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Isoliquiritigenin Blunts Osteoarthritis by Inhibition of Bone Resorption And www.nature.com/scientificreports OPEN Isoliquiritigenin blunts osteoarthritis by inhibition of bone resorption and angiogenesis in Received: 28 July 2017 Accepted: 19 December 2017 subchondral bone Published: xx xx xxxx Baochao Ji1, Zhendong Zhang1, Wentao Guo1, Hairong Ma2, Boyong Xu1, Wenbo Mu1, Abdusami Amat1 & Li Cao1 Isoliquiritigenin (ISL), a natural favonoid extracted from licorice, has been demonstrated to exert attenuation of osteoclastogenesis and anti-angiogenesis activity in a wide variety of cells. Here, we frst evaluated the efects of ISL on pathogenesis of osteoarthritis in a mouse model of OA. The data showed that ISL blunted progression of OA and lowered the Osteoarthritis Research Society International (OARSI)-Modifed Making Score and protected the articular cartilage. The thickness of calcifed cartilage zone was signifcantly decreased in ISL-treated ACLT mice compared with vehicle group. ISL increased expression level of lubricin and decreased collagen X (Col X), matrix metalloproteinase-13 (MMP-13). Moreover, ISL reduced aberrant active subchondral bone remodelling, including lowered trabecular pattern factor (Tb.pf) and increased bone volume/tissue volume (BV/TV, %) and thickness of subchondral bone plate (SBP) compared with vehicle-treated group. The results of immunostaining further revealed that ISL directly reduced RANKL-RANK-TRAF6 singling pathway induced osteoclastogenesis, prevented abnormal bone formation through indirect inhibition of TGF-β release. Additionally, ISL exerts anti-angiogenesis efects in subchondral bone through direct suppression of MMP-2. These results indicated that ISL attenuates progression of OA by inhibition of bone resorption and angiogenesis in subchondral bone, indicating that this may be a potential preventive therapy for OA. Osteoarthritis (OA) is the most frequent and costly form of arthritis, characterized by slowly, progressive, ulti- mately degenerative disorder confned to diarthrodial joints. Te disease not only causes loss of articular carti- lage but also involves the entire joint including infammation of synovium, formation of osteophyte, sclerosis of subchondral bone1,2. Tese pathologies lead to chronic joint pain, movement limitation and eventually disability. Osteoarthritis to varying degrees happened in an approximate 10–15% of adults over 60 all around the world3. Te cost of OA was estimated to make up of 0.50% of a country’s gross domestic product4. Even so, available agents only provide temporarily symptomatic relief but with numerous side-efects at present, and no medication has been currently approved by the FDA or any other agencies worldwide for OA management, which is mainly due to our limited understanding of the pathogenesis of OA. Terefore, this insufcient area of research is greatly needed as targets for preventive and disease-modifying therapies. In addition to cartilage degradation, the problem of cartilage defects extending into the underlying subchon- dral bone has received increasing attention recently5–8. Subchondral bone work as a structural girder and shock absorber, which could attenuate about 30% of the loads through joints9, and supports superfcial articular carti- lage10. Te interaction between the two structures is thought to be a central feature of this process. Te subchon- dral bone consists of the subchondral bone plate and the subarticular spongiosa. It is separated by the cement line from the calcifed zone of the articular cartilage11. Te architecture of subchondral bone is kept by a dynamic bal- ance between modelling and remodelling in response to mechanical stress12. Coupled bone remodelling process 1Department of Orthopaedics, First Afliated Hospital of Xinjiang Medical University, 137 South LiYuShan Road, Urumqi, Xinjiang, 830054, China. 2Research Institute of Clinical Medicine, First Afliated Hospital of Xinjiang Medical University, 137 South LiYuShan Road, Urumqi, Xinjiang, 830054, China. Baochao Ji and Zhendong Zhang contributed equally to this work. Correspondence and requests for materials should be addressed to L.C. (email: xjbone@21cn. com) SCIENTIFIC REPORTS | (2018) 8:1721 | DOI:10.1038/s41598-018-19162-y 1 www.nature.com/scientificreports/ Figure 1. Molecular structure of isoliquiritigenin (ISL, C15H12O4, MW = 256.25). depend on temporally and spatially regulation of osteoclast and osteoblast activity11. Several animal studies have confrmed that high bone remodelling takes place in the early stages, and might trigger the onset of OA13–15. Furthermore, recent research indicated that excessive activation of TGF-β1 by elevated osteoclast bone resorp- tion uncouples bone resorption and formation, which contributing to the sclerotic phenotype in the subchondral bone in OA animal models16, and the progression of OA could be attenuated by inhibiting TGF-β1 signalling17. Additionally, vascularisation in subchondral bone during the progression of OA have also been noted, which couples osteogenesis during bone modeling and remodeling18. As a consequence, an agent that could aim at the multiple pathological changes in subchondral bone would be really desired. Tere has been a recent global trend toward the use of naturally bioactive herbs with anti-infammatory prop- erties to treat arthritis and other infammatory diseases19–21. Isoliquiritigenin (ISL) (Fig. 1), a natural favonoid extracted from licorice, has drawn wide attention due to its lots of biologic activities, including anti-diabetic, anti-cancer, anti-oxidant as well as anti-infammatory properties and its proven pharmacologic safety22–24. It is also used in Western countries widely for culinary purpose25. Recently, it is reported that ISL could inhibit high glucose (HG)-upregulated connective tissue growth factor (CTGF) and tissue inhibitor of MMP-2 (TIMP-2) expression via disturbing transforming growth factor β1(TGF-β1) signaling in human mesangial cells (HRMC), as evidenced by TGF-β receptor I kinase (TGF-β RI) inhibitor26. ISL has also been reported to suppress receptor activator of nuclear factor kappa-B ligand (RANKL)-induced osteoclastogenesis and infammatory bone loss in vitro via RANKL-RANK-TRAF6, mitogen-activated protein kinases (MAPK), IκBα/NF-κB, and AP-1 signaling pathways27. Furthermore, ISL has been showed signifcantly inhibited the RANKL/osteoprotegerin (OPG) ratio by reducing the production of RANKL and restoring OPG production to control levels in hFOB1.19 cells stimu- lated with conditioned medium (CM) of MDA-MB-231 cells at non-toxicity concentrations28. In addition to reg- ulate bone metabolism, it is reported that ISL could induce anti-angiogenic efects, including inhibition of breast cancer neoangiogenesis via suppress vascular endothelial growth factor (VEGF)/VEGFR-2 signaling pathway and matrix metalloproteinase-2 (MMP-2)29, suppression platelet-derived growth factor-BB (PDGF-BB) which secreted by preosteoclasts induces angiogenesis during coupling with osteogenesis30. Seemingly, ISL could target the multiple pathological changes of OA. However, a search of Medline, PubMed, and Medscape revealed no arti- cle on the subject of ISL for treatment of OA. In this situation, we investigated whether ISL has potential efect for preventive treatment of OA, including delaying articular cartilage degeneration and subchondral bone sclerosis in mice anterior cruciate ligament transection (ACLT) models by inhibiting osteoclastogenesis, TGF-β-dependent Smad2/3 phosphorylation and angiogenesis. Results ISL preserved articular cartilage in ACLT mice. From the Safranin O and fast green staining, signif- icant loss of proteoglycan in vehicle -treated ACLT mice compared with the sham control, which was reten- tion by administrating ISL (40 mg/kg) (Fig. 2A top) at 30 day and 60 day afer operation. It is also supported by OARSI scores which were improved in ISL-treated group relative to vehicle group, whereas no diference was noted in ISL versus sham controls (Fig. 2C). Relative to vehicle-treated ACLT mice at 60 day postoperation, decreased thickness of calcifed cartilage zone in ISL-treated group was observed from HE staining (Fig. 2A bot- tom and Table 1). Abnormal expression of MMP-13 and collagen X (Col X) were found in vehicle group com- pared with the sham control group, which was normalised by administrating ISL as assessed by immunostaining (Fig. 2B,E,F). Conversely, the expression of lubricin (Fig. 2B,D) and Collagen II (COL II) (Supplementary Fig. 3) in vehicle group were signifcantly decreased, which were improved in ISL-treated group, whereas no diference was noted in ISL versus sham controls. ISL normalized high subchondral bone remodeling in ACLT mice. High-resolution Micro-CT was used to access whether the protective role of ISL on the articular cartilage is associated with its potential efect on the microarchitecture of tibial subchondral bone. Te results showed that in the vehicle group, the value of bone volume/tissue volume (BV/TV, %) reduced post ACLT, which was abrogated by receiving ISL. Additionally, ISL sig- nifcantly reduced trabecular pattern factor (Tb.pf) (a parameter of bone resorption) and increased SBP thickness (a parameter of bone formation) post ACLT compared with vehicle treatment and there was no statistically signif- icant diference in these parameters compared with sham controls (Fig. 3A–D). Correspondingly, ISL signifcantly reduced the number of TRAP-positive osteoclasts and osterix-positive osteoprogenitors postoperation relative to vehicle treatment (Fig. 3E–H). It is also noted that the majority of osterix-positive
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