Introduction
Osteoarthritis (OA), which is the most common chronic degenerative joint disorder worldwide, is characterized primarily by cartilage degradation and narrowing of the joint spaces[
1]. Both genetic and acquired factors, such as obesity, mechanical influences and age, are involved in the complex pathogenesis of OA, whereby cartilage homeostasis is disrupted by biophysical factors (for example, mechanical stress) and biochemical factors (for example, proinflammatory cytokines). The chondrocyte is a unique resident cell that synthesizes cartilage-specific extracellular matrix (ECM) components as well as various catabolic and anabolic factors. The pathogenesis of OA activates various biochemical pathways in chondrocytes, leading to proinflammatory cytokine production, inflammation, degradation of the ECM by matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), and cessation of ECM synthesis via the dedifferentiation and apoptosis of chondrocytes[
2,
3]. However, the molecular mechanisms underlying OA are not yet fully understood. The elucidation of such mechanisms could facilitate the development of new and effective therapeutic targets for the treatment of OA.
The Wnt signaling pathway is involved in cartilage development and homeostasis, as evidenced by the fact that a number of Wnt proteins and Frizzled (Fz) receptors are expressed in chondrocytes[
4] and the synovial tissues of arthritic cartilage[
5]. Interestingly, both chondrocyte-specific conditional activation and selective inhibition of β-catenin in mice have been shown to yield OA-like phenotypes, albeit via different mechanisms[
6,
7]. Several additional lines of evidence link Wnt/β-catenin signaling with OA, further supporting the notion that the Wnt/β-catenin pathway plays a role in the pathophysiology of cartilage[
8‐
10].
Low-density lipoprotein receptor-related protein 5 (LRP5), which, together with LRP6, forms a distinct subfamily of LRPs), is a coreceptor for Wnt ligands, whereby the interaction of LRP5 with Axin initiates Wnt signaling by binding to members of the Fz receptor family[
11]. LRP5 is one of the most intensively studied regulators of bone remodeling, largely because
Lrp5 loss-of-function mutations cause the autosomal recessive human disorder osteoporosis-pseudoglioma syndrome (OPPG)[
12], whereas activating mutations in
Lrp5 cause high bone mass syndrome[
13].
Lrp6- deficient mice display phenotypes similar to those seen in several
Wnt knockouts (KOs) and die between embryonic day 14.5 and birth[
14]. Despite the clear association of LRP5 with Wnt signaling and the involvement of Wnt/β-catenin signaling in cartilage degeneration, however, relatively few researchers have reported the involvement of LRP5 in OA pathogenesis. The OA susceptibility locus on chromosome 11q12-13 is in close proximity to the
Lrp5 gene, and a single polymorphism in
Lrp5 can confer increased risk for spinal OA and osteophyte formation[
15]. LRP5 expression is increased in articular cartilage from OA patients and has been linked to increased MMP13 expression in chondrocytes[
16]. Furthermore, bone morphogenetic protein 2–induced activation of Wnt/β-catenin signaling, which has been linked to enhanced catabolic activity of LRP5, contributes to hypertrophy in OA chondrocytes[
17]. However, in a recent study, investigators reported that LRP5 deficiency could increase (rather than decrease) cartilage degradation in instability-induced OA[
18]. Given this apparent discrepancy, additional work is clearly warranted to elucidate the molecular mechanisms underlying the LRP5-mediated regulation of OA pathogenesis.
In our present study, we investigated the distinct expression patterns of LRP5 and LRP6 in OA cartilage, elucidated the catabolic regulation of LRP5 in experimental OA using total and chondrocyte-specific conditional KO mice and examined the mechanisms underlying the LRP5-induced modulation of Wnt/β-catenin signaling. Our findings indicate that LRP5 (but not LRP6) plays an essential role in Wnt/β-catenin signaling–mediated OA cartilage destruction by upregulating catabolic factors (for example, MMP3 and MMP13) and downregulating the anabolic factor type II collagen.
Methods
Mice
Imprinting control region (ICR) mice were used for the chondrogenesis studies, and male C57BL/6,
Lrp5-/-,
Lrp5
fl/fl
;
Col2a1-cre[
19], STR/ort and CBA/CaCrl mice were used for the experimental OA studies. The
Lrp5-/- and
Lrp5
fl/fl
mice targeting exons 6 through 8 of
Lrp5 (kindly provided by Dr Gerard Karsenty of Columbia University (New York, NY, USA)[
20]) were backcrossed against the C57BL/6J strain for eight generations. The
Col2a1-cre-transgenic mice were obtained from The Jackson Laboratory (Bar Harbor, ME, USA) and backcrossed with
Lrp5
fl/fl
mice to generate chondrocyte-specific conditional KO mice (
Lrp5
fl/fl
;
Col2a1-cre). The genotyping primers for
Lrp5-/-,
Lrp5
fl/fl
and
Col2a1-cre were the same as those described previously[
20]. The STR/ort and CBA/CaCrl mice were obtained from Harlan Laboratories (Indianapolis, IN, USA). All protocols were reviewed and approved by the Institutional Animal Care and Use Committee of Chonnam National University.
Human arthritic cartilage and experimental osteoarthritis
Human OA cartilage was sourced from individuals undergoing arthroplasty[
21]. Human cartilage was kindly provided by Dr Churl-Hong Chun of Wonkwang University (Iksan, Republic of Korea). The Institutional Review Board of the Wonkwang University Hospital approved the use of these materials, and all individuals provided written informed consent to be donors before undergoing surgery. Spontaneous OA in STR/ort mice[
22] was examined at 28 weeks of age, with CBA/CaCrl mice used as controls. Aging studies were performed in 12-month-old mice, and experimental OA was induced in mice by destabilization of the medial meniscus (DMM) surgery[
23] or by intra-articular injection of collagenase in 8-week-old male mice[
24] and in in
Lrp5
-/-
mice and their wild-type (WT) littermates. Sham-operated and phosphate buffered saline–injected mice were used as controls for the DMM and collagenase-injected models, respectively. Mice were analyzed at 8 weeks after DMM surgery or 4 weeks after collagenase injection.
Micromass culture and primary culture of articular chondrocytes
Mesenchymal cells were derived from the limb buds of ICR mouse embryos 11.5 days postcoitus and maintained as micromass cultures for induction of chondrogenesis as described previously[
8]. Mouse articular chondrocytes were isolated from knee cartilage obtained from postnatal day 5 mice[
25]. The articular cartilage was preincubated for 2 hours at 37°C with 0.2% trypsin and 0.2% type II collagenase and further digested with 0.2% type II collagenase for 90 minutes. On culture day 3, the cells were treated with recombinant interleukin 1β (IL-1β) (Calbiochem, San Diego, CA, USA), Wnt3a or Wnt7a (R&D Systems, Minneapolis, MN, USA) for 24 hours. Apoptosis was induced by treatment with an anti-Fas antibody (BD Biosciences, San Jose, CA, USA). Briefly, chondrocytes from articular cartilage of WT or
Lrp5
-/-
mice were incubated in the presence or absence of IL-1β (1 ng/ml) for 24 hours, then exposed to the anti-Fas antibody and recombinant protein G for an additional 6 hours. Hamster immunoglobulin G2 was used as a control. The cells were stained with fluorescein isothiocyanate–conjugated annexin V (BD Biosciences), and apoptotic chondrocytes were quantified by fluorescence-activated cell sorting analysis.
Immunofluorescence microscopy and immunohistochemistry
Chondrocytes were cultured on glass coverslips, fixed with 3.5% paraformaldehyde and permeabilized with 0.1% Triton X-100. The cells were incubated for 1 hour with an antibody against type II collagen followed by incubation for 1 hour with an Alexa 488–conjugated secondary antibody (Invitrogen, Carlsbad, CA, USA). Ectopic expression of LRP5 was determined by labeling with an anti-LRP5 antibody and an Alexa 555–conjugated secondary antibody (Invitrogen). Apoptosis of chondrocytes in cartilage tissue was determined by terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling (TUNEL) staining using a kit purchased from Roche Diagnostics (Indianapolis, IN, USA). Specimens were visualized under an IX81 inverted fluorescence microscope (Olympus America, Center Valley, PA, USA) driven by MetaMorph imaging software (Molecular Devices, Sunnyvale, CA, USA). Normal and OA human cartilage samples were frozen, sectioned at a thickness of 6 μm and subjected to Alcian blue and immunohistochemical staining. Mouse cartilage was fixed in 4% paraformaldehyde, decalcified in 0.5 M ethylenediaminetetraacetic acid (pH 7.4), embedded in paraffin and sectioned at a thickness of 6 μm. Cartilage destruction was evaluated by Safranin O staining and scored according to Mankin’s method[
26]. Immunostaining of LRP5, MMP3, MMP13 and β-catenin in human and mouse cartilage was performed using standard techniques[
21].
RT-PCR and quantitative RT-PCR
Total RNA isolated from mouse articular chondrocytes and OA cartilage tissues was reverse-transcribed, and the resulting cDNA was PCR-amplified. The PCR primers and conditions used for mouse
Col2a1,
Mmp3,
Mmp13,
Ptgs2,
Nos2 and
Gapdh were previously described[
21]. The PCR primers for
Lrp5 and
Lrp6 were as follows: mouse
Lrp5, sense: 5′-CTGAGGAACGTCAAAGCCATCAACTATG-3′, and antisense: 5′-TACTGGCTGTACGATGT TGGCATCTTC-3′; mouse
Lrp6, sense: 5′-GCCCACTACTCCCTGAATGCTGACAAC-3′, and antisense: 5′-CCACTCCAACTGATCGTCCATCTAATC-3′; human
LRP5, sense: 5′-GGGAGACGCCAAGACAGACAAGATCG-3′, and antisense: 5′-GGTGAAGACCAAGAAGG CCTCAGG-3′; and human
LRP6, sense: 5′-ATTGTAGTTGGAG GCTTGGAGGATGC-3′, and antisense 5′-CCATCCATTCCAGCACGTTCTATC-3′. Quantitative RT-PCR (qRT-PCR) was performed using an iCycler (Bio-Rad Laboratories, Hercules, CA, USA) and SYBR
Premix Ex Taq (Tli RNaseH Plus) (TaKaRa Bio, Kyoto, Japan).
Western blot analysis
Total cell lysates were prepared with lysis buffer (pH 7.4) containing 150 mM NaCl, 1% Nonidet P-40, 50 mM Tris, 0.2% SDS, 5 mM NaF, a protease inhibitor cocktail and a phosphatase inhibitor cocktail. Proteins were resolved by SDS-PAGE, transferred to nitrocellulose membranes, detected by incubation with the appropriate primary antibody and a peroxidase-conjugated secondary antibody (Sigma-Aldrich, St Louis, MO, USA) and visualized using an enhanced chemiluminescence system (GE Healthcare Life Sciences, Pittsburgh, PA, USA). The primary antibodies used were purchased from ABGENT (LRP5, AP6157a; San Diego, CA, USA), EMD Millipore (type II collagen, MAB8887; Billerica, MA, USA), BD Biosciences (extracellular signal-regulated kinase (ERK), 610408; β-catenin, 610154), Santa Cruz Biotechnology (inhibitor of nuclear factor κB α, SC-371; and p38, SC-535; Santa Cruz, CA, USA) and Cell Signaling Technology (phosphorylated ERK, 9101; pp38, 9216; c-Jun N-terminal kinase (JNK), 9252; and phosphorylated JNK, 9255; Danvers, MA, USA).
Transfection and reporter gene assay
Mouse articular chondrocytes were cultured for 3 days, transfected for 4 hours with Lrp5 small interfering RNA (siRNA) (Dharmacon, Lafayette, CO, USA) or pSPORT6-Lrp5 (Open Biosystems, Huntsville, AL, USA) using Lipofectamine 2000 reagent (Invitrogen), then treated with IL-1β, Wnt3a or Wnt7a. A nonsilencing control siRNA and empty vector were used as the negative controls. To determine the transcriptional activity of β-catenin-Tcf/Lef, we used a reporter gene assay. Chondrocytes were transfected with 1 μg of reporter gene (TOPflash) or control gene (FOPflash) (both from Upstate Biotechnology, Lake Placid, NY, USA) and 1 μg of pCMV- β-galactosidase using Lipofectamine 2000. The transfected cells were treated with IL-1β, Wnt3a or Wnt7a for 24 hours, then luciferase activity was measured and normalized with respect to transfection efficiency (as measured by β-galactosidase activity).
Statistical analysis
The nonparametric Mann–Whitney U test was used to analyze data based on ordinal grading systems, such as International Cartilage Repair Society (ICRS) and Mankin scores. For qRT-PCR results and apoptotic cell numbers, the data were first tested for conformation to a normal distribution using the Shapiro-Wilk test, then analyzed by Student’s t-test (pairwise comparisons) or analysis of variance with post hoc tests (multiple comparisons) as appropriate. Significance was accepted at the 0.05 level of probability (P < 0.05).
Discussion
Disturbance of cartilage homeostasis is a main cause of OA pathogenesis. In OA, cartilage destruction is initiated by defects in joint biomechanics in conjunction with predisposing factors (for example, age, genetics and various systemic aspects), leading to an imbalance of anabolic and catabolic factors[
2]. Various biochemical pathways are modulated, resulting in the insufficient synthesis of cartilage matrix by chondrocytes, increased numbers of apoptotic chondrocytes[
27] and degradation of the ECM due to increased production of MMPs and ADAMTS[
2,
3]. In this study, we demonstrate that
Lrp5 is a crucial catabolic regulator of Wnt/β-catenin signaling–mediated OA cartilage destruction. We first observed upregulation of LRP5 in human and experimental mouse OA cartilage samples. Our evaluation of the specific functions of LRP5 in OA pathogenesis further revealed that
Lrp5 deficiency in mice (
Lrp5
-/-
) exerted a protective effect against OA pathogenesis. Our results additionally suggest that the catabolic regulation of LRP5 is associated with its capacity to initiate Wnt-mediated expression of catabolic factors, such as MMP3 and MMP13, and decrease the anabolic factor, type II collagen.
LRP5 and LRP6 are paralogs that are 70% identical, and both are capable of stimulating the Wnt/β-catenin signaling pathway. Even though they have redundant and overlapping functions[
28,
29], several previous reports have suggested that LRP5 and LRP6 also play distinct roles due to their differences in tissue distribution and ligand affinities[
11,
30]. For example, a loss-of-function mutation in
Lrp5 causes OPPG syndrome, a disorder involving low bone mass[
12], whereas
Lrp6 deficiency (
Lrp6
-/-
) in mice is an embryonic lethal disorder[
14], and a heterozygous loss-of-function mutation in
Lrp6 (
Lrp6
+/-
) is associated with decreased β-catenin signaling within articular cartilage and increased degenerative joint disease after ligament and meniscus injury[
31]. These previous findings indicate that the specific receptors for LRP5 and LRP6 control different functions, presumably by interacting with distinct ligands of the Wnt family. In an effort to further confirm the catabolic regulation of
Lrp5, we examined the expression levels of
Lrp5 and
Lrp6 in differentiating chondrocytes, human OA cartilage and cartilage samples from various experimental mouse models of OA. We observed distinct expression patterns for
Lrp5 and
Lrp6 during chondrogenesis and the IL-1β-induced dedifferentiation of chondrocytes. LRP5 expression in OA cartilage was increased, consistent with previous reports[
15,
16], whereas LRP6 expression was unaltered. These findings provide additional evidence that LRP5 and LRP6 have distinct expression patterns and may play different roles in OA cartilage destruction.
Previous studies have suggested that LRP5 may contribute to OA pathogenesis, but its function in OA cartilage destruction has been the subject of some controversy. LRP5 expression was found to be significantly upregulated in human OA cartilage[
16], and a cohort study suggested that haplotypes of the
Lrp5 gene are risk factors for OA[
15]. Conversely, however, mild instability-induced OA in
Lrp5
-/-
mice was reportedly associated with increased cartilage degradation[
18]. Our data are inconsistent with the latter observation, even though the two studies seem consistent in terms of the method used to induce OA (DMM surgery), the duration after surgery (8 weeks) and the utilized mouse strain (C57BL6/J). To examine whether whole-body
Lrp5 deficiency could affect gene expression in other tissues by altering the susceptibility to pathogenic stimulation, we examined the chondrocyte-specific
in vivo function of LRP5 in conditional KO mice (
Lrp5
fl/fl
;
Col2a1-cre) to exclude any unexpected side effects from the loss of
Lrp5 in other tissues. However, we found that the inhibitory effect of
Lrp5 deficiency on DMM surgery–induced OA cartilage degradation in
Lrp5
fl/fl
;
Col2a1-cre mice was consistent with the results from total
Lrp5
-/-
mice. These data indicate that LRP5 has catabolic effects during OA cartilage degradation.
In the current study, we used recombinant Wnt3a and Wnt7a as representative ligands of the canonical Wnt/β-catenin signaling pathway to evaluate the function of Lrp5. We did not examine the upregulation of Wnt molecules in the OA cartilage of our experimental systems, but Wnt3a is known to activate the canonical Wnt pathway and stimulate the expression of
Mmp13 and
Adamts4 in mouse chondrocytes[
32,
33]. We previously showed that IL-1β upregulates Wnt7a expression, thereby inhibiting type II collagen expression in chondrocytes[
34]. Moreover, we found that the expression levels of various Wnt and Fz receptor isotypes were regulated by IL-1β[
4]. In this study, we found that stimulation of canonical Wnt signaling via Wnt3a treatment caused upregulation of
Mmp13 in mouse articular chondrocytes, whereas Wnt7a treatment decreased
Col2a1 expression and increased
Mmp3 and
Mmp13 expression. Our observation that Wnt7a and IL-1β have similar effects on gene expression in chondrocytes is consistent with a previous report[
4] in which we showed that IL-1β induced upregulation of
Wnt7a in articular chondrocytes. Notably, however, the Wnt-mediated regulation of
Col2a1,
Mmp3 and
Mmp13 were abrogated in primary cultured chondrocytes from
Lrp5
-/-
mice. On the basis of these data, we speculate that catabolic gene expression is convergently modulated by IL-1β in chondrocytes, with IL-1β-mediated
Wnt7a and
Lrp5 expression triggering downregulation of
Col2a1 and upregulation of
Mmp3 and
Mmp13, potentially contributing to the IL-1β-induced activation of β-catenin.
The catabolic effects of LRP5 may be attributable to its capacity to upregulate
Mmp3 and
Mmp13, which encode proteins that are capable of degrading a variety of ECM components during the arthritic process[
35]. Moreover, genetic studies in mice have clearly demonstrated that MMP3 and MMP13 play crucial roles in OA pathogenesis[
36,
37]. We observed that Wnt3a induced the expression of
Adamts4 (data not shown). Notably, however,
Adamts4 deficiency in mice did not show protective effects against OA cartilage destruction[
38], whereas
Mmp13-KO mice are resistant to OA cartilage erosion[
37]. Therefore, the capacity of LRP5 to facilitate the Wnt-induced expression of MMP13 (a common catabolic factor that is regulated by both Wnt3a and Wnt7a) appears to be associated with the positive effects of LRP5 on OA cartilage destruction. The LRP5-induced downregulation of the anabolic factor type II collagen (a marker protein of chondrocytes) in articular chondrocytes also contributes to cartilage destruction. We found that ectopic expression of LRP5 induced the dedifferentiation of chondrocytes and was associated with the pathogenesis of OA. The apoptosis of chondrocytes, which is associated with the pathogenesis of OA, can be induced by a number of stimuli[
39,
40]. As we previously showed that Fas and its ligand are physiologically involved in chondrocyte apoptosis[
41], in our present study we used an anti-Fas antibody to evaluate the role of LRP5 in chondrocyte apoptosis. The decreased chondrocyte apoptosis in
Lrp5
fl/fl
;
Col2a1-cre mice subjected to DMM surgery supports our contention that LRP5 plays a catabolic role in OA cartilage destruction.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
YS designed and performed most of the in vitro and in vivo studies. YHH conceived the project, performed histological evaluations and drafted the manuscript. KK carried out the immunoassays and performed the statistical analysis. SK and KHP participated in the animal studies and analyzed the data. JTK and JSC participated in the design of the study and helped to draft the manuscript. JHR conceived the project and is responsible for the overall design and oversight of the project. All authors read and approved the final version of the manuscript.