# Role of disrupted polyamine synthesis during CKD-MBD related bone loss

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2022 · $402,119

## Abstract

Project Summary/Abstract:
Bone fragility increasing fracture risk is one of the defining components of mineral and bone disorder of
chronic kidney disease (CKD-MBD). Dysregulated bone homeostasis in CKD is significantly linked with
morbidity and mortality as patients with CKD that sustain a fracture exhibit higher mortality rates. Additionally,
inability to maintain normal bone homeostasis contributes to elevated circulating calcium and phosphorus and
development of vascular calcifications. The adenine-diet induced model of renal failure in mice exhibit
pathogenic bone alterations parallel to CKD patient bone biopsies including porosity and elevated osteoclasts
number. These histological features occur in conjunction with development of iron deficiency anemia, a
frequent occurrence during CKD. However, the direct effects of disrupted iron handling on bone homeostasis
during renal failure remain unclear. Previous studies have found iron deficiency blunts bone formation both in
calvaria osteoblasts and in rodents fed an iron deficient diet. Recent studies have found that iron deficiency
alters cellular polyamine synthesis ultimately reducing spermine and spermidine content. Both spermine and
spermidine have been found to be important for osteoblast differentiation and function Interestingly, patients
with CKD have also been observed to have reduced spermine levels compared to controls. The unifying
hypothesis of this proposal is osteoblast differentiation is impaired in CKD-MBD and critical portions of this
pathophysiology are mediated by iron deficiency reduced polyamine synthesis. We address this novel avenue
of research with two specific aims in this Stephen I. Katz Early Stage Investigator Research Grant. In Aim 1,
we will test the hypothesis that iron-deficiency mediated reduction in spermine inhibits osteoblast
differentiation. This will be accomplished by assessing spermine supplementation during iron deficiency
conditions both in vitro and in vivo. Previous studies indicate that iron deficiency may blunt spermine
conversion by reducing spermine synthase. Thus, we will also examine the bone protective transgenic
upregulation of spermine synthase during iron deficiency of CKD. Finally, to determine how these small
molecules alter gene expression, we will undertake epigenetic sequencing studies as both iron deficiency and
polyamines have been postulated to be involved in changes in DNA accessibility. In Aim 2 we will test the
hypothesis that iron deficiency of CKD promotes polyamine catabolism at the cellular and systemic level. In
patient studies, CKD serum is found to have elevated spermine oxidase activity compared to controls.
Additionally, iron deficiency can increase N-acetyltransferase protein levels that catabolize spermine. We will
undertake genetic and pharmacological inhibition of during iron deficiency of CKD to address these novel
questions. Completion of these studies will significantly enhance our understanding of bone homeostas...

## Key facts

- **NIH application ID:** 10333851
- **Project number:** 1R01DK130866-01
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Erica L Clinkenbeard
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $402,119
- **Award type:** 1
- **Project period:** 2021-12-15 → 2026-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10333851

## Citation

> US National Institutes of Health, RePORTER application 10333851, Role of disrupted polyamine synthesis during CKD-MBD related bone loss (1R01DK130866-01). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10333851. Licensed CC0.

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