The Role of ULK1 in the Pathophysiology of Osteoarthritis

Osteoarthritis (OA) is the most common musculoskeletal disease worldwide. It is one of the leading causes of pain and disability among adults, and represents a considerable burden on the healthcare system. OA is a disease of the entire joint, involving not only the articular cartilage but also the synovium, ligaments and subchondral bone. It is characterized by the progressive degeneration of the articular cartilage, osteophyte formation, remodelling of the subchondral bone, deterioration of tendons and ligaments and various degrees of inflammation of the synovium. While current therapies and management strategies can help alleviate symptoms early in the disease process, OA is characterized by almost inevitable progression towards end-stage disease. The exact pathogenesis of OA is largely unknown but the key event in OA is the degradation of the articular cartilage. The articular cartilage is only composed of chondrocytes; cells responsible for the synthesis of the extracellular matrix (ECM) and maintenance of articular cartilage homeostasis. Chondrocytes maintain the articular cartilage matrix by replacing degraded macromolecules and respond to focal cartilage injury or degeneration by increasing local synthesis activity. Since chondrocytes exhibit low levels of turnover, they rely on endogenous mechanisms such as autophagy (a cell survival and adaptation process) to remove damaged organelles and macromolecules in order to maintain articular cartilage homeostasis. Autophagy is a lysosomal degradation pathway that is essential for survival, differentiation, development and homeostasis. It regulates maturation and promotes survival of terminally differentiated chondrocytes under stress and hypoxic conditions. Studies by us and others have shown that compromised autophagy is associated with decreased chondroprotection, increased cell death and articular cartilage degeneration. Carames et al showed that autophagy is constitutively expressed in normal human articular cartilage. However, expression of key autophagy inducers is reduced in ageing cartilage. Our previous studies have also identified a panel of key autophagy genes that are expressed in low levels in human OA cartilage as well as in the articular cartilage from mouse and dog models of experimental OA. Specifically, we identified that expression of unc-51 like kinase-1 (ULK1) is suppressed in human OA cartilage and experimental OA models. ULK1 is a serine/threonine protein kinase and is the most upstream autophagy inducer. Loss of ULK1 results in disruption of autophagy induction. Since adequate autophagy signaling is required for maintaining chondroprotection as well as articular cartilage homeostasis, we hypothesized that ULK1 is required for autophagy induction in the articular cartilage and loss of it will result in decreased chondroprotection and enhanced chondrocyte death leading to the degeneration of articular cartilage. Since the exact role of ULK1 in pathogenesis of OA is unknown, I created for the first time, an inducible cartilage- specific ULK1 knockout (KO) mice using Cre-Lox technology and subjected these mice to the destabilization of the medial meniscus (DMM) mouse OA model to specifically elucidate the specific in vivo role of ULK1 in OA pathogenesis. My results show that ULK1 is essential for maintaining articular cartilage homeostasis. Specifically I show that loss of ULK1 in the articular cartilage results in an accelerated OA phenotype; which is associated with accelerated cartilage degeneration, enhanced chondrocyte cell death, increased expression of catabolic MMP-13. Using human OA chondrocytes transfected with ULK1 expression plasmid I show that ULK1 is able to reduce the expression of mTOR (major negative regulator of autophagy) and decrease the expression of OA catabolic factors including MMP-13, ADAMTS-5 and COX-2. My results so far suggest that ULK-1 is a potential therapeutic target to maintain articular cartilage homeostasis.

Keyphrases: ULK1, Chondrocytes, Osteoarthritis, Articular cartilage, Autophagy, Cell death, Chondrocytes