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UNCORRECTED PROOF 1 Technical Note 2 A method for isolating high quality RNA from mouse cortical and cancellous bones Q2 Q3 Natalie H. Kelly a,b , John C. Schimenti c , F. Patrick Ross d , Marjolein C.H. van der Meulen a,b,d, 5 a Sibley School of Mechanical and Aerospace Engineering, Cornell University, 105 Upson Hall, Ithaca, NY 14853, USA 6 b Department of Biomedical Engineering, Cornell University, 101 Weill Hall, Ithaca, NY 14853, USA 7 c College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA 8 d Research Division, Hospital for Special Surgery, 541 East 71st St., New York, NY 10021, USA abstract 9 article info 10 Article history: 11 Received 30 June 2014 12 Revised 18 July 2014 13 Accepted 19 July 2014 14 Available online xxxx 15 16 Edited by: Sundeep Khosla 17 Keywords: 18 Osteoporosis 19 Animal models 20 Gene expression 21 Cancellous bone 22 Cortical bone 23 The high incidence of fragility fractures in cortico-cancellous bone locations, plus the fact that individual skeletal 24 sites exhibit different responsiveness to load and disease, emphasizes the need to document separately gene 25 expression in cortical and cancellous bones. A further confounding factor is marrow contamination since its 26 high cellularity may effect gene expression measurements. We isolated RNA from cortical and cancellous 27 bones Q5 of intact mouse tibiae, and also after marrow removal by ushing or centrifugation. RNA isolated from 28 cancellous bone by each method was sufcient for gene expression analysis. Centrifugation removed contami- 29 nating cells more efciently than ushing, as indexed by histology and decreased expression of Icam4, a highly 30 expressed erythroid gene. In contrast, centrifuged cortical bone had 12- and 13- fold higher expression of the 31 bone-related genes Col1a1 and Bglap, while levels in marrow-free cancellous bone were 30- and 31-fold higher 32 when compared to bone where marrow was left intact. Furthermore, cortical bone had higher expression of 33 Col1a1 and Bglap than cancellous bone. Thus, RNA isolated by this novel approach can reveal site-specic changes 34 in gene expression in cortical and cancellous bone sites. 35 © 2014 Elsevier Inc. All rights reserved. 36 37 38 39 Q6 Introduction 41 Osteoporosis is a skeletal disease characterized by low bone mass 42 that often results in fracture. A majority of osteoporotic fractures occur 43 at cortico-cancellous sites such as the proximal femur, distal forearm, 44 and vertebra [1,2]. At these sites bone is a composite tissue consisting 45 of an outer cortical shell surrounding an inner cancellous network. 46 Mouse models have been developed to understand the etiology of oste- 47 oporosis and to identify possible treatments for osteoporosis-related 48 bone decline. Biophysical stimuli, including mechanical loading, are a 49 promising approach to maintain or recover bone mass. In vivo loading 50 often elicits a greater response in cancellous than cortical bone sites, 51 increasing metaphyseal cancellous bone volume fraction by 4973% 52 and diaphyseal cortical area by 41% in the mouse tibia [3,4]. But different 53 loading protocols can alter cancellous and cortical bone responses 54 selectively; some stimulate cancellous bone to a greater extent, while 55 others mainly affect cortical bone [5], indicating that differences 56 in mechanoresponsiveness may exist in cortical and cancellous bones. 57 To identify the nature and degree of change in these two bone tissues 58 requires denitive data on which genes are altered at cortical and can- 59 cellous sites following manipulation of test animals. To date this infor- 60 mation is largely unknown, as most studies have used approaches that 61 are derived from homogenized bone tissues. 62 The cellular and molecular mechanisms driving load-induced anabo- 63 lism at the tissue level have been examined using both quantitative real- 64 time polymerase chain reaction (qPCR) and microarray [69]. These 65 studies have examined tissues from whole bones, homogenizing cortical 66 and cancellous bones. In contrast, only a single study examined the load- 67 ing response in cancellous bone from the mouse vertebrae, but did not 68 compare the response to cortical bone [10]. Furthermore, marrow 69 cells have been left in place [8], removed by ushing [7], centrifugation 70 [6,9], or sequential collagenase digestion [10,11]. Collagenase digestion 71 has been shown to affect expression of bone-related genes [12], but 72 this effect may depend on the type of collagenase used; endotoxin-free 73 collagenase had a less detrimental effect on RNA quality [13]. However, 74 failure to remove the highly cellular marrow component may result in 75 extensive contamination of RNA isolated from unfractionated bone. 76 The relative efcacy of ushing to centrifugation has not been studied, 77 nor has the degree of bone marrow presence on gene expression. 78 More importantly, gene expression has not been reported in minimally 79 contaminated cortical versus cancellous bone, a challenging endeavor in 80 murine models. Bone xxx (2014) xxxxxx Financial support: National Institutes of Health grants R01-AG028664 (MCHM), NSF GRFP Q1 (NHK). Corresponding author at: Sibley School of Mechanical and Aerospace Engineering, Cornell University, 219 Upson Hall, Ithaca, NY 14853, USA Q4 . Fax: +1 607 255 1222. E-mail addresses: [email protected] (N.H. Kelly), [email protected] (J.C. Schimenti), [email protected] (F. Patrick Ross), [email protected] (M.C.H. van der Meulen). BON-10438; No. of pages: 5; 4C: http://dx.doi.org/10.1016/j.bone.2014.07.022 8756-3282/© 2014 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Bone journal homepage: www.elsevier.com/locate/bone Please cite this article as: Kelly NH, et al, A method for isolating high quality RNA from mouse cortical and cancellous bones, Bone (2014), http://dx.doi.org/10.1016/j.bone.2014.07.022
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BON-10438; No. of pages: 5; 4C:

Contents lists available at ScienceDirect

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Technical Note

A method for isolating high quality RNA from mouse cortical andcancellous bones☆

OFNatalie H. Kelly a,b, John C. Schimenti c, F. Patrick Ross d, Marjolein C.H. van der Meulen a,b,d,⁎

a Sibley School of Mechanical and Aerospace Engineering, Cornell University, 105 Upson Hall, Ithaca, NY 14853, USAb Department of Biomedical Engineering, Cornell University, 101 Weill Hall, Ithaca, NY 14853, USAc College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USAd Research Division, Hospital for Special Surgery, 541 East 71st St., New York, NY 10021, USA

☆ Financial support: National Institutes of Health grantGRFP (NHK).⁎ Corresponding author at: Sibley School of Mechanic

Cornell University, 219 Upson Hall, Ithaca, NY 14853, USAE-mail addresses: [email protected] (N.H. Kelly), jcs9

[email protected] (F. Patrick Ross), [email protected] (M.C.H

http://dx.doi.org/10.1016/j.bone.2014.07.0228756-3282/© 2014 Elsevier Inc. All rights reserved.

Please cite this article as: Kelly NH, et al, Ahttp://dx.doi.org/10.1016/j.bone.2014.07.0

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Article history:Received 30 June 2014Revised 18 July 2014Accepted 19 July 2014Available online xxxx

Edited by: Sundeep Khosla

Keywords:OsteoporosisAnimal modelsGene expressionCancellous boneCortical bone

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The high incidence of fragility fractures in cortico-cancellous bone locations, plus the fact that individual skeletalsites exhibit different responsiveness to load and disease, emphasizes the need to document separately geneexpression in cortical and cancellous bones. A further confounding factor is marrow contamination since itshigh cellularity may effect gene expression measurements. We isolated RNA from cortical and cancellousbones of intact mouse tibiae, and also after marrow removal by flushing or centrifugation. RNA isolated fromcancellous bone by each method was sufficient for gene expression analysis. Centrifugation removed contami-nating cells more efficiently than flushing, as indexed by histology and decreased expression of Icam4, a highlyexpressed erythroid gene. In contrast, centrifuged cortical bone had 12- and 13- fold higher expression of thebone-related genes Col1a1 and Bglap, while levels in marrow-free cancellous bone were 30- and 31-fold higherwhen compared to bone where marrow was left intact. Furthermore, cortical bone had higher expression ofCol1a1 and Bglap than cancellous bone. Thus, RNA isolated by this novel approach can reveal site-specific changesin gene expression in cortical and cancellous bone sites.

© 2014 Elsevier Inc. All rights reserved.

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Introduction

Osteoporosis is a skeletal disease characterized by low bone massthat often results in fracture. A majority of osteoporotic fractures occurat cortico-cancellous sites such as the proximal femur, distal forearm,and vertebra [1,2]. At these sites bone is a composite tissue consistingof an outer cortical shell surrounding an inner cancellous network.Mouse models have been developed to understand the etiology of oste-oporosis and to identify possible treatments for osteoporosis-relatedbone decline. Biophysical stimuli, including mechanical loading, are apromising approach to maintain or recover bone mass. In vivo loadingoften elicits a greater response in cancellous than cortical bone sites,increasing metaphyseal cancellous bone volume fraction by 49–73%anddiaphyseal cortical area by 41% in themouse tibia [3,4]. But differentloading protocols can alter cancellous and cortical bone responsesselectively; some stimulate cancellous bone to a greater extent, whileothers mainly affect cortical bone [5], indicating that differencesin mechanoresponsiveness may exist in cortical and cancellous bones.

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al and Aerospace Engineering,. Fax: +1 607 255 [email protected] (J.C. Schimenti),. van der Meulen).

method for isolating high qu22

To identify the nature and degree of change in these two bone tissuesrequires definitive data on which genes are altered at cortical and can-cellous sites following manipulation of test animals. To date this infor-mation is largely unknown, as most studies have used approaches thatare derived from homogenized bone tissues.

The cellular andmolecularmechanisms driving load-induced anabo-lism at the tissue level have been examined using both quantitative real-time polymerase chain reaction (qPCR) and microarray [6–9]. Thesestudies have examined tissues fromwhole bones, homogenizing corticaland cancellous bones. In contrast, only a single study examined the load-ing response in cancellous bone from the mouse vertebrae, but did notcompare the response to cortical bone [10]. Furthermore, marrowcells have been left in place [8], removed by flushing [7], centrifugation[6,9], or sequential collagenase digestion [10,11]. Collagenase digestionhas been shown to affect expression of bone-related genes [12], butthis effect may depend on the type of collagenase used; endotoxin-freecollagenase had a less detrimental effect on RNA quality [13]. However,failure to remove the highly cellular marrow component may result inextensive contamination of RNA isolated from unfractionated bone.The relative efficacy of flushing to centrifugation has not been studied,nor has the degree of bone marrow presence on gene expression.More importantly, gene expression has not been reported in minimallycontaminated cortical versus cancellous bone, a challenging endeavor inmurine models.

ality RNA from mouse cortical and cancellous bones, Bone (2014),

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We describe a method to isolate high quality RNA from cortical and,separately, cancellous bonewith almost no contamination frommarrowcells. Both the quantity and quality of the RNA are suitable for tran-scriptome studies, providing the ability to compare cancellous andcortical tissues to elucidate differences in cellular andmolecularmecha-nisms at these two sites.

Materials and methods

Animals

Fifteen 11-week-old male C57Bl/6 mice were euthanized and theirtibiae rapidly dissected for histology (left leg) or RNA isolation and anal-ysis (right leg). The epiphysis, all soft tissues, periosteum, fibula, and thevery distal end were removed. In five mice, bone marrow of the tibiaewas not removed (no marrow removal, NMR group). In another fivemice, marrow was flushed with 1 mL of phosphate buffered saline(PBS) by inserting a 26-gauge needle into the distal tibia. The tibiae inthe third groupwere centrifuged for 20 s at 16,100 g at room temperaturein nestedmicrocentrifuge tubes, where the inner tube (0.2mL) had holescreated with a 26-gauge needle to allowmarrow to travel into the outertube (0.65mL). Tibiaewere cut approximately 5mmdistal to the growthplate to isolate the metaphysis. The metaphysis was held with forceps sothe proximal end was perpendicular to a 1 mm biopsy punch (Miltex,Integra LifeSciences Corp., Plainsboro, NJ, USA), which was used tomechanically separate a cancellous core from the cortical shell (Fig. 1).The IACUC of Cornell University approved all animal procedures.

Histology

Cancellous and cortical sampleswere placed in 10% formalin for 24 hfor fixation, and decalcified in 45% formic acid for 4 days with daily

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Fig. 1. Schematic of cortical and cancellous bone sample preparation. Tibiae were rapidly dissewas left intact (group 1), flushedwith 1mL of PBS using a 26 g needle inserted distally (group 2cut approximately 5 mm distal to the proximal end to isolate the metaphysis, and a 1 mm bio

Please cite this article as: Kelly NH, et al, A method for isolating high quhttp://dx.doi.org/10.1016/j.bone.2014.07.022

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exchange of the solution. Samples were processed and embedded inparaffin and sectioned longitudinally (6 μmsections, Leica RM2255, Buf-falo Grove, IL, USA). Sectioned samples were stained with hematoxylinand eosin (H&E).

RNA isolation from bone

RNA isolation was performed using Trizol (Life Technologies,Carlsbad, CA, USA) and RNeasy Mini kit (Qiagen, Germantown, MD,USA) as described previously [8]. Briefly, cancellous and corticalsamples (n = 30) were pulverized in liquid nitrogen-cooled flasks(Mikro-dismembrator S, Sartorius Stedim Biotech, Bohemia, NY, USA).Following pulverization, Trizol (Life Technologies) was added to theflasks and the powdered bone/Trizolmixwas incubated at room temper-ature for 45 min. 300 μL of chloroform was added to samples, vortexedfor 15 s, and decanted into phase lock gel tubes (PLG, heavy, 5 Prime,Gaithersburg, MD, USA). Samples were centrifuged for 15 min at 4 Cand 11,500 rpm, to separate the nucleic acid phase (~600 μL), whichwas removed and added to an equal volume of 70% ethanol. Thismixturewas applied to purification columns (RNeasy Mini kit, Qiagen) followingthe manufacturer's instructions, including a DNase digestion (RNase freeDNase kit, Qiagen). A final volume of 30 μL of RNAwas eluted, and purityand quantity were tested using a spectrophotometer (Nanodrop 1000,Thermo Scientific, Wilmington, DE, USA) and RNA Quality Number(RQN) using a fragment analyzer (Advanced Analytical Technologies,Inc., Ames, IA, USA).

RNA isolation from marrow

Marrow from centrifuged bones (n= 3)was placed into RNAlater(Qiagen) at 4 C until RNA isolation. Samples were centrifugedfor 5 min, RNAlater was removed, and 600 μL of lysis buffer with

cted and soft tissues, periosteum, epiphysis, fibula, and distal end were removed. Marrow), or centrifuged in nestedmicrocentrifuge tubes for 20 s at 16,100 g (group 3). Tibiaewerepsy punch mechanically separated a cancellous core from the cortical shell.

ality RNA from mouse cortical and cancellous bones, Bone (2014),

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β-mercaptoethanol (Buffer RLT, Qiagen) was added (as describedin RNeasy Mini instructions). Samples were homogenized by passingthrough an 18-gauge needle, centrifuged, and the supernatant(~600 μL) was added to ethanol and applied to columns for RNApurification as described above.

Gene expression

RNA was reverse transcribed to cDNA following the manufacturer'sinstructions (High Capacity cDNA Reverse Transcription kit, Life Tech-nologies) and brought to 5 ng/μL with RNase-free water. A final volumeof 20 μL containing 2× SYBR Green (Perfecta SYBR Green Fastmix, withROX, Quanta Biosciences, Gaithersburg, MD) was assayed by triplicateqPCR using 40 cycles of denaturing (95 °C, 15 s) and annealing/elonga-tion (60 °C, 60 s) (7300 Real-Time PCR System, Life Technologies).Primers for genes that are highly expressed in bone (Collagen type 1alpha 1, Col1a1, and bone gamma-carboxyglutamic acid-containing pro-tein, Bglap) andmarrow (intracellular adhesionmolecule 4, Icam4)weredesigned (available on request). Cycles to threshold (CT) was deter-mined for each gene and compared to the reference gene Gapdh. NMR,flushed and centrifuged groups and marrow samples are presented asrelative expression compared to Gapdh (2−ΔC

T). Fold-change to corticaland cancellous NMR groups was calculated by the 2−ΔΔC

T method [14].

Statistics

To test differences in relative gene expression between cancellousand cortical bone sites, and fold-change compared to NMR, a two-

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Fig. 2. Centrifugation removes marrow more effectively than flushing in cortical and cancelloubones stained with H&E of (A,D) bones with no marrow removal, (B,E) bones where bone mTop row within each bone site is lower magnification and black rectangle outlines region of hi

Please cite this article as: Kelly NH, et al, A method for isolating high quhttp://dx.doi.org/10.1016/j.bone.2014.07.022

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factor ANOVA (main effects: marrow removal and site)with interaction(marrow removal ∗ site) was used with Tukey's HSD post-hoc (JMP Pro10, SAS, Cary, NC, USA). To test for differences in gene expressionbetween marrow and cancellous and cortical bone with marrow, aone-way ANOVA was used with Tukey's HSD post-hoc. Significancewas set at p b 0.05.

Results

Histology

To determine if centrifugation was more effective than flushing,we performed histology with H&E of longitudinal sections of cancellousand cortical bones (Fig. 2). Cortical (top panels) and cancellous bones(bottom panels) contained significant marrow that was removed in-completely by flushing. In marked contrast, marrow was barely detect-able in centrifuged samples.

RNA quantity/quality

Wealsodetermined if sufficient, high quality RNA could be extractedfrom cortical and cancellous bones separately and the effect of marrowcontamination onRNAquantity. Intact bonehadmore RNA thanflushedor centrifuged bone. Themean (±SD) concentration of cortical sampleswas 447 (±70), 279 (±13) and 45 (±37) ng/μL for NMR, flushed andcentrifuged bone, respectively, while those for analogous cancelloussamples was 186 (±54), 132 (±33) and 28 (±7) ng/μL. The averageconcentration for marrow samples was 191 (±130) ng/μL. The 260/

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s bones. Representative longitudinal 6 μm sections of (A–C) cortical and (D–F) cancellousarrow has been flushed, and (C,F) bones that have been centrifuged to remove marrow.gher magnification shown on bottom row. Scale bar = 400 μm.

ality RNA from mouse cortical and cancellous bones, Bone (2014),

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280 ratio waswithin an acceptable range (1.8–2.1) for all samples. Can-cellous samples were of higher quality than their cortical counterpartswith a mean (±SD) RQN of 6.3 (±0.7) and 4.4 (±0.4), respectively.

Gene expression

We examined bone- andmarrow-related gene expression in corticaland cancellous bones as well as bone marrow and the effect of bonemarrow contamination. Centrifuged cortical bone had 12- and 13-foldhigher expression of Col1a1 and Bglap than bone with marrow, whilethe analogous data for centrifuged cancellous bone were 30-fold and31-fold higher, respectively (Figs. 3A/B). Flushing also increased bone-related gene expression when compared to no marrow removal, butthis effectwas not significant (2-fold and 3-fold, Col1a1 and Bglap in cor-tical and cancellous bones, respectively). The absolute expression ofCol1a1 and Bglapwas lower in cancellous compared to cortical bone. Fi-nally, marrow samples had extremely low expression of bone-relatedgenes, ranging from 71-fold to 930-fold less than bone with marrow.

Centrifugation, but not flushing, decreased the expression of a genethat is highly expressed in bone marrow (Fig. 3C). Icam4 expressionin centrifuged cortical and cancellous boneswas 3- and 2-fold lower, re-spectively, than intact bone and similar in both bone tissues. Flushingdid not alter Icam4 expression.Marrow samples and cortical and cancel-lous bones with marrow had similar expression of Icam4.

Discussion

We initiated these experiments based on our desire to performmoredetailed analysis beyond our well-established tissue-level detailing ofchanges in cortical and cancellous bones following in vivo loading. More-over, our recent report on the sexually-dimorphic and tissue-specific

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Fig. 3. Centrifugation resulted in higher expression of bone related genes and lower expressiobottom panels are fold-change to NMR group (2−ΔΔC

T). (A) Col1a1was 12- and 30-foldmore hto NMR. Col1a1 expression in flushed bone was not significantly different than bone with marrthan cortical and cancellous bones with marrow, respectively (values above bar). (B) Bglapwaspectively, when compared to NMR. Bglap expression was not significantly changed in flushedthat was 261- and 71-fold lower than cortical and cancellous bones with marrow, respectivelylous boneswhen compared to NMR. Icam4 expression was similar in NMR, flushed bone, andmexpression to bone with marrow. Data are mean ± SD, n = 3–5 per group. *Main effect of sno marrow removal or marrow and flushed different from centrifuged. a–cGroups with differecancellous NMR and marrow groups by one-way ANOVA.

Please cite this article as: Kelly NH, et al, A method for isolating high quhttp://dx.doi.org/10.1016/j.bone.2014.07.022

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responses following loading ofmice lacking estrogen receptor-alpha pro-vided further impetus to pursue cellular- and molecular-based stud-ies [15]. Finally, a review of the literature revealed no publicationsdocumenting the goals and techniques described here.

We show that RNA can be successfully isolated from centrifugedcortical and cancellous tissues of the mouse tibia separately and usedfor gene expression analysis. The ability to measure gene expressionseparately in cortical and cancellous bones is an important achieve-ment. For example, we discovered that the expression of two highly-expressed bone genes varies between the two tissue types. While bothmethods decreased marrow contamination, centrifugation removedmarrow more completely than flushing in both cortical and cancelloussites when compared to intact bone. Quantitatively, this removal ofcontaminating marrow cells allowed bone transcripts to be more easilydetected by qPCR. Bone genes were as much as 31-fold more highlyexpressed in centrifuged bone, while the expression of a marrow genewas decreased as much as 3-fold.

The ability to examine transcriptional activity in cortical and cancel-lous bones separately from a mouse is a significant achievement thathas the potential to impact osteoporosis and mechanotransduction re-search. Cancellous bone, the major modulator of osteoporosis-associatedfragility fractures, may respond differently to mechanical loading thanthe adjacent cortical component; this subject remains completely unex-plored. While several studies in rodents have examined gene expressionin cancellous bone [10,16,17], none have compared expression to the cor-tical bone at the same location in themouse. Importantly, here cancellousbone from unmanipulated wild type mice had lower expression levels ofbone-related genes than cortical bone, demonstrating the importance ofexamining these sites separately.Moreover, these site-specific differencesare likely to vary with age, sex, genetic background or exposure to a widerange of environmental, lifestyle or drug treatment-related stimuli.

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n of a gene in bone marrow. Top panels show relative expression to GAPDH (2−ΔCT) and

ighly expressed in centrifuged cortical and cancellous bones, respectively, when comparedow. Marrow had very low relative expression of Col1a1 that was 932- and 307-fold lowers 13- and 31-fold more highly expressed in centrifuged cortical and cancellous bones, re-bone compared to bone with marrow. Marrow had very low relative expression of Bglap(values above bar). (C) Icam4 expression was decreased in centrifuged cortical and cancel-arrow as indicated by dashed line at a fold-change value of one.Marrow had similar Icam4ite: cancellous different from cortical. Brackets indicate main effect of marrow removal:nt letters are significantly different by Tukey HSD post-hoc. †Cortical NMR different from

ality RNA from mouse cortical and cancellous bones, Bone (2014),

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Although we have shown that centrifugation is an efficient methodof marrow removal, heterogeneous cells are likely to still exist in thebone samples: for example, adherent hematopoietic and endothelialcells and a mixture of osteoblasts and osteocytes. Further work shoulddetermine the exact cellular makeup of our bone samples, including amarker of endothelial cells, such as CD31. The amount of RNA obtainedfrom these bone sites after centrifugation was relatively small, limitingthe number of genes that can be examined with qPCR. However, theRNAwas of high quality and is appropriate for gene expression profilingwith RNA sequencing, which requires much less input material.

Conclusions

Cancellous and cortical bones can be isolated separately from themouse tibia for RNA isolation and used for gene expression studies. Inall future studies examining bone gene expression centrifugationshould be adopted for removing bone marrow from bone tissue sinceit ismore efficient thanflushing. The separate examination of cancellousand cortical bones has the potential to elucidate the differential re-sponse tomechanical loading aswell as geneticmanipulations resultingin different bone phenotypes in these sites.

Disclosures

All authors state that they have no conflicts of interest.

Acknowledgments

We thank Adrian McNairn, PhD, and Mary Lou Norman for thetechnical assistance and the Cornell CARE staff. Funding for this studywas provided by: NIH R01-AG028664 and NSF GRFP.

Authors' roles: Study design: NHK, JCS, FPR, MCHM. Study conduct:NHK. Data collection: NHK. Data analysis: NHK. Data interpretation:NHK, JCS, FPR, MCHM. Drafting manuscript: NHK. Revising manuscriptcontent: JCS, FPR, MCHM. Approving final version of manuscript: allauthors. NHK takes responsibility for the integrity of the data analysis.

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Please cite this article as: Kelly NH, et al, A method for isolating high quhttp://dx.doi.org/10.1016/j.bone.2014.07.022

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