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Clinical Chemistry 43: 2076-2082, 1997;
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(Clinical Chemistry. 1997;43:2076-2082.)
© 1997 American Association for Clinical Chemistry, Inc.


Articles

Improved purification of human bone sialoprotein and development of a homologous radioimmunoassay

Markus Karmatschek1,a, Ina Maier1, Markus J. Seibel2, Henning W. Woitge2, Reinhard Ziegler2 and Franz P. Armbruster1

1 Immundiagnostik GmbH, Wiesenstr. 4, 64625 Bensheim, Germany.

2 Department of Medicine, Division of Endocrinology and Metabolism, University of Heidelberg Medical School, Bergheimerstr. 58, 69115 Heidelberg, Germany.
a Author for correspondence. Fax Int. +49-6251-39084.


   Abstract
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
Bone sialoprotein (BSP) is a phosphorylated skeletal glycoprotein. Here we describe a new procedure for the purification of BSP involving wide-pore reversed-phase HPLC, and the development of a homologous RIA for human BSP. The immunoassay showed linearity between 3 and 120 µg/L, a lower detection limit of 0.7 µg/L, and a mean recovery rate of 99.4%. Intraassay variation was 7.0% (mean = 10.9 µg/L) and 6.1% (mean = 38.8 µg/L), and interassay variation was 9.2% (mean = 11.1 µg/L) and 9.4% (mean = 39.0 µg/L). No cross-reactivity was detected with osteocalcin, osteonectin, or bone alkaline phosphatase. Preliminary clinical evaluation in healthy controls (n = 90) showed a mean serum BSP concentration of 12.1 ± 5.0 µg/L (±SD). BSP was significantly increased in patients with Paget disease of bone, primary and secondary hyperparathyroidism, and also in subjects with renal failure without skeletal involvement. Impairment of hepatic function did not affect serum BSP concentrations.


   Introduction
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
Bone sialoprotein (BSP) is one of the most abundant noncollageneous and phosphorylated glycoproteins in human bone (1).1 It contains an RGD sequence that binds to the vitronectin-like receptor {alpha}vß3 of the transformed murine cell line ROS 17/2.8 (2). According to human cDNA analysis, the molecular mass of the core protein is ~33 kDa (3). In a 4–20% sodium dodecyl sulfate (SDS) gradient gel, BSP migrates as a 80-kDa band, as carbohydrates contribute to nearly 50% of the molecular mass (1).

The function of BSP is still not fully understood. BSP stimulates hydroxyapatite formation in vitro (4) and appears to mediate adhesion between cellular surfaces and extracellular matrix components via the RGD binding site. The expression of BSP is stimulated by dexamethasone and inhibited by calcitriol in vitro (5).

BSP has been found predominantly in bone. However, Northern analysis of total RNA has shown mRNA encoding for BSP also in epiphyseal cartilage and decidua, although these amounts were much smaller than those detected in skeletal tissues (3). Bone sialoprotein appears to be present mainly in cells derived from bone, such as osteoblasts, osteocytes, osteoclasts, and, to a lesser extent, hypertrophic chondrocytes (6). The only nonmineralizing tissue where BSP was also detected is the developing placental trophoblast (6).

The present paper describes the purification of BSP from human femoral bone, by wide-pore reversed-phase HPLC, and the development of a new RIA for the measurement of circulating BSP in human serum.


   Materials and Methods
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
reagents
Guanidine HCl (98%) was obtained from Acros (Fisher). An 8 mol/L solution of guanidine HCl was purified by the addition of charcoal; the suspension was stirred for 3 h and filtered twice (filter type 595 1/2; Schleicher u. Schüll). To determine the actual guanidine concentration, the absorbance was measured at 280 nm and the concentration was calculated by the following formula: Mguanidine = density 1.003/0.02359. "Stains all" was purchased from Sigma. PPNE buffer was 0.07 mol/L sodium phosphate pH 7.4, 1 g/L NaN3, and 1 mmol/L Na-EDTA (Roth). Bovine serum albumin (BSA) was from Pentex (Bayer). Sepharose 6B and DEAE-Sephacel were purchased from Pharmacia; nitrocellulose was from Sartorius and peroxidase-conjugated rabbit anti-IgY was purchased from Dianova; donkey anti-IgY was from Immundiagnostik and Na125I was purchased from Amersham Buchler. All other chemicals were of analytical grade. Osteonectin was purchased from Hematologic Technologies, bone alkaline phosphatase was from Hybritech, and osteocalcin was from Immundiagnostik.

extraction
Human femoral bone was obtained from total hip replacements. The extraction was performed according to the method of Fisher et al. (7). Bone was crushed and ground in a Retsch mill cooled with liquid nitrogen. For each preparation, 100 g of bone powder was washed for 30 min in water. The powder was then transferred to 3 L of buffer containing 4 mol/L guanidine HCl, 50 mmol/L Tris pH 7.4, and protease inhibitors (0.1 mol/L 6-aminocaproic acid, 5 mmol/L benzamidine HCl, and 1 mmol/L phenylmethylsulfonyl fluoride) and incubated for 48 h at 4 °C. The suspension was centrifuged at 3000g for 20 min, the supernatant was discarded, and the bone proteins were extracted for 72 h with 0.5 mol/L sodium EDTA in 3 L of the above buffer. The extract was centrifuged (3000g, 20 min), the supernatant was filtered through a glass fiber filter to remove lipids, and then concentrated to a volume of 30 mL in a Millipore tangential ultrafiltration system with 10-kDa filter cutoff.

gel filtration
A sample of 10 mL was centrifuged for 20 min at 10 000g, applied to a Sepharose 6B column (100 x 2.5 cm), and eluted with 4 mol/L guanidine HCl and 50 mmol/L Tris pH 7.4 at a flow rate of 0.5 mL/min. The elution was monitored at 280 nm and fractions of 5 mL were collected.

anion-exchange chromatography
The BSP-containing fractions obtained from the gel filtration, identified by SDS-polyacrylamide gel electrophoresis (PAGE) and Stains All, were pooled. The material was concentrated and the buffer was exchanged to a starting buffer containing 7 mol/L urea and 50 mmol/L sodium acetate pH 4.5 with a Millipore tangential ultrafiltration system. The sample was centrifuged at 10 000g for 2 min, loaded on a DEAE-Sephacel column (10 x 1 cm), and washed until the absorbance at 280 nm returned to baseline. BSP was eluted with a gradient ranging from 0 to 0.5 mol/L sodium chloride in starting buffer, and fractions of 5 mL were collected.

reversed-phase hplc chromatography
Fractions of the anion-exchange step containing BSP were concentrated in an Amicon stirring cell equipped with a YM 10 filter (cutoff 10 kDa) to a volume of 200 µL and centrifuged. One hundred microliters were chromatographed on a Latek Hypersil WP 300-C4 5 µm, 150 x 4 mm column. For the elution of BSP, a gradient of buffer A (1.3 mL/L heptafluorbutyric acid) and buffer B (1.3 mL/L heptafluorbutyric acid, 750 mL/L CH3CN) was applied as follows: 0 min, 30% buffer B; 30 min, 100% buffer B; 35 min, 100% buffer B; 40 min, 30% buffer B. The system was run with a flow rate of 1 mL/min and fractions of 1 mL were collected. The elution was monitored at 280 nm.

sds-page
The fractions obtained by chromatography were monitored by SDS-PAGE. Samples were diluted 10-fold with 980 mL/L ethanol and proteins were allowed to precipitate for 3 h at -20 °C. The samples were centrifuged (10 min, 10 000g) and washed with ethanol. The pellet was dried for 1 h at 60 °C, resuspended in loading buffer, and analyzed by a nonreduced linear 4–20% polyacrylamide gel stained with Stains All according to Wallace and Begovac (8).

western blotting
Reversed-phase HPLC-purified BSP and osteopontin, which was purified according to the method of Fisher et al. (7), were electrophoresed on a linear 4–20% polyacrylamide gel. The gel was transblotted for 1 h at 500 V onto nitrocellulose according to the method of Towbin et al. (9) with the following changes: The last washing was performed by a buffer containing 10 mmol/L Tris pH 7.5, 14 g/L NaCl, and 0.1 g/L Tween 20 to reduce negative bands on the blot. The chicken anti-human BSP was present in a dilution of 1:100 and the peroxidase-conjugated rabbit anti-IgY was diluted 1:1000.

automated amino acid sequencing
The N-terminal amino acid sequence of 5 pmol of BSP was determined by automated Edman degradation on an Applied Biosystems Procise amino acid sequencer.

immunization
A chicken was immunized with 100 µg of BSP-containing fractions from the anion-exchange chromatography in 0.5 mL of 0.1 mol/L sodium acetate, pH 6.3, emulsified in 0.5 mL of Freund's complete adjuvant (Calbiochem) by intramuscular injection at multiple sites. Four weeks later the chicken was boosted with 50 µg of human BSP in 0.5 mL of 0.1 mol/L sodium acetate (NaAc), pH 6.3, emulsified in 0.5 mL of Freund's incomplete adjuvant (Difco Labs.). The antibodies were isolated from the egg yolk according to the method of Polson et al. (10).

preparation of 125i-labeled bsp
Reversed-phase HPLC-purified human BSP, 1 µg dissolved in 10 µL of 0.1 mol/L NaAc pH 6.3, was radioiodinated with 13 MBq (350 µCi) of Na125I according to the chloramine T method described by Hunter and Greenwood (11). Radiolabeled BSP was separated from Na125I by purification on a Sep-Pac C18 cartridge (Millipore) as reported by Schöneshöfer et al. (12). The 125I-labeled BSP was diluted in PPNE containing 20 g/L BSA and 100 g/L polyethylene glycol (Mr 6000) to a final concentration of 60 000 cpm/100 µL.

preparation of the calibration curve
The protein concentration of reversed-phase HPLC-purified human BSP was determined by the Pierce protein assay calibrated with BSA. A BSP calibration curve was then prepared by diluting BSP with PPNE containing 20 g/L BSA to the following concentrations: 120, 60, 30, 15, 7.5, 3.75, and 1.875 µg/L.

assay procedure (bsp ria)
One-hundred microliters of calibrator, serum sample, or control sera were incubated for 24 h with 100 µL of 125I-labeled BSP and 100 µL of the 1:200 diluted chicken anti-human BSP antibody in RIA tubes (0.6 mL volume; Sarstedt). All analyses were done in duplicate. For determination of nonspecific binding, the antibody was replaced by PPNE containing 1 g/L BSA. The bound and free ligands were separated by incubation with 100 µL of donkey anti-chicken IgY for 30 min, followed by centrifugation at 1800g for 10 min. The supernatants were removed and the pellets washed by addition of 250 µL of NaCl (0.9 g/L) with polyethylene glycol 6000 (60 g/L) and subsequent centrifugation at 1800g for 10 min. The radioactivity in the precipitate was counted in a {gamma}-spectrometer for 1 min. All procedures were performed at 4 °C. The calibration curve (Fig. 1 ) was prepared with B/B0 vs concentration of BSP (µg/L). The amount of BSP in patient sample was calculated by a four-parameter curve-fitting algorithm.



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Figure 1. Typical calibration curve for human BSP obtained with the newly developed RIA.

stability of analyte and preliminary clinical evaluation
All venous blood samples were obtained in Vacutainer Tubes without additive between the hours of 0800 and 1000. The material was centrifuged at 1500g within 2 h of collection, and serum aliquots were stored at -20 °C.

To evaluate the stability of BSP in serum during prolonged storage, serum aliquots of 1 mL were stored for up to 3 months at ambient temperatures of -20 °C, 4 °C, and 25 °C, respectively.

In a preliminary clinical evaluation, serum concentrations of circulating BSP were also determined in healthy controls ages 20–80 years (n = 90), and in patients with Paget disease of bone (n = 24), primary hyperparathyroidism (PHPT; n = 11), renal secondary hyperparathyroidism (SHPT; n = 25), chronic renal failure without SHPT (RF; n = 26), and alcoholic liver cirrhosis (LC; n = 35). Data on anthropometric and clinical chemistry variables are summarized in Table 1 . In each group, the respective diagnosis was based on standard clinical evaluation techniques, including history, physical examination, plain radiograms, bone density, and laboratory measurements (see Table 1 ). Before sample collection, written informed consent was obtained from each individual. The study was approved by the local ethics committees and was performed in accordance with the Declaration of Helsinki, amended by the 29th and 35th World Medical Assembly.


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Table 1. Characteristics of preliminary study population.


   Results
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
purification of bsp
The BSP-containing fractions obtained by anion-exchange chromatography were contaminated with several other proteins (data not shown). Therefore, all BSP-containing fractions were pooled, concentrated, and submitted to wide-pore reversed-phase HPLC (Fig. 2 ). BSP was clearly separated from other proteins at a concentration of 41% buffer B. The purity and identity of BSP was shown by SDS-PAGE (Fig. 3 ) and by N-terminal amino acid sequencing (Table 2 ). The determined amino acid sequence is identical to the one described by Fisher et al. (7).



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Figure 2. Elution profile of the wide-pore reversed-phase HPLC.

BSP-containing fractions of the anion-exchange chromatography were concentrated and chromatographed on reversed-phase HPLC. BSP eluted in fractions 4–7 (indicated by horizontal bar).



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Figure 3. SDS-PAGE of appropriate fractions of the wide-pore reversed-phase HPLC visualized by Stains All.

Fractions 4–7 contain pure BSP. St, molecular mass calibrator.


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Table 2. N-terminal amino acid sequence of purified BSP (upper line) compared with the sequence described by Fisher et al. [7] (lower line).

preparation of 125i-labeled bsp and assay development
One microgram of human BSP purified by reversed-phase HPLC was radioiodinated. The specific activity was 16.28 MBq/µg (440 µCi/µg). The iodinated BSP was diluted to 60 000 cpm/100 µL, equal to 0.14 ng of 125I-labeled BSP per assay tube.

During the development of a specific RIA for human BSP, several variables had to be optimized. Thus, although assay kinetics were similar at 4, 25, and 37 °C, radioactive yield was lower at higher incubation temperatures. To maximize count rates, a temperature of 4 °C was therefore chosen for all incubations. Incubations of 24 h for the first incubation and 30 min for the second antibody precipitating step proved sufficient for the reactants to reach equilibrium.

assay characteristics
The specificity of the assay for BSP was demonstrated by testing for cross-reactivity with other noncollageneous components such as osteocalcin, osteonectin, and bone alkaline phosphatase. None of these proteins showed any reactivity within the concentration ranges tested (Fig. 4 ). The specificity of the chicken anti-BSP was demonstrated by Western blotting. No cross-reactivity was detected with human osteopontin (Fig. 5 ).



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Figure 4. Cross-reactivity of the BSP RIA with other bone matrix proteins.

BSP (•), bone alkaline phoshatase (+), osteocalcin (*), osteonectin ({square}). B, cpm; B0, cpm of zero calibrator.



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Figure 5. Western blot of BSP and osteopontin (OP).

Five micrograms of each protein was electrophoresed on a SDS 4–20% gradient polyacrylamide gel and transblotted onto nitrocellulose. BSP was detected by the chicken anti-human BSP antibody. Immunodetection by peroxidase-conjugated second antibody and 4-chloro-1-naphthol as substrate is described in Materials and Methods.

The linearity of the assay was determined by serial dilution of three serum samples. The correlation coefficients, determined by linear regression, were 0.9819 (sample 1: 91.7 µg/L), 0.9937 (sample 2: 70.6 µg/L), and 0.9933 (sample 3: 63.8 µg/L). The recovery was tested by supplementing a human serum sample and an EDTA-plasma sample with different concentrations of BSP from calibration solutions. The recovery was between 92% and 108% in serum but only between 18% and 26% in EDTA-plasma.

For testing accuracy, two control sera were tested 12 times in one assay. A within-run variation of 7.0% (mean 10.9 µg/L) and 6.1% (mean 38.8 µg/L) was found. Reproducibility was tested by measuring two control sera nine times on different days. A between-run variation of 9.2% (mean 11.0 µg/L) and 9.4% (mean 39.0 µg/L) was found.

The lowest detectable concentration was 0.7 µg/L, as defined by the concentration 3 SD above B0 (zero calibrator), which was measured 12 times.

stability of bsp in stored serum samples
The stability of BSP during prolonged storage was tested for various intervals and at different temperatures (Table 3 ). At -20 °C, serum BSP concentrations remained essentially unchanged over 3 months. When serum samples were stored at 4 °C, no significant change in BSP concentrations was observed during the first 5 days of storage. However, after 14 days and thereafter, increased concentrations of BSP were measured. Also, storage of serum samples at 25 °C led to an increase in apparent BSP concentrations.


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Table 3. Stability of BSP in serum.

preliminary clinical evaluation
Measurements obtained from 90 healthy controls showed a mean serum BSP concentration of 12.1 ± 5.0 µg/L (mean ± SD) with individual values ranging between 6.2 and 22.4 µg/L. In patients with Paget disease of bone, serum BSP concentrations were 32.3 ± 17.3 µg/L, whereas in patients with PHPT a mean concentration of 24.7 ± 13.5 µg/L was noted (P <0.01 vs healthy controls for both groups). In patients with RF and no apparent SHPT, BSP concentrations were on average 23.0 ± 14.7 µg/L, whereas in those patients with both RF and SHPT, mean concentrations were increased to 30.6 ± 18.9 µg/L (P <0.01 vs healthy controls for both groups). Patients with alcoholic liver cirrhosis had mean serum BSP values of 12.6 ± 7.6 µg/L, which were not significantly different from healthy controls (Fig. 6 ).



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Figure 6. Serum BSP concentrations in skeletal and nonskeletal disease.

Healthy controls, (NC) n = 90; Paget disease of bone (MP), n = 24; PHPT, n = 11; SHPT, n = 25; RF, n = 26; and LC, n = 35. *, groups with significantly increased BSP (P <0.05 vs controls). Horizontal lines are medians; rectangles indicate mean ± SD.


   Discussion
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
Compared with other noncollageneous proteins, BSP exhibits a rather restricted pattern of tissue distribution. The protein or its mRNA is detected mainly in mineralized tissue such as bone and dentin (13)(14), and at the interface of calcifying cartilage and bone (15). Although not entirely specific to the skeleton, BSP has previously been suggested as a potential marker of bone turnover (3)(16). In an attempt to develop a specific immunoassay for BSP in serum, Chenu and Delmas described a heterologeous immunoassay using bovine BSP for immunization and preparation of tracer and calibrators. However, according to the authors (17), their assay of human BSP was greatly hampered by platelet-derived immunoreactivity.

We present here a homologous RIA specific for human BSP in serum. First, the purification procedure of Fisher et al. (7) developed for fetal bone had to be adapted to our source of the immunogen, bone obtained from hip replacements performed in elderly patients. The crucial step in our modified procedure was wide-pore C4 reversed-phase HPLC, which yielded a highly purified protein, as confirmed by N-terminal amino acid sequencing.

Because the yield of BSP from elderly bone was rather low, the BSP-containing fractions obtained from anion-exchange chromatography were used for immunization. This was also feasible, as at the time of immunization we did not know whether the HPLC fractionation would in any way affect the antigenicity of BSP. Our results, however, show no change in BSP antigenicity, thus making reversed-phase HPLC a new strategy to purify BSP from human bone.

Chickens were selected for immunization because the minimum quantity of antigen required is about half of that used for conventional immunization of rabbits or mice. This advantage is attributed to the large phylogenetic distance between birds and mammals, which results in increased sensitivity to antigen exposure and decreased background noise in immunoassay (18). High antibody concentrations in egg yolk and easy techniques for IgY separation allow a cost-effective production on a routine basis. By using these BSP antibodies and a highly specific 125I-labeled human BSP tracer, a reliable assay for the measurement of BSP in human serum was developed.

Our immunoassay showed no cross-reactivity with other noncollageneous bone proteins such as osteocalcin, osteonectin, or alkaline phosphatase. Furthermore, osteopontin was undetectable by Western blotting. Therefore, the measurement of BSP appears not to be influenced by these proteins.

Interestingly, BSP could not be measured in EDTA-plasma. In our hands, the recovery of EDTA-plasma samples supplemented with purified BSP ranged between 18% and 25%. We propose that this behavior may be attributed to the calcium-binding properties of BSP. Thus, the addition of EDTA to blood samples may displace calcium ions from the BSP molecule, which in turn is likely to lead to changes in the tertiary structure of the molecule, promoting aggregation and precipitation of BSP. This process results in higher count rates in the pellet, simulating low serum BSP concentrations. Aggregation may also explain the loss of BSP during purification without chaotropic agents. Between the chromatographic steps, we noted a near total loss of BSP when the sample was concentrated in the absence of urea or guanidine HCl. On the other hand, recalcification of EDTA-plasma samples also led to a dose-dependent increase of the count rates caused by precipitation of 125I-labeled BSP (data not shown). Thus, being a bone matrix protein with calcium-binding properties, BSP appears to be sensitive to changes in calcium concentrations, a fact that should be kept in mind when performing the assay.

In the 90 healthy controls studied in this investigation, serum BSP concentrations ranged from 6.2 to 22.4 µg/L, with a mean concentration of 12.1 ± 5.0 µg/L (± SD). This value is slightly but not significantly higher than that reported earlier by us (19), due to the fact that most of the individuals were different from those studied in our previous publication (19). Interestingly, in both publications, mean serum values of BSP are comparable with those of serum osteocalcin, another noncollagenous protein of the extracellular bone matrix synthesized by osteoblasts and released into serum. As described elsewhere (20), serum concentrations of BSP and osteocalcin do not correlate with each other, suggesting that the two components reflect different processes of bone turnover. Compared with the healthy controls, serum BSP concentrations were significantly increased in patients with metabolic bone disease. Highest concentrations were seen in subjects with active Paget disease of bone and in individuals with secondary renal hyperparathyroidism. These values are somewhat but not significantly higher than those reported earlier for these disease groups (19). Again, this is because patients in the present investigation were largely different from those evaluated earlier. As both disorders are usually associated with high bone turnover, i.e., increased bone formation and accelerated bone resorption, classification of serum BSP to either of these processes can currently not be achieved. Saxne et al. have recently shown increased serum and synovial BSP in patients with active rheumatoid arthritis (21). These authors attributed these changes to an increase in bone turnover often observed in patients with inflammatory joint disease (22). However, we also observed significantly increased concentrations of serum BSP in patients with asymptomatic PHPT. We have previously shown that this frequent disorder of calcium homeostasis is associated with increased bone resorption, as indicated by increased concentrations of urinary pyridinium cross-links. In contrast, markers of bone formation (such as alkaline phosphatase or osteocalcin) were normal in these patients (20) (see also Table 1Up ). Since BSP is primarily a product of osteoblasts, our preliminary observations indicate that serum BSP may reflect processes related to both bone resorption and bone formation. However, further data from our own group, including studies on the effect of intravenous bisphosphonates on BSP and other markers of bone turnover, suggest that circulating BSP may be associated with osteoclast rather than osteoblast activity (19).

In the present investigation, we also noted that serum BSP concentrations were strongly affected by renal function, and values were significantly increased in those patients with additional SHPT. In contrast, no significant changes were seen in subjects with advanced liver failure. Taken together, these observations indicate that circulating BSP is processed and (or) eliminated by the kidney, whereas the liver appears to play only a minor role in the metabolism of this glycoprotein.


   Acknowledgments
 
We are indebted to Gisela Schwahn, Beatrice Auler, and Angelika Huck for excellent technical assistance. We thank Wolf Georg Forssmann (Institute for Peptide Research GmbH Hannover, Hannover, Germany) for providing the N-terminal amino acid sequence of purified BSP. We also thank Ute Gröschel-Stewart (Institute for Zoology, Technische Hochschule Darmstadt, Darmstadt, Germany) and Mats Paulsson (Department of Biochemistry, University of Köln, Köln, Germany) for their valuable advice regarding the isolation of BSP from human bone. This study was supported by a grant from the Ministry for Research and Technology, Germany.


   Footnotes
 
1 Nonstandard abbreviations: BSP, bone sialoprotein; SDS, sodium dodecyl sulfate; PPNE, phosphate–NaN3–Na-EDTA buffer; BSA, bovine serum albumin; PAGE, polyacrylamide gel electrophoresis; PHPT, primary hyperparathyroidism; SHPT, secondary hyperparathyroidism; RF, renal failure; and LC, liver cirrhosis.


   References
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 

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H. W. Woitge, H. Oberwittler, S. Heichel, A. Grauer, R. Ziegler, and M. J. Seibel
Short- and Long-Term Effects of Ibandronate Treatment on Bone Turnover in Paget Disease of Bone
Clin. Chem., May 1, 2000; 46(5): 684 - 690.
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Clin. Cancer Res.Home page
I. J. Diel, E.-F. Solomayer, M. J. Seibel, J. Pfeilschifter, H. Maisenbacher, C. Gollan, M. Pecherstorfer, R. Conradi, G. Kehr, E. Boehm, et al.
Serum Bone Sialoprotein in Patients with Primary Breast Cancer Is a Prognostic Marker for Subsequent Bone Metastasis
Clin. Cancer Res., December 1, 1999; 5(12): 3914 - 3919.
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J. Biol. Chem.Home page
M. Wuttke, S. Muller, D. P. Nitsche, M. Paulsson, F.-G. Hanisch, and P. Maurer
Structural Characterization of Human Recombinant and Bone-derived Bone Sialoprotein. FUNCTIONAL IMPLICATIONS FOR CELL ATTACHMENT AND HYDROXYAPATITE BINDING
J. Biol. Chem., September 21, 2001; 276(39): 36839 - 36848.
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