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Krüppel-like factor-4 and Krüppel-like factor-2 are important regulators of joint tissue cells and protect against tissue destruction and inflammation in osteoarthritis
  1. Manabu Kawata1,
  2. Takeshi Teramura2,
  3. Philip Ordoukhanian3,
  4. Steven R Head3,
  5. Padmaja Natarajan3,
  6. Aishwarya Sundaresan3,
  7. Merissa Olmer1,
  8. Hiroshi Asahara1,
  9. Martin K Lotz1
  1. 1 Department of Molecular Medicine, Scripps Research, La Jolla, California, USA
  2. 2 Division of Cell Biology for Regenerative Medicine, Institute of Advanced Clinical Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
  3. 3 Center for Computational Biology & Bioinformatics and Genomics Core, Scripps Research, La Jolla, California, USA
  1. Correspondence to Professor Martin K Lotz, Department of Molecular Medicine, Scripps Research, La Jolla, CA 92037, USA; mlotz{at}


Objectives Analysing expression patterns of Krüppel-like factor (KLF) transcription factors in normal and osteoarthritis (OA) human cartilage, and determining functions and mechanisms of KLF4 and KLF2 in joint homoeostasis and OA pathogenesis.

Methods Experimental approaches included human joint tissues cells, transgenic mice and mouse OA model with viral KLF4 gene delivery to demonstrate therapeutic benefit in structure and pain improvement. Mechanistic studies applied global gene expression analysis and chromatin immunoprecipitation sequencing (ChIP-seq).

Results Several KLF genes were significantly decreased in OA cartilage. Among them, KLF4 and KLF2 were strong inducers of cartilage collagen genes and Proteoglycan-4. Cartilage-specific deletion of Klf2 in mature mice aggravated severity of experimental OA. Transduction of human chondrocytes with Adenovirus (Ad) expressing KLF4 or KLF2 enhanced expression of major cartilage extracellular matrix (ECM) genes and SRY-box transcription factor-9, and suppressed mediators of inflammation and ECM-degrading enzymes. Ad-KLF4 and Ad-KLF2 enhanced similar protective functions in meniscus cells and synoviocytes, and promoted chondrocytic differentiation of human mesenchymal stem cells. Viral KLF4 delivery into mouse knees reduced severity of OA-associated changes in cartilage, meniscus and synovium, and improved pain behaviours. ChIP-seq analysis suggested that KLF4 directly bound cartilage signature genes. Ras-related protein-1 signalling was the most enriched pathway in KLF4-transduced cells, and its signalling axis was involved in upregulating cartilage ECM genes by KLF4 and KLF2.

Conclusions KLF4 and KLF2 may be central transcription factors that increase protective and regenerative functions in joint tissue cells, suggesting that KLF gene transfer or molecules upregulating KLFs are therapeutic candidates for OA.

  • Osteoarthritis
  • Chondrocytes
  • Inflammation

Data availability statement

All data relevant to the study are included in the article. The GEO accession numbers for all the datasets used in the present study are available in online supplemental materials and methods.

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Data availability statement

All data relevant to the study are included in the article. The GEO accession numbers for all the datasets used in the present study are available in online supplemental materials and methods.

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  • Handling editor Josef S Smolen

  • Contributors MKL designed the study. MK and MO performed the experiments. MK, PN, AS and MO analysed the data. MK, TT, PO, SRH, PN, AS and MO provided expertise and/or materials. PO, SRH, HA and MKL supervised the project. MK and MKL drafted the paper, which was approved by all coauthors. MKL acts as guarantor.

  • Funding National Institutes of Health grants R01AG049617 and R01AG056144 (MKL).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.