Targeted apoptosis of macrophages and osteoclasts in arthritic joints is effective against advanced inflammatory arthritis

Caifeng Deng,Bin Zhou,Guanghua Lei,Penghui He,Xun Sun,Ke He,Zhirong Zhang,Quan Zhang,Tao Gong

doi:10.1038/s41467-021-22454-z

Abstract

Insufficient apoptosis of inflammatory macrophages and osteoclasts (OCs) in rheumatoid arthritis (RA) joints contributes toward the persistent progression of joint inflammation and destruction. Here, we deliver celastrol (CEL) to selectively induce apoptosis of OCs and macrophages in arthritic joints, with enzyme-responsive nanoparticles (termed PRNPs) composed of RGD modified nanoparticles (termed RNPs) covered with cleavable PEG chains. CEL-loaded PRNPs (CEL-PRNPs) dually target OCs and inflammatory macrophages derived from patients with RA via an RGD-αvβ3 integrin interaction after PEG cleavage by matrix metalloprotease 9, leading to increased apoptosis of these cells. In an adjuvant-induced arthritis rat model, PRNPs have an arthritic joint-specific distribution and CEL-PRNPs efficiently reduce the number of OCs and inflammatory macrophages within these joints. Additionally, rats with advanced arthritis go into inflammatory remission with bone erosion repair and negligible side effects after CEL-PRNPs treatment. These findings indicate potential for targeting chemotherapy-induced apoptosis in the treatment of advanced inflammatory arthritis.

Highlights

Insufficient apoptosis of inflammatory macrophages and osteoclasts (OCs) in rheumatoid arthritis (RA) joints contributes toward the persistent progression of joint inflammation and destruction
In contrast with the smooth bone surface and negligible bone erosion in ankle joints from rats with early-stage arthritis, adjuvant-induced arthritis (AIA) rats with advanced arthritis displayed rough bone surfaces, severe bone erosion, and significantly decreased bone mineral density (BMD) (Fig. 1a–c)
Significant reductions of safranin O- and toluidine blue-positive areas were observed on the cartilage surface of AIA rats with advanced arthritis, indicating that a loss of GAGs and cartilage destruction occurred in advanced arthritis (Supplementary Fig. 1)

Summary

Introduction

Insufficient apoptosis of inflammatory macrophages and osteoclasts (OCs) in rheumatoid arthritis (RA) joints contributes toward the persistent progression of joint inflammation and destruction. In an adjuvant-induced arthritis rat model, PRNPs have an arthritic joint-specific distribution and CEL-PRNPs efficiently reduce the number of OCs and inflammatory macrophages within these joints. Rats with advanced arthritis go into inflammatory remission with bone erosion repair and negligible side effects after CEL-PRNPs treatment. These findings indicate potential for targeting chemotherapy-induced apoptosis in the treatment of advanced inflammatory arthritis. OCs in RA-affected joints can accelerate synovial inflammation through the production of proinflammatory cytokines[17,18] Both OCs and synovial inflammatory macrophages express high levels of αvβ[3] integrin. Current antirheumatic drugs, including glucocorticoids and biological antibodies, mainly target the macrophages-induced inflammatory response to reduce synovial inflammation[5,27]

Methods

Results

Conclusion