The specific in vivo role of PPARgamma and its downstream signaling pathway in the pathophysiology of Osteoarthritis

Osteoarthritis (OA) is an age related degenerative joint disease with unknown pathogenesis. Recent studies suggest that the activation of the transcription factor Peroxisome Proliferator-Activated Receptor gamma (PPARγ) is a therapeutic target for OA. Agonists of PPARγ inhibit inflammation and reduce the synthesis of cartilage degradation products both in vitro and in vivo. However, studies using agonists of PPARγ do not elucidate the exact effects mediated by this complex gene. Indeed, some of these agonists have the ability to regulate, in vivo, various other signaling pathways independent of PPARγ, resulting in serious side effects. It is therefore vital, in order to achieve therapeutic efficacy with potentially less safety concerns, to elucidate the exact in vivo role of PPARγ in OA pathophysiology. Thus, the aim of my PhD project was to determine the specific in vivo role of PPARγ in OA pathophysiology using cartilage-specific PPARγ knockout (KO) mice and subjecting these mice to surgical model of OA.  I generated two separate PPARγ KO mice harboring a (a) constitutive cartilage-specific germ-line deletion of PPARγ gene for developmental and age-related OA study and (b) inducible cartilage-specific deletion of PPARγ in adult mouse specifically for OA studies using LoxP Cre system. Previous study in my laboratory using germ-line PPARγ KO mice shows that these mice exhibit cartilage developmental defects. I further explored if these mice which exhibit early developmental defects have any phenotypic changes in the articular cartilage during ageing. My results showed that adult PPARγ KO mice exhibited a spontaneous OA phenotype associated with enhanced cartilage degradation, hypocellularity, synovial fibrosis, and increased expression of catabolic and inflammatory factors. This study showed that PPARγ is a critical regulator of cartilage health, the lack of which leads to an accelerated spontaneous OA phenotype (Vasheghani et al, 2013; American Journal of Pathology). From this aim of the study, I could not ascertain if cartilage-specific germline PPARγ KO mice exhibited spontaneous OA because of developmental defects or as a result of PPARγ deficiency. To bypass the developmental defects, I then generated inducible cartilage-specific PPARγ KO mice using Col2rTACre system and subjected these mice to destabilization of medial meniscus (DMM) model of OA surgery. My results revealed that PPARγ KO mice showed accelerated cartilage degradation, hypo-cellularity, synovial fibrosis and increased expression of catabolic and inflammatory factors during OA. Loss of chondrocyte cellularity within the articular cartilage is one of the critical events that initiate the degradation of the cartilage during OA. Recent studies suggest that the process of autophagy, a form of programmed cell survival, is impaired during OA and may contribute towards decreased chondro-protection resulting in cartilage degradation. Thus, I further explored the role of PPARγ in chondro-protection by determining the effect of PPARγ deficiency in the cartilage on the expression of mTOR (master negative regulator of autophagy) and autophagy genes during OA. My results revealed that PPARγ-deficient chondrocytes exhibit significantly enhanced expression of mTOR and decreased expression of genes that initiate autophagy process compared to chondrocytes extracted from control OA mice. I then hypothesized that PPARγ controls mTOR/autophagy signaling and ultimately the fate of chondrocytes and the expression of catabolic and inflammatory factors in the articular cartilage. To test this, I transfected PPARγ KO OA chondrocytes with PPARγ expression vector to determine if restoration of PPARγ expression can rescue the phenotype of PPARγ KO OA cells. I observed that restoration of PPARγ expression in PPARγ KO cells significantly down-regulated the expression of mTOR and up-regulate the expression of autophagy genes along with significant rescue in the expression of collagen type II and aggrecan and significant down-regulation in the expression of critical catabolic and inflammatory markers. To validate our in vitro finding that enhanced mTOR signalling and resultant decrease in autophagy is responsible for accelerated OA phenotype observed in PPARγ KO mice, I generated inducible cartilage-specific PPARγ-mTOR double KO mice and subjected these mice to DMM model of OA. My results clearly demonstrate that PPARγ-mTOR double KO mice exhibit significant protection against DMM-induced OA associated with significant protection from cartilage destruction, proteoglycan loss and loss of chondro-cellularity compared with control mice. Since mTOR is a major repressor of autophagy, I found that the expression of two critical autophagy markers (ULK1 and LC3B) was significantly elevated in PPARγ-mTOR double KO mice compared to control mice. My in vitro rescue studies using PPARγ expression vector and in vivo studies using PPARγ- mTOR double KO mice clearly show that PPARγ is involved in the regulation of mTOR/autophagy signalling in the articular cartilage. Therefore, deficiency of PPARγ upregulates mTOR signalling resulting in the suppression of autophagy and decreased chondroprotection and increased catabolic activity leading to accelerated severe OA. This study for the first time provides direct evidence on the role of PPARγ in chondroprotection by modulation of mTOR/autophagy signalling in the articular cartilage.  These findings outline PPARγ and its downstream signalling by mTOR/autophagy as potential therapeutic targets for the treatment of OA.

Keyphrases: Osteoarthritis, Knockout mice, Cartilage, PPARγ, Catabolism, Inflammation, Aging, Chondro-protection, mTOR, Autophagy, Souris knock-out