In this study, M2 macrophage-derived exosomal miR-26b-5p was selected via high-throughput miRNA sequencing and bioinformatic analysis. The effects of miR-26b-5p on macrophage polarization and chondrocyte hypertrophy were assessed in vitro and in vivo. The results indicated that exosomal miR-26b-5p could repolarize proinflammatory M1 macrophages to an anti-inflammatory M2 type by targeting the TLR3 signaling pathway. Moreover, miR-26b-5p could inhibit articular cartilage hypertrophy by targeting COL10A1. Finally, miR-26b-5p ameliorated gait abnormalities and postponed OA progression. These data demonstrated that miR-26b-5p might be a potential OA treatment.
Therapeutic approaches, including nonpharmacologic and pharmacologic methods, have been applied to treat OA.26 However, only a few strategies can efficiently delay OA progression because numerous factors are involved in slow cartilage degradation.27, 28 As a component of the first line of immune defense, macrophages play vital roles during OA progression.29 Previous study has shown that synovial macrophages could aggravate synovial inflammation and chondrocyte hypertrophy by secreting several proinflammatory cytokines such as IL-1β, IL-6 and TNF-α.30 Thus, immunomodulatory strategies involving synovial macrophages may represent a potential treatment for OA. In this study, a synovial tissue was detected with mickle M1 macrophage infiltration accompanied by a small proportion of M2 macrophages. The results showed that miR-26b-5p could transform synovial proinflammatory M1 macrophages to an anti-inflammatory M2 type, thereby repairing the immune microenvironment in OA joints.
Exosomes play multiple roles in physiological and pathological processes by regulating intercellular communications. In OA progression, exosomes released from joint cells, including chondrocytes, osteoblasts, synovial fibroblasts, and macrophages, can be detected in the articular cavity.31 The crosstalk between synovium-derived exosomes and joint cells in OA is yet to be fully understood, but a previous study reported that exosomes derived from IL-1β stimulated synovial fibroblasts (SFB) can dramatically induce articular cartilage degeneration.32 On the contrary, exosomes produced by synovial mesenchymal stem cells (MSCs) can promote articular chondrocyte proliferation and migration; consequently, cartilage tissue regeneration is enhanced.33 In addition to SFB and MSCs, other synovial cells, including macrophages, T cells, and endothelial cells, may participate in these processes; however, the function and mechanism of exosomes derived from these cells are largely unknown. Considering that M2 macrophages are anti-inflammatory cells, we speculated that M2 macrophage-derived exosomes could inhibit inflammation and promote tissue repair. Thus, we focused on M2 macrophage-derived exosomal miRNAs and further analyzed the mechanism in this work.
miR-26b-5p is upregulated in ACL tissues of OA joints, indicating that it may participate in OA.34 It also targets CH25H, thereby inactivating the TLR pathway and repressing M1 macrophage polarization. However, an ischemia/reperfusion (I/R) mouse model has been used, and the effects of miR-26b-5p on the TLR3 pathway have not been evaluated.18 In another work, miR-26b-5p is significantly downregulated in OA cartilage and can regulate chondrocyte senescence by affecting asporin, demonstrating an miR-26b-5p-based therapeutic strategy for OA.19 On the basis of sequencing and bioinformatic analysis, our work showed that miR-26b-5p was upregulated in M2 macrophage-derived exosomes and could target TLR3/COL10A1.
TLRs are pattern recognition receptors that sense multiple pathogen-associated molecular patterns (PAMPs), including microbial nucleic acids and surface glycoproteins. TLRs activate innate immunity. In the TLR family, TLR3 promotes intracellular signaling by recruiting the Toll/IL-1 receptor (TIR) domain-containing adaptor-inducing IFN-β (TRIF) adaptor to induce MyD88-independent signaling.35 In response to dsRNA or polyI:C, TLR3 acts on several downstream signaling molecules including TNF receptor associated factor 6 (TRAF6). Furthermore, TRAF6 promotes the activation of TAK1 and IκB kinase (IKK) complex, causing the proteasomal degradation of IκBα. Phosphorylated p65 transfers into the nucleus and induces inflammation and immune regulation.36 As a dsRNA receptor, TLR3 is traditionally generated during most viral infections, whereas degraded bacteria, damaged tissues, and necrotic cells can induce TLR3 expression.23 TLR3 stimulation is important for M1 macrophage polarization.21 Thus, TLR3 inhibition may be a potential strategy for skewing proinflammatory M1 macrophages to the anti-inflammatory M2 type. In this study, TLR3 was expressed under the stimulation of M1-CM, which contained various inflammatory factors. Under poly(I:C) treatment, the TAK1/IKKα/IκBα/NK-κB p65 axis was activated, promoting NF-κB p65 transcription. Therefore, miR-26b-5p overexpression could inhibit the TLR3 signaling pathway and consequently further repolarized M1 macrophages to the M2 type.
ATDC5 is a commonly used chondrogenic cell line that can be induced to chondrocytes via ITS stimulation.37 During chondrogenesis, M1-CM is deployed to induce chondrocyte hypertrophy in ATDC5 cells. In our study, the conditioned media of macrophages were analyzed with a Luminex liquid chip for multicytokine detection. The concentration of inflammatory cytokines, including IL-1β, IL-6, TNF-a, and IFN-γ (Table S2), in M1-CM was higher. On the one hand, these cytokines can cause articular cartilage hypertrophy; on the other hand, they can induce the surrounding quiescent macrophages to polarize to the M1 type.7, 9 These two paths eventually accelerate OA progression. Conversely, the application of miR-26b-5p could simultaneously block the two pathogeneses by targeting TLR3 in macrophages and COL10A1 in chondrocytes
M1 and M2 macrophages express different characteristic surface receptors. For example, M1 macrophages express high levels of MHC II molecules, CD16/32, CD80, and CD86,38 and M2 macrophages highly express phagocytosis markers, including CD163 and CD206.39 In the present study, CD16/32 was chosen as a marker of M1 macrophages and CD206 of M2 macrophages as described previously.40 Flow cytometry analysis revealed that some macrophages were positively stained with CD16/32 and CD206. These non-M1- and non-M2-phenotype cells may be in a wandering state between M1 and M2 macrophages.41 Although the role of this macrophage subset remains unclear, this result indicated that M1/M2 macrophages could not be absolutely distinguished, and polarization could be a dynamic process.
We applied intra-articular injection, a commonly used method for OA treatment, to administer miRNA to the joints. Intra-articular injection can increase local drug concentration and bioavailability, minimize systemic exposure and adverse events, and reduce cost compared with those of systemic drug delivery.42 In the present study, all mice did not suffer from joint infections, indicating the safety of intra-articular injection to a certain degree. The dosage and frequency of miRNA used in this work were based on previous studies.43, 44 We applied miRNA agomir, which has been specially labeled and chemically modified, to regulate the biological functions of target genes by mimicking endogenous miRNA. We administered miRNA to target synovial macrophages and articular chondrocytes. However, we have yet to clarify whether miRNA could infiltrate the subchondral bone and affect bone remodeling or be absorbed into blood circulation.
In addition to ACLT, the destabilization of the medial meniscus (DMM) is a commonly used model of OA. However, a DMM-induced OA model shows lower levels of synovitis than ACLT does.37 In the present study, an ACLT-induced OA model was applied to evaluate the effects of miR-26b-5p on synovitis more clearly. Our data showed that synovial inflammation was obvious in OA mice. In particular, the thickness of synovial lining cells and the number of blood vessels increased; furthermore, inflammatory cell infiltration in the synovium was enhanced. Hence, the OA mice had a significantly high Krenn score, which was designed to evaluate synovial inflammation. Under miR-26b-5p treatment, the M1/M2 macrophage phenotype shifted, and Krenn score obviously decreased.
Gait analysis and von Frey test are important behavioral analyses for measuring pain in patients with OA. In this study, the VisuGait system was deployed for gait analysis in accordance with previously described methods.45 Several mouse gait-related parameters, including print area, pressure intensity of limb, swing phase duration, swing speed, and duty cycle, were obtained. Previous results of gait analysis in OA mice remain inconsistent, possibly because of variations in the operation method, analysis time point, kind and number of animals, and other aspects.45–48 In this study, OA mice presented gait abnormalities induced by hyperalgesia in ACLT-induced joints. The results of gait analysis in this study were presented as the ipsilateral knee/contralateral knee to eliminate individual differences. Thus, miR-26b-5p treatment could ameliorate gait abnormalities to a certain degree while significantly reducing mechanical allodynia in OA mice.