Control of the Autophagy Pathway in Osteoarthritis: Key Regulators, Therapeutic Targets and Therapeutic Strategies
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International Journal of Molecular Sciences Review Control of the Autophagy Pathway in Osteoarthritis: Key Regulators, Therapeutic Targets and Therapeutic Strategies Maria Teresa Valenti 1 , Luca Dalle Carbonare 1,* , Donato Zipeto 2 and Monica Mottes 2 1 Department of Medicine, Section of Internal Medicine, University of Verona, 37134 Verona, Italy; [email protected] 2 Department of Neurosciences, Biomedicine and Movement Sciences, Section of Biology and Genetics, University of Verona, 37134 Verona, Italy; [email protected] (D.Z.); [email protected] (M.M.) * Correspondence: [email protected]; Tel.: +39-045-8126062 Abstract: Autophagy is involved in different degenerative diseases and it may control epigenetic modifications, metabolic processes, stem cells differentiation as well as apoptosis. Autophagy plays a key role in maintaining the homeostasis of cartilage, the tissue produced by chondrocytes; its impairment has been associated to cartilage dysfunctions such as osteoarthritis (OA). Due to their location in a reduced oxygen context, both differentiating and mature chondrocytes are at risk of premature apoptosis, which can be prevented by autophagy. AutophagomiRNAs, which regulate the autophagic process, have been found differentially expressed in OA. AutophagomiRNAs, as well as other regulatory molecules, may also be useful as therapeutic targets. In this review, we describe and discuss the role of autophagy in OA, focusing mainly on the control of autophagomiRNAs in OA pathogenesis and their potential therapeutic applications. Citation: Valenti, M.T.; Dalle Keywords: mesenchimal stem cells; chondrocytic commitment; autophagy; osteoarthritis; miRNAs Carbonare, L.; Zipeto, D.; Mottes, M. Control of the Autophagy Pathway in Osteoarthritis: Key Regulators, Therapeutic Targets and Therapeutic 1. Background Strategies. Int. J. Mol. Sci. 2021, 22, Chondrogenesis, the process by which cartilage is formed, occurs as a result of mes- 2700. https://doi.org/10.3390/ enchymal cell condensation and chondroprogenitor cell differentiation. SOX9 is the master ijms22052700 transcription factor for MSCs differentiation into chondrocytes [1]. During development, chondrogenesis is subject to complex regulation by several interplaying factors such as Academic Editor: Nicola Veronese fibroblast growth factor (FGF), transforming growth factor β (TGFβ), bone morphogenetic proteins (BMPs) and Wnt signaling pathways. Among regulatory factors, TGFβ plays a key Received: 16 February 2021 role in development. TGFβ receptors are present in many cells, and an integrin-applied Accepted: 4 March 2021 β Published: 7 March 2021 force is required to release TGF- from its prodomain. Force application has been shown to occurs through the prodomain of TGF-β and through the β subunit of the integrin [2]. Publisher’s Note: MDPI stays neutral In the process termed endochondral ossification, chondrocytes undergo proliferation and with regard to jurisdictional claims in terminal differentiation to hypertrophy and apoptosis, whereby hypertrophic cartilage is published maps and institutional affil- replaced by bone tissue. In mature articular cartilage, instead, chondrocytes are respon- iations. sible for the production and homeostatic maintenance of the extracellular matrix (ECM) components. Structural ECM components are: collagens (mainly type II collagen), proteoglycans, (including aggrecan, decorin, biglycan and fibromodulin) and noncollagenous proteins, such as cartilage oligomeric protein (COMP), cartilage matrix protein (CMP) and fibronectin. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. The primary matrix degrading enzymes involved in cartilage turnover are metallopro- This article is an open access article teinases (MMPs) and cathepsins (CTS). In healthy articular cartilage, balanced degradation distributed under the terms and and synthesis by chondrocytes ensure tissue homeostasis. conditions of the Creative Commons Autophagy plays a key role in the preservation of cartilage integrity [3]. Besides Attribution (CC BY) license (https:// playing a crucial role in adaptive response to different stimuli, it is also required for creativecommons.org/licenses/by/ intracellular quality control and is involved in removing and recycling misfolded proteins, 4.0/). damaged organelles or dysfunctional cell components [4]. Int. J. Mol. Sci. 2021, 22, 2700. https://doi.org/10.3390/ijms22052700 https://www.mdpi.com/journal/ijms Int. J. Mol. Sci. 2021, 22, x FOR PEER REVIEW 2 of 15 Autophagy plays a key role in the preservation of cartilage integrity [3]. Besides play- Int. J. Mol. Sci. 2021ing, 22, 2700a crucial role in adaptive response to different stimuli, it is also required for intracel- 2 of 15 lular quality control and is involved in removing and recycling misfolded proteins, dam- aged organelles or dysfunctional cell components [4]. Authophagy mayAuthophagy be distinguished may be distinguished into (i) macroautophagy; into (i) macroautophagy; (ii) microautophagy; (ii) microautophagy; (iii) (iii) chaperonechaperone mediated mediatedautophagy. autophagy. Macroautophagy Macroautophagy represents representsthe prevalent the form prevalent of form of au- autophagy in differenttophagy incell different types. cellIt starts types. with It starts a membrane with a membrane formation, formation, the phagophore, the phagophore, which which expandsexpands to engulf to engulfthe cellular the cellular cargo, cargo, genera generatingting the autophagosome. the autophagosome. This Thislatter latter structure structure maturesmatures through through fusion fusion with withlysosomes. lysosomes. mTOR mTOR is a major is a major player player in autophagy in autophagy and acts and acts as a signalingas a signaling control control point downstream point downstream of growth of growthfactor receptor factor receptorsignaling, signaling, hy- hypoxia, poxia, ATP levelsATP and levels insulin and insulinsignaling. signaling. It is activated It is activated downstream downstream of Akt kinase, of Akt kinase,PI3- PI3-kinase kinase and growthand growthfactor receptor factor receptor and acts and to inhibit acts to inhibitautophagy autophagy by modulating by modulating the Ulk1 the Ulk1 (Atg1) (Atg1) complex.complex. In response In response to the autophagy to the autophagy cascade activation, cascade activation, the IIIPI3K the complex IIIPI3K complexpro- produces duces PI3P andPI3P induces and induces other Atg other proteins Atg proteins,, such as such the asAtg12 the- Atg12-Atg5-Atg-16Atg5-Atg-16 and LC3 and LC3 (Atg8)- (Atg8)-phosphatidylethanolaminephosphatidylethanolamine complex complexes.es. After translation, After translation, proLC3 proLC3 is proteolytically is proteolytically cleaved cleaved generatinggenerating LC3-I. LC3-I.Upon induction Upon induction of autophagy, of autophagy, LC3-I is LC3-I conjugated is conjugated by the Atg7, by the Atg7, Atg3 Atg3 and Atg12and-Atg5 Atg12-Atg5-Atg16L-Atg16L complex complexeses to the highly to the highlylipophilic lipophilic phosphatidylethanola- phosphatidylethanolamine (PE) mine (PE) moietymoiety to generate to generate LC3 LC3-II.-II. Finally, Finally, PE PEpromotes promotes integration integration of ofLC3 LC3-II-II into into lipid lipid membranes membranes allowingallowing autophagosomes autophagosomes formation. formation. Due Due to toitsits crucial crucial role role as asa natural a natural de- defense mecha- fense mechanismnism against against inflammatory, inflammatory, i infectiousnfectious andand degenerativedegenerative disorders,disorders, the the autophagic au- process tophagic processmust must be tightlybe tightly regulated. regulated. Several Several molecular molecular mechanisms mechanisms of of autophagy autophagy regulation have regulation havebeen been investigated: investigated: microRNAs microRNAs (miRNAs) (miRNAs) stand stand out, out, among among others others [5]. [5] These. small non- These small noncodingcoding RNAs RNAs act act as as negative negative regulators regulators of of specific specific target target mRNAs mRNAs expression. expres- One single miRNA can act as a post-transcriptional repressor by binding to partially complementary sion. One single miRNA can act as0 a post-transcriptional repressor by binding to partially complementarysequences sequences in in the the 3 UTR3′UTR sites sites of of various various mRNAs. mRNAs. miRNAs miRNAs which which regulate regulate the autophagic the autophagicprocess, process, predominantly predominantly targeting targeting the the pathway pathway early early stages, stages, are are called called autophagomiRNAs. au- tophagomiRNAs.In several In several pathological pathological conditions, conditions, e.g., e.g. degenerative, degenerative disorders, disorders, autophagomiRNAs autoph- have been found to be differentially expressed [6]. agomiRNAs have been found to be differentially expressed [6]. Increasing evidence suggests that autophagy dysregulation is closely related to the Increasing evidence suggests that autophagy dysregulation is closely related to the pathogenesis of osteoarthritis (OA) [7] (Figure1). pathogenesis of osteoarthritis (OA) [7] (Figure 1). Figure 1. SchematicFigure 1. representation Schematic representation showing changes showing occurring changes in occurring the autophagic in the autophagic process in normalprocess versus in nor- osteoarthritic mal versus osteoarthritic chondrocytes. chondrocytes. OA, a chronic, age-related degenerative disease of articular cartilage, is associated with