J. Anat. (2003) 202, pp51– 58
Digital development and morphogenesis
Blackwell Science, Ltd
J. J. Sanz-Ezquerro1 and C. Tickle2
1
Departamento de Inmunología y Oncología, Centro Nacional de Biotecnología, Cantoblanco UAM, 28049 Madrid, Spain
Division of Cell & Developmental Biology, School of Life Sciences, MSI /WTB Complex, University of Dundee, Dow Street,
Dundee DD1 5EH, UK
2
Abstract
Signalling interactions between the polarizing region, which produces SHH, and the apical ectodermal ridge, which
produces FGFs, are essential for outgrowth and patterning of vertebrate limbs. However, mechanisms that mediate
translation of early positional information of cells into anatomy remain largely unknown. In particular, the molecular and cellular basis of digit morphogenesis are not fully understood, either in terms of the formation of the
different digits along the antero-posterior axis or in the way digits stop growing once pattern formation has been
completed. Here we will review recent data about digit development. Manipulation of morphogenetic signals
during digit formation, including application of SHH interdigitally, has shown that digit primordia possess a certain
plasticity, and that digit anatomy becomes irreversibly fixed during morphogenesis. The process of generation of
joints and thus segmentation and formation of digit tips is also discussed.
Key words chick; embryo; joint; limb; spacing mechanisms.
Introduction
One of the major challenges in developmental biology
is to understand how detailed anatomy is generated.
The limb contains more than 50 named muscles, precisely shaped individual skeletal elements and tendons
with specific attachment sites to link muscles and
skeleton. The limb is also supplied with blood vessels
and nerves and these elements have a stereotypical
pattern. Here we will review recent work on morphogenesis of the digits, which also involves such fundamental processes as spacing and segmentation.
Stages in digit morphogenesis
The different parts of the limb along the proximo-distal
axis are laid down in sequence as the limb bud grows
out. Bud outgrowth is mediated by signals from the
apical ectodermal ridge, the thickened epithelium
that rims the tip of the limb bud and expresses Fgf
Correspondence
Dr C. Tickle, Division of Cell & Developmental Biology, School of Life
Sciences, MSI/WTB Complex, University of Dundee, Dow Street,
Dundee DD1 5EH, UK. E-mail: c.a.tickle@dundee.ac.uk
Accepted for publication 6 November 2002
© Anatomical Society of Great Britain and Ireland 2003
genes (Saunders, 1948; Summerbell, 1974; Martin,
1998; see also Lonai, this issue). Sequential formation
of proximo-distal structures is particularly clearly seen
with respect to the development of the limb skeleton
which is initially laid down in cartilage. Chondrogenesis
can be monitored by deposition of matrix which can
be seen using alcian blue staining or incorporation of
S35 (Hinchliffe, 1977). A single chondrogenic element
forms in the proximal part of the limb which will
develop into humerus. Slightly later, a Y-shaped condensation appears – the arms of the Y represent forerunners of radius/ulna or tibia /fibula. Then wrist/ankle
elements can be seen, and finally digits. In the chick
wing, separate condensations that will form each of
the three digits emerge between stages 27 and 28
(Hamilton–Hamburger stages; 5–6 days of development) in a posterior to anterior sequence (Hinchliffe,
1977; Fig. 1). These condensations initially form a series
of rays within the hand plate and are joined by soft
tissue. In the chick leg, condensations that will form
each of the four toes arise at around stage 27, again in
a posterior to anterior sequence (Fig. 1). Digital rays
start off as continuous rods of cartilage that elongate
and periodically segment to form interphalangeal
joints and thus generate a precise number of phalanges
(Fig. 2).
52 Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle
mesenchyme cells at the posterior margin of the bud. A
mirror image duplication of digits can be induced by
grafting a polarizing region from one chick limb bud to
the anterior margin of another early bud (Saunders &
Gasseling, 1968). In the wing, this manipulation produces a complete set of additional digits (423 in mirror
image with the normal set, 234) when carried out at
stage 22 or earlier (Summerbell, 1974). Given that a
polarizing graft takes about 18 h to produce full duplications in the wing (data for stage 20; Smith, 1980), this
suggests that the number of digital rays must be set
around 18 h after stage 22, i.e. around stage 25. Stage
25 is the latest stage at which posterior wing tissue can
elicit full digit duplications when grafted to the anterior margin of an early wing bud (Honig & Summerbell,
1985). When the graft is made later, branching of digits
Fig. 1 Alcian Blue-stained chick limb buds at early stages in
digit formation. First metacarpo/metatarso-phalangeal joints
(asterisks) and digit /toe condensations (arrows) appear in the
most posterior rays. R, radius; U, ulna; mc, metacarpal bone;
dc, digital condensation; T, tibia; F, fibula; mt, metatarsal
bone; tc, toe condensation.
Establishing digit number and identity
Both digit number and digit identity (thumb vs. little
finger/big toe vs. little toe) are controlled by signalling
from the polarizing region (see Panman and Zeller,
this issue). The polarizing region is a small group of
is produced (Summerbell, 1974).
Digit identity depends on distance from the polarizing region, the most posterior digit forming next to the
polarizing region; the most anterior furthest away.
Reducing polarizing strength (for example, by irradiating the polarizing region before grafting or grafting a
smaller number of polarizing region cells) has the same
effect as reducing length of exposure to the signal (for
example, removing the polarizing region graft after a
short length of time); only additional anterior digits are
specified (Smith et al. 1978; Smith, 1980; Tickle, 1981).
This can be understood in terms of a model in which
signalling by the polarizing region first induces cells
next to the graft to form an anterior digit and then
promotes this anterior digit into a posterior digit and
Fig. 2 Series of Alcian Blue-stained chick leg buds showing sequential appearance of joints and phalanges in toes. Continuous
distal cartilage condensations become segmented by generation of a joint. From stage 29 to stage 34 represents about 3 days
of development.
© Anatomical Society of Great Britain and Ireland 2003
Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle 53
specifies a new anterior digit further away (Tickle,
1995). This could be envisaged as being due to a local
increase in signal strength together with further
spread of the signal away from the graft.
Digit number is related to the width of the bud and
this depends on the length of the apical ectodermal ridge
(Lee & Tickle, 1985; Brickell & Tickle, 1989). After polarizing region grafts, the limb bud widens and the apical
ridge is maintained over the anterior part of the wing
bud. In normal chick limb development, cell marking
experiments have shown that cells in the anterior part
of the apical ridge leave the ridge and form non-ridge
ectoderm as the bud grows out (Vargesson et al. 1997).
Cells in the polarizing region express Shh and there
is evidence that both digit number and identity depend
on SHH signalling. In SHH–/– mutant mouse embryos,
only a single rudimentary digit forms and it has been
suggested that this is an ‘anterior’ digit (Chiang et al.
2001; Kraus et al. 2001). This fits with the idea that
development of a proper hand plate with a series of
digits and progressive posteriorization of digit identity
depends on SHH. The effects of SHH seem to be mediated
by downstream signals such as BMPs and also Gremlin,
a BMP antagonist (reviewed Sanz-Ezquerro & Tickle,
2001; see also Panman & Zeller, this issue).
Very recently, it has been shown that an important
function of SHH signalling is to prevent processing of
Gli3 protein to the repressor form in the posterior part
of the limb bud where digits will form. Gli3 is expressed
widely in the limb bud, particularly in the anterior
region, and in the absence of SHH, the repressive form
of Gli3 protein predominates and further distal development of almost the entire limb bud is shut down
(Litingtung et al. 2002; Welscher et al. 2002).
Gremlin appears to be necessary to allow expression
of Fgf4 in the posterior region of the apical ridge
(Zuniga et al. 1999). There is evidence for a positive
feedback loop involving FGF4 (and probably FGF9,
FGF17) that ensures continued expression of Shh in
the polarizing region, and SHH, in turn ensures continued expression of Fgf4 and these other Fgf genes
in posterior ridge (Laufer et al. 1994; Niswander et al.
1994). Thus Gremlin appears to be the apical ridge
maintenance factor that was hypothesized to be
produced by the polarizing region, in addition to the
patterning signal (reviewed in Saunders, 1977).
Fate mapping experiments have shown that the digits
come from the posterior part of the limb bud under the
region of the ridge expressing Fgf4 (Vargesson et al.
© Anatomical Society of Great Britain and Ireland 2003
1997). Fgf4 expression in the chick wing bud persists at
least until around stage 26 (Duprez et al. 1996), just
after the stage at which the number of digital rays
appears to be fixed. Shh expression seems to switch off
at about the same time (stage 26–27, Dahn & Fallon,
2000; J.J.S.E., unpublished observations), although
some reports have suggested that expression persists
until later stages (stage 29, Riddle et al. 1993).
The signalling molecules that pattern the chick wing
and leg are the same. A major step forward is the
identification of Tbx genes, Tbx5 and Tbx4, which are
expressed specifically in upper and lower limbs, respectively. How exactly Tbx gene expression contributes to
the patterning process is not understood (reviewed by
Niswander, 1999).
Digit morphogenesis
Recent work has shown that, surprisingly, development
of the digital rays is relatively plastic (Dahn & Fallon,
2000). According to the model for polarizing region
signalling outlined earlier, each of the digital rays will
develop from cells with a particular antero-posterior
identity and this identity should then determine the
subsequent morphogenesis of that particular ray, for
example number, relative length and shape of phalanges.
In a series of experiments using barriers to bisect digital primordia, removing interdigital mesenchyme and
grafting digital primordia to heterotopic interdigital
host environments, Dahn and Fallon showed that morphogenesis of rays can be modified by adjacent interdigital mesenchyme and that the rays develop in
accordance with the most posterior interdigital cues
received. In the chick leg, each toe has a different
number of phalanges (going from anterior to posterior,
toe 1, 2 phalanges; toe 2, 3; toe 3, 4; toe 4, 5; see Fig. 3).
Digital primordia transplantations can lead both to
gain and loss of phalanges in digital ray development,
and thus, as Dahn and Fallon point out, digital rays can
be anteriorized as well as posteriorized. This contrasts
with the earlier limb bud antero-posterior patterning
process in which specification always seems to proceed
from anterior to posterior, i.e. posteriorization.
Toes with extra phalanges can also be produced by
grafting beads soaked in SHH to interdigital tissue (Dahn
& Fallon, 2000). This was also discovered independently
in a series of experiments designed to examine the
effects of SHH on interdigital cell death (Sanz-Ezquerro
& Tickle, 2000). Figure 4 shows an example in which toe
54 Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle
with an endogenous signalling system that controls
morphogenesis of each individual digital ray, possibly
based on Ihh. The finding that mutations in Ihh are
present in patients with brachydactyly type A-1
(characterized by shortening or absence of middle
phalanges) supports this idea (Gao et al. 2001; see also
Wilkie, this issue).
Separation and spacing of digits
Fig. 3 Stage 36 (10 days incubation) chick embryo leg stained
for cartilage with Alcian Blue. Completed toes can be seen
with phalanges, joints and tips, which will bear claws.
Numbers refer to identity of toes, from anterior (1 = big toe)
to posterior (4). Note increasing number of phalanges in more
posterior toes.
Fig. 4 Application of beads soaked in SHH to the interdigital
spaces leads to generation of longer digits with extra
phalanges (arrow) and joint (arrowhead). Asterisk marks
position of SHH-soaked bead.
2 developed an additional phalange. It should be noted
that, at the time when these experiments are carried
out, stage 28, Shh is no longer expressed. One interpretation of these effects of SHH is that this is interfering
The mechanisms involved in setting up digital vs.
interdigital areas and thus spacing the digits are not
understood. The initial divergence between digital
and interdigital regions determines the fate of cells
in an alternating fashion, and different programmes
of cell differentiation (chondrogenesis or apoptosis,
respectively) will be activated. Members of the
TGFβ superfamily of signalling molecules have been
implicated as the signals responsible for executing the
two different programmes – TGFβs as chondrogenic
signals and BMPs as apoptotic signals (Ganan, 1996).
However, interdigital tissue has a high chondrogenic
potential, both in vitro, when assayed in micromass or
in organ explant cultures, and even in vivo. Removal of
dorsal ectoderm or interdigital apical ectodermal ridge
leads to chondrogenesis, with sometimes the development of a reasonably formed extra digit (Hurle &
Ganan, 1986). This can also be produced by application
to interdigital mesenchyme of several signalling molecules, including TGFβ and with low frequency, SHH.
Figure 5 shows such an extra digit with phalanges,
joint and tip. This has led to the proposal that chondrogenic potential of interdigital cells before the
onset of cell death must be actively repressed. Negative
ectodermal influences through FGF-FGFR2 signalling
(Moftah et al. 2002) and of neighbouring digits,
perhaps also involving retinoic acid signalling (Lee
et al. 1994), have been proposed. This potential of
interdigital tissue to form cartilage could account
for the reported observation that interdigital cells
contribute to digit condensations by cell migration
(Omi et al. 2000). Some kind of lateral inhibition
mechanism could also be operating during digital condensation, and expression of members of the Notch
signalling pathway in the edges of digital rays from the
beginning of condensation is suggestive of a role in
such a process (Vargesson et al. 1998). An autoregulatory loop of chondrogenic activators and diffusible
inhibitors, on the lines of diffusion–reaction models,
© Anatomical Society of Great Britain and Ireland 2003
Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle 55
(Chautan et al. 1999) and could account for at least
part of interdigital death. Recently, a direct regulation
by a homeobox transcription factor of genes involved
in activating cell death in a morphogenetic context
(head formation in Drosophila) has been reported
(Lohmann et al. 2002). It will be of interest to investigate the possibility that a similar process operates in
vertebrate embryos during interdigital cell death, and
the fact that Hoxa13 mutant mice have syndactyly is
very suggestive in this context (Stadler et al. 2001). In
contrast, however, in Hypodactyly mouse mutants in
which Hoxa13 mutations have a dominant negative
effect (Post et al. 2000), there is extensive cell death in
the digital plate and only one digit forms (Robertson
et al. 1996).
Segment and joint formation
Fig. 5 Ectopic extra digit (arrow) induced in the interdigital
space of a chick embryo leg bud by application of sn SHHsoaked bead (asterisk). Note that extra digit contains a distal
phalange and tip.
has also been proposed but, to date, not directly
demonstrated to occur in vivo.
Another important process during digit morphogenesis is cell death, which helps sculpt the autopod by
freeing digits. Interdigital cell death has been shown to
occur mainly by caspase-dependent apoptosis. TUNELpositive cells can be readily detected during interdigital
death and mice null for molecules involved in the
execution (Apaf-1 –/–) (Cecconi et al. 1998) or regulation (double bax –/–, bak –/–) (Lindsten et al. 2000) of
apoptosis have soft-tissue syndactyly due to lack of
interdigital cell death. However, a necrotic caspaseindependent mechanism has also been reported
© Anatomical Society of Great Britain and Ireland 2003
Morphological observations support the model in which
an initially continuous cartilage condensation becomes
divided successively into distinct segments as a result of
joint formation (Fig. 2; reviewed in Francis-West et al.
1999b). This happens through the appearance first of
the interzone, a region of higher cell density where
chondrogenesis is repressed. These interzone cells stop
expressing characteristic cartilage markers, such as type
II collagen, and this region will eventually cavitate to
form the joint cavity and surrounding capsule. However, the mechanisms involved both in specifying a
joint area and in spacing of joints are not understood.
Several genes are expressed in joints during digit
morphogenesis, including those encoding signalling
molecules such as BMP2, their secreted antagonists
such as Chordin or transcription factors such as Cux1
(Lizarraga et al. 2002). However, two genes have been
more directly implicated in joint formation. Gdf5, a
gene member of the TBFβ superfamily, is specifically
expressed in developing joints (Fig. 6), and null or lossof-function mutations in this gene result in the absence
or aberrant formation of joints both in mice and in
humans (Polinkovsky et al. 1997; Storm & Kingsley,
1999). However, the effect of ectopic application of
GDF5 is not the induction of a joint, but rather inhibition of chondrogenesis (Francis-West et al. 1999a;
Merino et al. 1999; Storm & Kingsley, 1999), likely
placing the function of this gene downstream of joint
specification. So far, the only gene suggested to have an
inductive role in joint formation is the gene encoding
WNT-14, another secreted molecule but belonging to
56 Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle
Fig. 6 Stage 35 chick leg bud showing
expression (arrow) of Gdf5 by wholemount in situ hybridization. Note
intense staining of all interphalangeal
joints as well as metacarpo-phalangeal
joints.
the WNT family. Wnt-14 is expressed at sites of joint
formation (Hartmann & Tabin, 2001), and when overexpressed is able to inhibit chondrogenesis and induce
changes, both morphological (gaps in chondrogenic
condensation) and molecular (activation of joint markers including Gdf5), characteristic of joint formation.
Also in the context of these experiments, the observation that such ectopic joint-like regions are able to suppress formation of adjacent endogenous joints has led
to the proposal that an auto-inhibition process could
account for spacing of joints. Once a joint has been
specified, among its products would be a secreted
inhibitor that would prevent, above a certain threshold, the induction of a new interzone in the vicinity.
Growth of the condensation would lead to loss of the
negative influence and then positive signals for joint
induction could operate again to form a new joint.
Positive influences of BMPs from the interdigital areas,
and negative influences of the BMP inhibitor Chordin
from joints have also been suggested to play a role.
Another aspect of joint development is cell death,
which occurs during later differentiation of joints.
Although the occurrence of apoptosis has been
reported in connection with cavitation, its functional
significance has yet to be investigated.
Tip formation
After pattern formation has been completed, limb buds
stop growing out. However, the molecular mechanisms
involved in the cessation of outgrowth and tip formation are not known. Heterochronic grafts between
mesenchyme and ectodermal hulls have shown that
the signal that primarily maintains outgrowth resides
in the mesenchyme (Rubin & Saunders, 1972). Since it is
now known that apical ridge signalling is mediated by
FGFs, and mesenchyme acts by maintaining apical ridge
signalling, the problem then is to control how long
expression of FGFs is maintained in the ridge. This process
may be related to earlier antero-posterior patterning,
© Anatomical Society of Great Britain and Ireland 2003
Digit morphogenesis, J. J. Sanz-Ezquerro and C. Tickle 57
in that disappearance of Fgf8 expression from the apical ridge in chick embryo leg buds occurs at different
times in different digital rays. Fgf8 switches off first
from anterior digit tips and later from more posterior
digits (Merino et al. 1998). Interestingly, the time at
which Fgf8 expression switches off correlates not with
absolute digit length but rather with the number of
phalanges that will form, and thus is related to digit
identity.
Digit tips have special regenerative powers. Higher
vertebrates have pretty much lost the regenerative
potential characteristic of lower animals, such as
urodeles, and, in the case of limbs, is restricted to digit
tips. This regenerative potential has been correlated
with the expression domain of Msx1 gene in that
region (Reginelli et al. 1995). Understanding the
process of tip determination-formation could lead to
improvements in regenerative ability. Finally, the control of digit growth and tip formation could represent
a mechanism leading to evolutionary morphological
diversity. A delay in timing the end of digit formation
could allow for generation of longer digits, by maintaining the process of digit growth and segmentation. This
could have been the case for the hyperphalangic flippers
of dolphins and whales (Richardson & Oelschläger, in
press).
Acknowledgments
Cheryll Tickle is a Royal Society Professor and the
authors’ research on limb development is supported by
the MRC.
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