Sunday, July 10, 2022

Tooth Development and Redevelopment

Wouldn't it be nice to regrow teeth? Sharks do.

Imagine for a minute if instead of fillings, crowns, veneers, posts, bridges, and all the other advanced technologies of dental restoration, a tooth could be removed, and an injection prompt the growth of a complete replacement tooth. That would be amazing, right? Other animals, such as sharks and fish, regrow teeth all the time. But we only get two sets- our milk teeth and mature teeth. While mature mammalian teeth are incredibly tough and generally last a lifetime, modern agriculture and other conditions have thrown a wrench into human dental health, which modern dentistry has only partially restored. As evolution proceeded into the mammalian line, tooth development became increasingly restricted and specialized, so that the generic teeth that sharks spit out throughout their lives have become tailored for various needs across the mouth, firmly anchored into the jaw bone, and precisely shaped to fit against each other. But the price for this high-level feature set seems to be that we have lost the ability to replace them.

So researchers are studying tooth development in other animals- wondering how similar they are to human development, and whether some of their tricks can be atavistically re-stimulated in our own tissues. While the second goal remains a long way off, the first has been productively pursued, with teeth forming a model system of complex tissue development. A recent paper (with review) looked at similarities between molecular details of shark and mammalian tooth development.

Teeth are the result of an interaction between epithelial tissues and mesenchymal tissues- two of the three fundamental tissues of early embryogenesis. Patches of epithelium form dental arches around the two halves of the future mouth. Spots around these arches expand into dental placodes, which grow into buds, and as they interact continuously with the inner mesenchyme, form enamel knots. The epithelial cells of the knot then eventually start producing enamel as they pull away from interface, while the mesenchymal cells produce dentin and then the pulp and other bone-anchoring tissues of the inner tooth and root as they pull away in the opposite direction. 

Embryonic tooth development, which depends heavily on the communication between epithelial tissue (white) and mesenchymal tissue (pink). An epithelial "enamel knot" (PEK/ SEK) develops at the future cusp(s), where enamel will be laid down by the epithelial cells, and dentin by the mesenchymal cells. Below are some of the molecules known to orchestrate the activities of all these cells. Some of these molecules are extracellular signals (BMP, FGF, WNT), while others are cell-internal components of the signaling systems (LEF, PAX, MSX).

Naturally, all this doesn't happen by magic, but by a symphony of gene expression and molecular signals going back and forth. These signals are used in various combinations in many developmental processes, but given the cell types located here, due to the prior location-based patterning of the embryo in larger coordinate schemes, and the particular combination of signals, they orchestrate tooth development. Over evolution, these signals have been diverse in the highest degree across mammals, creating teeth of all sorts of conformations and functions, from whale baleen to elephant tusks. The question these researchers posed was whether sharks use the same mechanisms to make their teeth, which across that phylum are also highly diverse in form, including complicated cusp patterns. Indeed, sharks even develop teeth on their skin- miniature teeth called denticles.

Shark skin is festooned with tiny teeth, or denticles.

These authors show detailed patterns of expression of a variety of the known gene-encoded components of tooth development, in a shark. For example, WNT11(C)  is expressed right at the future cusp, also known as the enamel knot, an organizing center for tooth development. Dental epithelium (de) and dental mesenchyme (dm) are indicated. Cell nuclei are stained with DAPI, in gray. Dotted lines indicate the dental lamina composed of he dental epithelium, and large arrows indicate the presumptive enamel knot, which prefigures the cusp of the tooth and future enamel deposition.

The answer- yes indeed. For instance, sharks use the WNT pathway (panel C) and associated proteins (panels A, B, D) in the same places as mammals do, to determine the enamel knot, cusp formation, and the rest. The researchers use some chemical enhancers and inhibitors of WNT signaling to demonstrate relatively mild effects, with the inhibitor reducing tooth size and development, and the enhancer causing bigger teeth, occasionally with additional cusps. While a few differences were seen, overall, tooth development in sharks and mammals is quite similar in molecular detail. 

The researchers even went on to deploy a computer model of tooth development that incorporates twenty six gene and cellular parameters, which had been developed for mammals. They could use it to model the development of shark teeth quite well, and also model their manipulations of the WNT pathway to come out with realistic results. But they did not indicate that the overall differences in detail between mouse and shark tooth development were recapitulated faithfully by these model alterations. So it is unlikely that strict correspondence of all the network functions could be achieved, even though the overall system works similarly.

The authors offer a general comparison of mouse and shark tooth development, centered around the dental epithelium, with mesenchyme in gray. Most genes are the same (that is, orthologous) and expressed in the same places, especially including an enamel knot organizing center. For mouse, a WNT analog is not indicated, but does exist and is an important class of signal.

These authors did not, additionally, touch on the question of why tooth production stops in mammals, and is continuous in sharks. That is probably determined at an earlier point in the tissue identity program. Another paper indicated that a few of the epithelial stem cells that drive tooth development remain about in our mouths through adulthood. Indeed, these cells cause rare cancers (ameloblastoma). It is these cells that might be harnessed, if they could be prodded to multiply and re-enter their developmental program, to create new teeth.


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