Small Animal models of Osteoarthritis: Testing Emerging treatments, drug delivery and mechanisms of action"

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1 Small Animal models of Osteoarthritis: Testing Emerging treatments, drug delivery and mechanisms of action" Dr. Mohit Kapoor Head, Cartilage Biology Research Group Co-chair, Arthritis Program Biobank Toronto Western Hospital Associate Professor Department of Surgery University of Toronto Toronto, Canada

2 Two possible therapeutic options Stem cell Therapy Targeting Autophagy

3 Osteoarthritis Approximately 190 million people worldwide are suffering from osteoarthritis Osteoarthritis affects 10 to 15% of the world population 68% of women over 65 have osteoarthritis 58% of men over 65 have osteoarthritis

4 Joint Structures affected in OA OA Joint Femoral condyle Inflamed synovium Subchondral bone Tibial plateau Degraded cartilage Normal Human Cartilage Normal subchondral bone Normal Synovium Human OA Cartilage OA Subchondral bone OA Synovium

5 Pathophysiology of Osteoarthritis Kapoor M, et al. (2011) Nature Review Rheumatology

6 Small Animal models of Osteoarthritis

7 Small animal models of OA Spontaneous agerelated Models Mouse C57BL/6 STR/ort BALB/c DBA/1 Guinea Pig Hartley Guinea Pig Model of rapidly progressive OA Induced Models Intraarticular injections (MIA) Surgically induced models: Meniscectomy and/or anterior cruciate ligament transection Ovariectomy Genetic Models MMP-13 over expression TIMP-3 deficient mice COL2A1 gene deletion TGF-β deficient mice Integrin α1 KO mice Cartilage-specific PPARgamma deficiency

8 Spontaneous OA model Cartilage-specific PPARγ KO mice exhibit spontaneous OA phenotype.

9 Cartilage-specific deletion of PPARγ results in acceleratedoa like characteristics during aging Vasheghani et al., Am J Pathol (2013), Monemdjou et al Arthritis and Rheumatism (2012), Vasheghani et al, Annals of Rheumatic Diseases (In revision)

10 Aged PPARγ KO mice exhibit increased synovial inflammation and macrophage influx Heterozygote KO Homozygote KO Macrophage marker stain Hematoxylin and Eosin stain Control Enhanced synovial inflammation 14 months old mice synovium Control Heterozygote KO Homozygous KO Enhanced macrophage influx in synovium

11 Destabilization of Medial Meniscus OA model Surgical Model of Osteoarthritis in Mice

DMM Model of OA Zhang et al..kapoor M. Annals of Rheumatic Diseases 2014 Kapoor M, Nature reviews rheumatology, 2012.

(partial cartilage erosion and fissures, proteoglycan depletion, synovial inflammation, synovial fibrosis as well as some

12 DMM Model of OA Zhang et al..kapoor M. Annals of Rheumatic Diseases 2014 Kapoor M, Nature reviews rheumatology, Destablization of medial meniscus: Resulting moderate OA-like phenotype This surgery results in a modest degree of OA (partial cartilage erosion and fissures, proteoglycan depletion, synovial inflammation, synovial fibrosis as well as some degree of subchondral bone remodeling. This model of relatively slow progression of OA is more reflective of human pathogenesis.

DMM model: Effects on articular cartilage and subchondral

proteoglycan loss Some loss of articular cartilage

articular cartilage roughening No significant bone changes

proteoglycan loss Significant loss of articular cartilage

Mild-Moderate degree of subchondral bone remodelling Signs

13 DMM model: Effects on articular cartilage and subchondral bone OA Characteristics 5 weeks post surgery Mild degree of proteoglycan loss Some loss of articular cartilage cellularity (mostly superficial layer) Mild degree of articular cartilage roughening No significant bone changes at this time point 10 weeks post surgery Moderate degree of proteoglycan loss Significant loss of articular cartilage cellularity Moderate degree of cartilage degeneration Mild-Moderate degree of subchondral bone remodelling Signs of fibrosis in the cartilage Cell Death Catabolic Activity Collagen Type II Breakdown

DMM model: Synovial Inflammation and Fibrosis

surgery Significant amount of synovial fibrosis

fibroblasts activation (Myofibroblast like

14 DMM model: Synovial Inflammation and Fibrosis Monocytes/macrophages Synovium 5 weeks post surgery Significant amount of synovial fibrosis Increased TGF-beta/Smad signalling Synovial fibroblasts activation (Myofibroblast like phenotype) Significant influx of inflammatory cells (Monocytes/Macrophages)

15 MIDMM (Minimally Invasive Destabilization of Medial Meniscus) Model of OA In Mouse This model closely resembles human OA by limiting surgical exposure to minimum. There is a learning curve associated with the technique. MMTL transection is carried out using micro-surgical techniques under direct vision. This model results in mild OA at 8 weeks post surgery. Application in transgenic mice & evaluation of DMOADs.

16 Method 1mm skin incision is made over antero-medial region of knee. Arthrotomyis carried out and fat pad over medial meniscus dissected. MMTL is identified and transected under direct vision with special micro-surgical knife. Joint irrigation and closure is done.

17 Minimally Invasive Model

18 Notes The technique utilized an in house custom knife with blunt tip to reduce surgical trauma. To our knowledge, this is the only mouse OA model with: minimum surgical trauma early mouse weight bearing

19 Histopathology

20 Cell Therapy: Small animal models of OA Feasibility and challenges Characterization of Cells Type, amount, route of administration Intra-articular injection (DMM Model) Read outs Characterization of cells: assessment of proliferation, differentiation potential In vivo tracking of cells/biodistribution using MRI, near- Infrared Ag 2 S quantum dots etc Histopathology and micro CT: Bone, cartilage and synovial membrane histomorphometric analysis to determine any phenotypic changes/differences in joint pathology. Regenerative Potential Kinetics of OA initiation/progression and severity Pro- and anti-inflammatory cytokine analysis of serum and synovial fluid Toxicological analysis.

21 Ongoing testing of new therapies to treat Osteoarthritis In my lab

Deliver autophagy specific gene ULK1 in mouse OA

22 Deliver autophagy specific gene ULK1 in mouse OA cartilage (intra-articularly) ULK1 adenovirus Intra-articular injection OA surgery (Concentration 50 MOI, 5ul injection, 2 times) 1st injection: 10 days post surgery 2nd Injection: 20 days post surgery Evaluate severity of OA 10 weeks post surgery

23 Deliver bone marrow derived MSCs intra-articularly Stem cell therapy Animal Models Clinical trial

24 MK Research Team Department of Orthopedics and Rheumatology TWH Dr. M Hurtig Dr. F Beier Dr. J-M Pelletier Dr. JP Pelletier Arthritis Program Dr. LJ Crofford Dr. P Gilbert Dr. AM Tager Dr. P Roughley

Acknowledgements Osteoarthritis Research Unit University of

Jean-Pierre Pelletier Dr. Hassan Fahmi Dr.

Bertrand Lussier Administrative Assistance Santa Fiori Lise

Frank Beier Dr. Veronica Ulici Dr. Shangxi Lui Dr.

Martin Lotz Noboru Taniguchi Merck Frosst Canada Pfizer Inc

Scleroderma Research Group Dr. Yue Zhang Senior Scientist Dr.

25 Acknowledgements Osteoarthritis Research Unit University of Montreal Dr. Johanne Martel-Pelletier Dr. Jean-Pierre Pelletier Dr. Hassan Fahmi Dr. Daniel Lajeunesse Dr. Bertrand Lussier Administrative Assistance Santa Fiori Lise Giguere Virginia Wells Canadian Scleroderma Research Group Dr. Murray Baron Dr. Anie Phillip Dr. Ali Bouallegue University of Western Ontario, London Dr. Frank Beier Dr. Veronica Ulici Dr. Shangxi Lui Dr. Andrew Leask Shriners Hospital for Children (Montreal) Dr. Rene St-Arnaud Dr. Peter Roughley Dr. John Mort Scripps Research Institute La Jolla Dr. Martin Lotz Noboru Taniguchi Merck Frosst Canada Pfizer Inc Fonds de la Recherche en Santé du Québec (FRSQ) Canadian Scleroderma Research Group Dr. Yue Zhang Senior Scientist Dr. Gladys Valverde Franco (Postdoctoral fellow (Co-Director) Gemma Perez (Research Assistant) Roxana Monemdjou Meryem Blati (Master s student) (Research Assistant) Parisa Ghassemi (Master s student) Faezeh Vasheghani (PhD student)

Protection from osteoarthritis: targeting mtor and autophagy

Dr. Yue Zhang Protection from osteoarthritis: targeting mtor and autophagy Cartilage scientist, Division of Genetics and Development, The Toronto Western Research Institute, Toronto Western Hospital, University