml, respectively) compared with the control (0.253&#x00B1;0.084 ng/ml). At culture day 14, a high concentration of sema3A significantly decreased the concentration of PTH-R1 in chondrocytes (0.211&#x00B1;0.017 ng/ml) when compared with the control (0.310&#x00B1;0.053 ng/ml) (P=0.004).</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>To investigate the effects of sema3A on the various functions of human dental pulp stem cells, Yoshida <italic>et al</italic> (<xref rid="b7-br-0-0-1128" ref-type="bibr">7</xref>) added a 10 ng/ml concentration of recombinant human sema3A in medium for human dental pulp stem cells. To examine the function of sema3A in the regulation of osteoclast differentiation, Hayashi <italic>et al</italic> (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>) added a 500 ng/ml concentration of recombinant sema3A in medium for osteoblasts. The concentrations of recombinant human sema3A used in the present study were selected according to these previous studies.</p>
<p>Type II collagen produced by cells is incorporated into the extracellular matrix (<xref rid="b11-br-0-0-1128" ref-type="bibr">11</xref>,<xref rid="b12-br-0-0-1128" ref-type="bibr">12</xref>). However, in the present study, type II collagen was not detected in cells and matrix, nevertheless type II collagen was digested by pepsin and elastase for solubilizing collagen. Instead of type II collagen in extracellular matrix, concentrations of type II collagen in culture medium were measured out, which was already soluble.</p>
<p>Sema3A is expressed in osteoblasts (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>). Plexin A2, which is a semaphorin receptor, is also expressed in osteoblasts, and it has been suggested that sema3A and plexin A2 binding stimulates osteoblast differentiation (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>). Gomez <italic>et al</italic> (<xref rid="b9-br-0-0-1128" ref-type="bibr">9</xref>) reported that sema3A and plexin A2 mRNA were expressed in a mouse chondrogenic cell line. In the present study, the addition of recombinant human sema3A significantly (P&#x003C;0.001) increased the protein content of human chondrocytes (<xref rid="f2-br-0-0-1128" ref-type="fig">Fig. 2</xref>). Protein content is thought to indicate the degree of cell growth and accumulation of extracellular matrices (<xref rid="b13-br-0-0-1128" ref-type="bibr">13</xref>,<xref rid="b14-br-0-0-1128" ref-type="bibr">14</xref>). The results of the present study and a previous study (<xref rid="b9-br-0-0-1128" ref-type="bibr">9</xref>) therefore suggest that plexin A2 may be expressed in not only mouse but also human chondrocytes, and that exogenous sema3A may bind plexin A2 on proliferative human chondrocytes and induce the acceleration of cell growth and/or accumulation of extracellular matrices of chondrocytes, although the present study did not assert whether the expression of plexin A2 is constant or regulated by exogenous sema3A.</p>
<p>Active mandibular growth occurs in an endochondral growth of the condyle of the temporomandibular joint (<xref rid="b8-br-0-0-1128" ref-type="bibr">8</xref>). In the temporomandibular joint, endogenous cytokines are reportedly produced by non-inflammatory cells including osteoblasts and chondrocytes and interact with their receptors (<xref rid="b13-br-0-0-1128" ref-type="bibr">13</xref>). The <italic>PTHrP</italic> gene is located on chromosome 12p12.1-p11.2 and encodes a member of the parathyroid hormone family. The protein PTHrP, via its receptor, PTH-R1, regulates endochondral bone development. The PTHrP ligand is expressed in mouse undifferentiated (proliferative) chondrocytes in the growth plate of developing bones (<xref rid="b15-br-0-0-1128" ref-type="bibr">15</xref>,<xref rid="b16-br-0-0-1128" ref-type="bibr">16</xref>). PTH-R1 is expressed in mouse chondrocytes located mainly in the proliferative zone and the hypertrophic zone of the growth plate (<xref rid="b15-br-0-0-1128" ref-type="bibr">15</xref>&#x2013;<xref rid="b17-br-0-0-1128" ref-type="bibr">17</xref>). Expression of the <italic>PTH-R1</italic> gene coincides with the type II collagen gene (<xref rid="b16-br-0-0-1128" ref-type="bibr">16</xref>). Activation of PTH-R1 interferes with the early stages of chondrogenesis through the cyclic AMP/protein kinase A signaling pathway (<xref rid="b18-br-0-0-1128" ref-type="bibr">18</xref>). Namely, PTH-R1 functions to maintain proliferative chondrocytes and delays the production of hypertrophic chondrocytes in mice (<xref rid="b18-br-0-0-1128" ref-type="bibr">18</xref>). Indian hedgehog is expressed in pre-hypertrophic chondrocytes and stimulates the production of PTHrP in mice (<xref rid="b18-br-0-0-1128" ref-type="bibr">18</xref>,<xref rid="b19-br-0-0-1128" ref-type="bibr">19</xref>). Experiments using chimaeric mice (<xref rid="b19-br-0-0-1128" ref-type="bibr">19</xref>) revealed that a negative feedback loop functions in chondrogenesis. In the present study, to examine whether sema3A is associated with the endochondral growth of the condyle of the temporomandibular joint, effects of exogenous sema3A on PTH-R1 in human chondrocytes were preliminarily investigated.</p>
<p>In the present study, the addition of a high concentration (100 ng/ml) of recombinant human sema3A significantly (P=0.002) decreased the expression of PTH-R1 in human chondrocytes at culture day 14 (<xref rid="f4-br-0-0-1128" ref-type="fig">Fig. 4</xref>). The novel results of the present study suggested that exogenous sema3A may function on plexin A2 in proliferative human chondrocytes and suppresses PTH-R1 and/or PTHrP expression in proliferative human chondrocytes, although the mechanism remains unknown. Suppression of PTH-R1 and/or PTHrP expression potentially accelerates the differentiation of hypertrophic chondrocytes and the subsequent endochondral ossification at puberty (in other words, early termination of condylar endochondral growth). The mutation of the <italic>PLXNA2</italic> gene may inhibit this action of sema3A on chondrocytes and delay this early termination of condylar endochondral growth. Therefore, the mutation of <italic>PLXNA2</italic> gene encoding plexin A2 may be a candidate gene of mandibular prognathism, even though the results of the present study were limited.</p>
<p>In the present study, there was no data of expression of sema3A, plexin A2 and PTH-R1 when the calcium concentration was changed. In general, PTH enhances the release of calcium from the large reservoir contained in the bones. PTH and PTH-R1 binding stimulates osteoblasts to increase their expression of receptor activator of nuclear factor &#x03BA;-B (RANKL). The binding of RANKL to RANK stimulates these osteoclast precursors to fuse, forming novel osteoclasts, which ultimately enhances bone resorption (<xref rid="b6-br-0-0-1128" ref-type="bibr">6</xref>). Interestingly, Ohta <italic>et al</italic> (<xref rid="b20-br-0-0-1128" ref-type="bibr">20</xref>) reported that plexin A2 mediates cell-cell adhesion via a homophilic binding mechanism under the presence of calcium ions. Therefore, the association between the expression of plexin A2 and calcium concentration will be analyzed in the future.</p>
<p>Another limitation in the present study lies in the &#x2018;dedifferentiation&#x2019; of chondrocytes. Chondrocytes grow and express the phenotypes of chondrocytes in monolayer cultures (<xref rid="b21-br-0-0-1128" ref-type="bibr">21</xref>,<xref rid="b22-br-0-0-1128" ref-type="bibr">22</xref>). However, in monolayer cultures cultured over two weeks in a previous study, the growing chondrocytes appeared to be dedifferentiated (<xref rid="b21-br-0-0-1128" ref-type="bibr">21</xref>,<xref rid="b22-br-0-0-1128" ref-type="bibr">22</xref>). Chondrocytes dedifferentiated by monolayer cultures transform into a fibroblast-like morphology and express type I collagen accompanied with a fibroblast-like phenotype (<xref rid="b23-br-0-0-1128" ref-type="bibr">23</xref>,<xref rid="b24-br-0-0-1128" ref-type="bibr">24</xref>), whereas proliferative chondrocytes are polygonal and express type II collagen accompanied with a chondrocyte phenotype. In the present study, the increased protein content and the decreased type II collagen and PTH-R1 expression in human chondrocytes at culture day 14 may result from the dedifferentiation accelerated by exogenous sema3A.</p>
<p>To facilitate the &#x2018;redifferentiation&#x2019; of the dedifferentiated chondrocytes incubated by monolayer cultures over two weeks, high cell density three-dimensional cultures performed by assembling chondrocyte in alginate beads, synthetic polymer gels or compressing into pellets (spheroid formation) have been attempted (<xref rid="b25-br-0-0-1128" ref-type="bibr">25</xref>,<xref rid="b26-br-0-0-1128" ref-type="bibr">26</xref>). In future studies, three-dimensional cultures for human chondrocytes will be utilized.</p>
<p>In conclusion, a previous GWAS had revealed <italic>PLXNA2</italic> encoding a member of the plexin-A family of semaphorin co-receptors as one of the candidate genes for mandibular prognathism. The present preliminary study proposed that sema3A functions on not only murine but also human chondrocytes and revealed the novel result that exogenous sema3A suppresses the expression of PTH-R1 in human proliferative chondrocytes. Exogenous sema3A may function on human chondrocytes by binding plexin A2. Suppression of PTH-R1 and/or PTHrP expression potentially accelerates the early termination of condylar growth. The mutation of the <italic>PLXNA2</italic> gene may delay the early termination of the condylar growth. Therefore, the mutation of the <italic>PLXNA2</italic> gene encoding plexin A2 may be a candidate gene of mandibular prognathism.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>Not applicable.</p>
</ack>
<sec>
<title>Funding</title>
<p>The present study was supported by the Japanese Society for the Promotion of Science KAKENHI (Grants-in-Aid for Scientific Research; grant no. JP16K20630) and National Institutes of Health/National Institute if Dental and Craniofacial Research (grant no. R01DE023538).</p>
</sec>
<sec>
<title>Availability of data and materials</title>
<p>The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.</p>
</sec>
<sec>
<title>Authors&#x0027; contributions</title>
<p>TK conceived and designed the study, acquired the data, analyzed and interpreted the data and drafted the article. AO conceived and designed the study and revised the article for important intellectual content. MH acquired the data, analyzed and interpreted the data and revised the article for important intellectual content. JYamaz analyzed and interpreted the data and revised the article for important intellectual content. JYamas analyzed and interpreted the data and revised the article for important intellectual content. JI conceived and designed the study and revised the article for important intellectual content.</p>
</sec>
<sec>
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Patients consent for publication</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Competing interest</title>
<p>The authors declare that they have no competing interests.</p>
</sec>
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<fig id="f1-br-0-0-1128" position="float">
<label>Figure 1.</label>
<caption><p>Effect of exogenous sema3A on the morphology of human chondrocytes. Cells cultured for 1 day were exposed to 1 ng/ml (low) or 100 ng/ml (high) sema3A for 7 or 14 days in 100 mm diameter culture plates. Upper lane, day 7; lower lane, day 14. Scale bars, 100 &#x00B5;m. Sema3A, semaphorin 3A.</p></caption>
<graphic xlink:href="br-09-03-0253-g00.tif"/>
</fig>
<fig id="f2-br-0-0-1128" position="float">
<label>Figure 2.</label>
<caption><p>Protein content in human chondrocytes and matrices in the absence or presence of exogenous sema3A. Cells cultured for 1 day were grown without any addition (control), with 1 ng/ml sema3A (low) or 100 ng/ml sema3A (high). Left, day 7; right, day 14. The data represent the mean &#x00B1; standard deviation of five samples. &#x002A;&#x002A;&#x002A;P&#x003C;0.001 and &#x002A;&#x002A;P&#x003C;0.01 with comparisons shown by lines. Sema3A, semaphorin 3A.</p></caption>
<graphic xlink:href="br-09-03-0253-g01.tif"/>
</fig>
<fig id="f3-br-0-0-1128" position="float">
<label>Figure 3.</label>
<caption><p>Concentration of type II collagen in culture medium of human chondrocytes at culture day 7 in the absence or presence of exogenous sema3A. Cells cultured for 1 day were grown without any addition (control), with 1 ng/ml sema3A (low) or 100 ng/ml sema3A (high). The data represent the mean &#x00B1; standard deviation of five samples. Sema3A, semaphorin 3A.</p></caption>
<graphic xlink:href="br-09-03-0253-g02.tif"/>
</fig>
<fig id="f4-br-0-0-1128" position="float">
<label>Figure 4.</label>
<caption><p>Concentration of PTH-R1 in human chondrocytes and matrices in the absence or presence of exogenous sema3A. Cells cultured for 1 day were grown without any addition (control), with 1 ng/ml sema3A (low) or 100 ng/ml sema3A (high). Left, day 7; right, day 14. The data represent the mean &#x00B1; standard deviation of five samples. &#x002A;&#x002A;P&#x003C;0.01 with comparisons shown by lines. PTH-R1, parathyroid hormone-related peptide receptor 1; sema3A, semaphorin 3A.</p></caption>
<graphic xlink:href="br-09-03-0253-g03.tif"/>
</fig>
<table-wrap id="tI-br-0-0-1128" position="float">
<label>Table I.</label>
<caption><p>Results of a previous genome-wide association of mandibular prognathism using microsatellite markers.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th/>
<th/>
<th/>
<th/>
<th align="center" valign="bottom" colspan="2">Allele frequency</th>
<th align="center" valign="bottom" colspan="2">Fishers exact test P-value</th>
<th/>
</tr>
<tr>
<th/>
<th/>
<th/>
<th/>
<th align="center" valign="bottom" colspan="2"><hr/></th>
<th align="center" valign="bottom" colspan="2"><hr/></th>
<th/>
</tr>
<tr>
<th align="left" valign="bottom">Microsatellite</th>
<th align="center" valign="bottom">Cytobands</th>
<th align="center" valign="bottom">Alleles (n)</th>
<th align="center" valign="bottom">Significant allele<sup><xref rid="tfn1-br-0-0-1128" ref-type="table-fn">a</xref></sup></th>
<th align="center" valign="bottom">Cases</th>
<th align="center" valign="bottom">Controls</th>
<th align="center" valign="bottom">2&#x00D7;2</th>
<th align="center" valign="bottom">2&#x00D7;m</th>
<th align="center" valign="bottom">Odds ratio (95&#x0025; confidence interval)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top"><italic>D1S1358i</italic></td>
<td align="center" valign="top">1q32.2</td>
<td align="center" valign="top">7</td>
<td align="center" valign="top">92</td>
<td align="center" valign="top">0.362</td>
<td align="center" valign="top">0.465</td>
<td align="center" valign="top">0.000422</td>
<td align="center" valign="top">0.007</td>
<td align="center" valign="top">0.65 (0.51&#x2013;0.83)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-br-0-0-1128"><label>a</label><p>Significant allele presents the size of the amplicon. m, Number of alleles for the marker.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tII-br-0-0-1128" position="float">
<label>Table II.</label>
<caption><p>Information on nearest candidate gene of susceptibility locus obtained from previous genome-wide association study of mandibular prognathism using microsatellites.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th/>
<th/>
<th align="center" valign="bottom" colspan="2">Physical position of amplicon<sup><xref rid="tfn2-br-0-0-1128" ref-type="table-fn">a</xref></sup></th>
<th/>
<th/>
</tr>
<tr>
<th align="left" valign="bottom">Microsatellite</th>
<th align="center" valign="bottom">Cytobands</th>
<th align="center" valign="bottom">From</th>
<th align="center" valign="bottom">To</th>
<th align="center" valign="bottom">Nearest gene</th>
<th align="center" valign="bottom">Gene location<sup><xref rid="tfn2-br-0-0-1128" ref-type="table-fn">a</xref></sup></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top"><italic>D1S1358i</italic></td>
<td align="center" valign="top">1q32.2</td>
<td align="center" valign="top">208365606</td>
<td align="center" valign="top">208365706</td>
<td align="center" valign="top"><italic>PLXNA2</italic></td>
<td align="center" valign="top">(chr1: 208200588 - 208391267)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn2-br-0-0-1128"><label>a</label><p>Physical position of amplicon was referred to GRCh build 37/hg19. <italic>PLXNA2</italic>, plexin A2.</p></fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</article>
