Abstract

BackgroundGout is an inflammatory arthritis caused by monosodium urate monohydrate (MSU) crystals’ joint deposition. MSU phagocytosis by resident macrophages is a key step in gout pathogenesis. MSU phagocytosis triggers nuclear factor kappa B (NFκB) activation and production of cytokines and chemokines. Proteoglycan-4 (PRG4) is a glycoprotein produced by synovial fibroblasts and exerts an anti-inflammatory effect in the joint mediated by its interaction with cell surface receptor CD44. PRG4 also binds and antagonizes TLR2 and TLR4. The objective of this study is to evaluate the efficacy of recombinant human PRG4 (rhPRG4) in suppressing MSU-induced inflammation and mechanical allodynia in vitro and in vivo.MethodsTHP-1 macrophages were incubated with MSU crystals ± rhPRG4 or bovine submaxillary mucin (BSM), and crystal phagocytosis, cytokines and chemokines expression and production were determined. NFκB p65 subunit nuclear translocation, NLRP3 induction, caspase-1 activation and conversion of proIL-1β to mature IL-1β were studied. MSU phagocytosis by Prg4+/+ and Prg4−/− peritoneal macrophages was determined in the absence or presence of rhPRG4, BSM, anti-CD44, anti-TLR2, anti-TLR4 and isotype control antibodies. Rhodamine-labeled rhPRG4 was incubated with murine macrophages and receptor colocalization studies were performed. Lewis rats underwent intra-articular injection of MSU crystals followed by intra-articular treatment with PBS or rhPRG4. Weight bearing and SF myeloperoxidase activities were determined.ResultsrhPRG4 reduced MSU crystal phagocytosis at 4 h (p < 0.01) and IL-1β, TNF-α, IL-8 and MCP-1 expression and production at 6 h (p < 0.05). BSM did not alter MSU phagocytosis or IL-1β production in human and murine macrophages. rhPRG4 treatment reduced NFκB nuclear translocation, NLRP3 expression, caspase-1 activation and generation of mature IL-1β (p < 0.05). MSU-stimulated IL-1β production was higher in Prg4−/− macrophages compared to Prg4+/+ macrophages (p < 0.001). rhPRG4, anti-CD44, anti-TLR2 and anti-TLR4 antibody treatments reduced MSU phagocytosis and IL-1β production in murine macrophages (p < 0.05). rhPRG4 preferentially colocalized with CD44 on Prg4−/− peritoneal macrophages compared to TLR2 or TLR4 (p < 0.01). rhPRG4 normalized weight bearing and reduced SF myeloperoxidase activity compared to PBS in vivo.ConclusionrhPRG4 inhibits MSU crystal phagocytosis and exhibits an anti-inflammatory and anti-nociceptive activity in vitro and in vivo. rhPRG4’s anti-inflammatory mechanism may be due to targeting CD44 on macrophages.

Highlights

  • Gout is an inflammatory arthritis caused by monosodium urate monohydrate (MSU) crystals’ joint deposition

  • Monosodium urate monohydrate (MSU)-stimulated Interleukin-1 beta (IL-1β) production was higher in Prg4−/− macrophages compared to Prg4+/+ macrophages (p < 0.001). recombinant human PRG4 (rhPRG4), anti-CD44, anti-Toll-like receptor 2 (TLR2) and anti-Toll-like receptor 4 (TLR4) antibody treatments reduced MSU phagocytosis and IL-1β production in murine macrophages (p < 0.05). rhPRG4 preferentially colocalized with CD44 on Prg4−/− peritoneal macrophages compared to TLR2 or TLR4 (p < 0.01). rhPRG4 normalized weight bearing and reduced synovial fluid (SF) myeloperoxidase activity compared to Phosphate-buffered saline (PBS) in vivo

  • THP-1 macrophages internalized MSU crystals at 2 and 4 h with more cells appearing in the P2 region of interest at 4 h compared to 2 h (Fig. 1b and e). rhPRG4 treatment appeared to reduce the number of THP-1 macrophages in the P2 region, especially following incubation for 4 h (Fig. 1f )

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Summary

Introduction

Gout is an inflammatory arthritis caused by monosodium urate monohydrate (MSU) crystals’ joint deposition. MSU phagocytosis triggers nuclear factor kappa B (NFκB) activation and production of cytokines and chemokines. Gout is an inflammatory arthritis characterized by deposition of monosodium urate monohydrate (MSU) crystals in synovial joints and periarticular tissues [1, 2]. Tissue MSU crystal deposits initiate inflammation in resident macrophages, mediated in part by pattern recognition receptors of the innate immune system, such as toll-like receptors (TLR2 and TLR4) [4,5,6,7,8]. Particulate danger signals e.g. MSU crystals are thought to cause lysosomal disruption following their endocytosis by macrophages and trigger inflammasome activation and conversion of proIL-1β to IL-1β with downstream enhancement of the inflammatory cascade and inflammatory cell influx to the affected joint [18,19,20,21,22]

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