Baicalein has been shown to have chondroprotective potential in vitro. However, its effect on disease modification in osteoarthritis (OA) is largely unknown. The present study is aimed at determining whether baicalein could slow the progression of OA and inhibit OA-related inflammation in a rat model of destabilization of the medial meniscus (DMM) and the underlying mechanisms. The rats subjected to DMM surgery were treated with baicalein (0.8, 1.6, and 3.2 μg/L, 50 μL, once a week) by intra-articular injection for 6 weeks. Dexamethasone (0.4 mg/mL, 50 μL, once a week) was used as a positive control. Histologic grading of cartilage degeneration was performed using the Osteoarthritis Research Society International (OARSI) recommended grading system (on a scale of 0-6). The expression levels of molecules associated with cartilage homeostasis and inflammatory cytokines were analyzed; moreover, the NLRP3 inflammasome activation and cartilage oxidative stress-associated molecules were determined. Baicalein treatment reduced the OARSI score and slowed OA disease progression in a dose-dependent manner within a certain range. Compared with DMM rats, intra-articular injection of baicalein led to (1) reduced levels of inflammatory mediates such as IL-1β and TNF-α, (2) reduced immunochemical staining of MMP-13 and ADAMTS-5, (3) suppressed immunochemical staining loss of type II collagen, (4) reduced expression of cartilage degradation markers including CTX-II and COMP in urine, and (5) inhibited NLRP3 inflammasome activation rather than regulated expression of SOD, GSH, and MDA. In contrast to the administration of baicalein, dexamethasone injection showed similar effects to slow OA progression, while dexamethasone inhibited NLRP3 inflammasome partly through decreasing levels of SOD, GSH, and MDA. This study indicated that baicalein may have the potential for OA prevention and exerts anti-inflammatory effects partly via suppressing NLRP3 inflammasome activation without affecting oxidative stress-associated molecules, and inhibition of cartilage catabolism enzymes in an OA rat model.
1. Introduction
Osteoarthritis (OA) is the most common arthritis and degenerative disease of the articular joints involving the articular cartilage, subchondral bone, and synovium and characterized by joint dysfunction, chronic pain, and disability [1]. The only current therapeutic option for OA is pain-relief drugs, such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) [2]. However, safety is focused due to gastrointestinal injury and cardiovascular events for long-term administration of NSAIDs [3].
In recent years, a variety of plant extracts, such as curcumin [4], L-theanine [5], and resveratrol [6], have been found to exert therapeutic or preventive effects on OA progression. Baicalein, a major flavonoid constituent in the plants of genus Scutellaria (Lamiaceae) [7], is found in abundant quantity in the root of S. baicalensis. Baicalein have been found to exhibit several pharmacological activities, such as antioxidant [8], anticancer [9], anticardiovascular [10], antidiabetic [11], and anti-inflammatory [12] activities. Evidence from several studies suggested that baicalein is effective in mitigating OA chondrocyte apoptosis and inflammation in vitro. For example, baicalein has been shown to alleviate the inflammatory process by reducing the expression of inflammatory cytokines such as IL-6, IL-8, and iNOS, in contrast increasing IL-10 production [13] and inhibiting degrading enzymes of the extracellular matrix such as matrix metalloproteinase-3 (MMP-3) and MMP-13 in human chondrocytes and in IL-1β- and TNF-α-treated mouse articular cartilage explants [14]. Moreover, our recent in vitro study determined the effects of baicalein on IL-1β-induced primary chondrocytes of rats. The results showed that baicalein downregulated the elevated caspase-3 levels but promoted the expression of Bcl-2. Baicalein treatment significantly inhibited NF-κB signaling pathway activation and suppressed apoptosis and matrix degradation, indicating that baicalein might exert OA protective effect [15].
As is known, low-grade inflammation is believed to be involved in the development and progression of OA [16]; moreover, inflammatory cytokines such as IL-1β, IL-18, and TNF-α have demonstrated overexpression in posttraumatic osteoarthritis (PTOA) patients [17] and animal models [1]. A number of studies demonstrated that elevated levels of IL-1β and TNF-α suppress the synthesis of type II collagen and aggrecan, furthermore stimulating chondrocytes to release MMP-1, MMP-3, MMP-13, and disintegrin metalloproteinase with thrombospondin motifs (ADAMTS), which are major chondrocyte catabolic components to degrading the cartilage extracellular matrix [18–21]. Interestingly, it was determined that activation of inflammasome plays a key role in proinflammatory cytokine production, especially IL-1β. As a most studied inflammasome, NLRP3 inflammasome (NLR family, pyrin domain containing 3; NLR refers to “nucleotide-binding domain, leucine-rich repeat”) is responsible for the activation of caspase-1 and caspase-5, which leads to the secretion of IL-1β and IL-18, in turn causing pyroptosis [22]. Much higher levels of NLRP3 are detected in the OA synovium than in normal, subsequent activated caspase-1, and the release of IL-1β and IL-18 by pyroptotic chondrocytes triggers the inflammatory cascade, leading to cartilage degradation and chondrocyte death [23, 24]. There are various NLRP3 activators, such as mitochondrial damage, lysosomal damage, cytosolic K+ efflux, and reactive oxygen species- (ROS-) induced cell oxidative stress [25]. Several lines of evidences suggest that oxidative stress, which contributes to the imbalance of the expression of antioxidant enzymes and ROS scavenging systems, causes abnormalities in cartilage and bone metabolism, aggravating cartilage degradation [26]. Whether baicalein exerts its anti-inflammatory effects through NLRP3 inflammasome and the role of oxidative stress in the activation of NLRP3 during baicalein treatment are still unknown.
In a word, the chondrocyte protective effects and the underlying mechanism of baicalein for OA have not been well investigated. In our study, dexamethasone was used as a positive control due to its exact effect on OA disease modification through intra-articular injection [27], and the anti-inflammatory properties of dexamethasone have been considered [28]. Based on the above properties of baicalein, we aim to study the efficacy of baicalein compared to dexamethasone and the possible mechanism using a DMM-induced rat OA model in vivo.
2. Materials and Methods
2.1. Experimental Design
Rats were housed on a standardized pelleted diet and supplied with tap water. All animal experiments were carried out in accordance with the guidelines of the China Ethical Committee for Animal Experiments. OA was induced in 8-week-old male SD rats (bought from the laboratory animal center of Liaoning Changsheng Biotechnology Co., Ltd., China) by DMM surgery of the right knees as described [29]. Sham surgery was performed on the right knee joint using a separated group of rats as the control. Rats were randomly divided into 6 groups (/group): (1) DMM group, (2) sham group (vehicle control), (3) baicalein (0.8 μg/L, 50 μL), (4) baicalein (1.6 μg/L, 50 μL), (5) baicalein (3.2 μg/L, 50 μL), and (6) dexamethasone (DXM, 0.4 mg/mL, 50 μL). After 1 week, rats in the treatment group received baicalein or dexamethasone (once a week) postoperatively via articular cavity injection for 6 weeks. Baicalein (Sigma-Aldrich, St. Louis, MO, USA) was dissolved in DMSO, and further dilutions were prepared in saline. In the control group, rats were injected with 2% DMSO (in saline) only. The dose of baicalein is determined based on our in vitro experiments and preliminary experiments [15]. Three different doses are set to avoid a single dose that is not effective, so as to choose a dose that can work.
After the last treatment, euthanasia was performed on the rats, and serum and urine samples were collected for the ELISA assay. Three out of 8 rats were chosen randomly of each group to observe the gross morphology, and subsequently, the articular cartilage was collected to detect the levels of MMP-13 and ADAMTS-5, and the experiment was repeated three times. Another 5 rats were used for pathological analysis, and the complete knee joints were immobilized in 4% paraformaldehyde.
2.2. Histological Examination
The knee joint in each group (/group) was placed in a bucket which was filled up with decalcification solution (Servicebio Biotechnology Co., Ltd, Wuhan, China, G1105) and then put in a constant temperature shaker. The replacement period of the decalcification solution is 2-3 d. The degree of decalcification is observed every two days. If the needle can be moved, the tissue is cut with a Lycra blade according to the material requirements, which can accelerate the softening speed. The dehydrating process was performed in gradient alcohol, and the intact flexed joint was embedded in paraffin. Then, serial sagittal sections were obtained across the entire knee joint. Slides were stained for sulfated glycosaminoglycans (GAGs) with Safranin O/Fast Green. Histologic grading of cartilage degeneration was performed using the Osteoarthritis Research Society International (OARSI) recommended grading system (on a scale of 0-6) [30], and histological analyses were performed by two experienced observers and double-blinded.
2.3. Immunohistochemical Assessment
After 6-week intra-articular injection, the complete right knee of every group (/group) was collected for the histologic section, and the procedures were in accordance with the histological examination. After deparaffinization, the sections were rinsed with 0.3% H2O2 in 60% methanol for 30 min and permeabilized with 0.1% Triton X-100 in phosphate-buffered saline (PBS) for 20 min. The section then was incubated in goat serum in PBS for nonspecific adsorption. For immunohistochemistry, sections were incubated with (1) anti-rabbit polyclonal antibody directed at collagen II (1 : 400; Abcam, ab34712), (2) anti-MMP-13 mouse monoclonal antibody (1 : 150; Novus, OTI2D8), (3) anti-ADAMTS-5 rabbit polyclonal antibody (1 : 100; Novus, NBP2-15286), (4) anti-NLRP3 rabbit polyclonal antibody (1 : 200; ABclonal, A12694), or anti-caspase-1 rabbit polyclonal antibody (1 : 150; ABclonal, A0964). Horseradish peroxidase- (HRP-) conjugated secondary antibody was applied and stained with a diaminobenzidine (DAB) kit. The positive stained chondrocytes in three central regions of articular cartilage were counted using Image-Pro Plus version 6.0 software.
2.4. Measurements of Inflammatory Cytokines
Serum samples from eight rats were collected, and concentrations of IL-1β and TNF-α were measured using specific rat enzyme-linked immunosorbent assay (ELISA) kits (Huijia Biotechnology Co., Ltd., Nanjing, China) according to the manufacturer’s instructions.
2.5. Measurements of Cartilage Catabolism Protein
The cartilage of knee joints (/group) was collected, and the cartilage was ground with PMSF : RIPI (1 : 99) (Beyotime, China) under low temperature for 30 min and then centrifuged at 12000 rpm. 200 μL of lysis buffer was added per 100 mg cartilage sample. The supernatant was collected for measuring the levels of MMP-13 and ADAMTS-5 via the ELISA kit (Huijia Biotechnology Co., Ltd (China). Rat urine samples (/group) were collected and centrifuged at for 15 min within 1 h. The supernatant was stored at −80°C until future analysis. The concentrations of COMP and CTX-II (Jingmei Co., Ltd., Jiangsu, China) were measured in urine according to the manufacturer’s instructions.
2.6. Measurements of SOD, GSH, and MDA Levels in Serum
Serum levels of superoxide dismutase (SOD), glutathione peroxidase (GSH), and malonaldehyde (MDA) were examined using detection kits (Beyotime Biotechnology Co., Ltd., Shanghai, China) according to the manufacturer’s instructions.
2.7. Statistical Analysis
All statistical analyses were performed using SPSS 22.0 software, and the results are expressed as the . One-way analysis of variance (ANOVA) was used for comparisons between groups, and was considered statistically significant. Multiple comparisons between groups were performed using a post hoc Tukey test. Histological analyses were performed by two experienced investigators who were double-blinded.
3. Results
3.1. Changes in Gross Morphology of the Joints in the DMM-Induced OA Model
A healthy articular surface was observed in both femur and tibia in sham cartilage (Figure 1). There were obvious macroscopic changes in the appearance of the right joints in the OA model at 7 weeks postsurgery. DMM cartilage was abraded and contained fibrotic tissue, and the cartilage showed significant osteophyte formation at the medial tibia plateau (MTP) and the intercondylar space of the femur (Figure 1). Moreover, the cartilage of baicalein-treated rats with 0.8 and 1.6 μg/L exhibited no detectable macroscopic difference compared to DMM cartilage. In contrast, the joints administrated with 3.2 μg/L baicalein or dexamethasone showed significantly milder injuries than DMM joints, including cartilage opacity and roughness (Figure 1).