US Patent for Composition and methods for treating articulating joint disorders with nucleoside reverse transcriptase inhibitors Patent (Patent # 12,121,530 issued October 22, 2024) (2024)

RELATED APPLICATIONS

This application claims the benefit of priority under 35 U.S.C. § 119(e) to U.S. Provisional Application Nos. 62/670,705, filed May 11, 2018, and 62/671,356, filed May 14, 2018, the entire contents of each of which is incorporated herein by reference in their entireties.

STATEMENT AS TO FEDERALLY SPONSORED RESEARCH

This invention was made with government support under P20 GM104937, P30 GM122732 awarded by the National Institutes of Health. The Government has certain rights in the invention.

INCORPORATION BY REFERENCE OF SEQUENCE LISTING

The contents of the sequence listing text file named “21486-641001WO_Sequence_Listing_ST25.txt”, which was created on May 10, 2019 and is 131,072 bytes in size, is hereby incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to orthopedic disorders.

BACKGROUND

Arthritis affects tens of millions of patients in the U.S. annually. By 2040, an estimated 78 million (26%) of U.S. adults aged 18 years or older are projected to have physician-diagnosed arthritis. Osteoarthritis (OA) is the most common form of arthritis.

With knee OA, total or half knee replacement is a typical outcome, particularly in elderly subjects. Not infrequently, some patients have to go through secondary repair. Intra-medullar infection, lethal fat embolism, surgery related fracture, unpredictable prognosis and endless post-operative physical therapy are risks shared by the patients. Moreover, patients usually have to double those aforementioned sufferings on the contralateral knee, and even for both hips.

Degenerative disorders such as osteoarthritis, osteoporosis, neurodegeneration, and tumorigenesis are often associated with aging and injury, which induce pro-inflammatory cytokines and matrix proteinases and result in tissue degeneration. For example, OA is a complicated chronic and highly prevalent degenerative joint disease. As the most common musculoskeletal disorder, OA is characterized by the degradation of articular cartilage and joint inflammation. Large numbers of individuals with OA throughout the world suffer from pain most in knees and hips joints. Current treatments are restricted to behavioral interventions and ultimately joint replacement surgery. There are still no effective pharmacological methods for prevention and treatment of OA.

SUMMARY OF THE INVENTION

The invention provides a solution to the long standing problem of treating osteoarthritic conditions in aging joints, e.g., greater than 50 year old, as well as trauma-induced joint OA, e.g., subsequent to an injury such as ligament tear/breach or cartilage, e.g., meniscus damage in an articulating joint.

Accordingly, a method for treating an articulating joint disorder comprises systemically administering to a subject a nucleoside reverse transcriptase inhibitor (NRTI). For example, the subject, e.g., a human subject, is diagnosed as comprising osteoarthritis (OA). In some embodiments, the subject does not comprises an human immunodeficiency virus (HIV, e.g., HIV-1 or HIV-2) infection. Exemplary compounds for treatment include NRTIs such as 3TC (lamivudine), FTC (Emtriva,) ABC (abacavir), TDF (tenofovir), ZDV (azidothmidine), or DDl (Didanosine). Animal subjects such as companion animals, e.g., dogs, cats, as well as performance animals, e.g., horses, are within the scope of the inventions. Joint disorders include age-related and trauma-related OA.

As described above, it is therefore an object of the present invention to provide compounds and pharmaceutical compositions that exhibit anti-inflammation, and in particular, anti-chronic inflammation and/or anti-cartilage degeneration disease activity, as well as pharmaceutical compositions for the treatment of cartilage degeneration diseases, including all kinds of arthritis and skeletal disorders and for the treatment of cartilage degeneration diseases.

Any one or more of these and/or other objects of the invention may be readily gleaned from a review of the description of the invention which follows. Each embodiment disclosed herein is contemplated as being applicable to each of the other disclosed embodiments. Thus, all combinations of the various elements described herein are within the scope of the invention.

Despite the demographics and prevalence of osteoarthritic disease, there are still few or no effective pharmacological methods for prevention and treatment of tissue degenerative orders such OA. NRTIs are currently used for treatment of viral diseases (HIV etc.), the data described herein indicates that these NRTIs are effective for treatment of OA. The compositions and methods described herein do not require surgery or invasive means for therapy, e.g., the methods exclude surgery and/or are used in concert with a surgical intervention. Advantages of the invention include avoidance of an invasive procedure such as surgery as well an ease of use, low cost, and high patient compliance. Furthermore, the method causes neither tissue damage nor pain, and requires less patient supervision and decreased cost of care.

In aspects, provided herein are methods for treating an aging-associated joint disorder, comprising systemically administering to a subject a nucleoside nucleoside reverse transcriptase inhibitor (NRTI). In embodiments, the subject is at least 30, 40, 50, 60, 70, 80 years old or older. In other embodiments, the subject has been diagnosed with an aging-associated joint disorder (e.g., osteoarthritis (OA)). Post-traumatic OA can occur in individuals of any age. In embodiments, the method for treating an aging-associated joint disorder (OA), includes administering an NRTI, e.g., 3TC, FTC, ABC, TDF, ZDV, or DDl.

In other examples, the joint disorder originates or is associated with a trauma (post-traumatic OA), e.g., an injury to the joint or a surgery to a joint. In some embodiments, the subject does not comprise rheumatoid arthritis, an auto-immune disorder. In other embodiments, the subject comprises the auto immune disorder, rheumatoid arthritis.

In embodiments, the NRTI for treating an articulating joint disorder or an aging-associated joint disorder, inhibits the expression of osteoarthritis markers. In embodiments, the osteoarthritis markers comprise collagen type X alpha 1 chain (COL10A1), A Disintegrin and Metalloproteinase with Thrombospondin Motifs 5 (ADAMTS5), matrix metallloeptidase 13 (MMP13), senescence-associated secretory phenotype interleukin-6 (SASP IL-6), Indian hedgehog (Ihh) or interferon type 1 (IFN).

In other embodiments, the NRTI or treating an articulating joint disorder or an aging-associated joint disorder promotes the expression of anabolic markers, wherein the anabolic markers comprise aggrecan (ACAN) and Collagen, type II, alpha 1 (COL2A1).

In aspects, also provided herein are methods for treating a post-traumatic osteoarthritis (PTOA) injury in a subject, comprising systemically administering a nucleoside reverse transcriptase inhibitor (NRTI). In embodiments the subject is diagnosed as comprising osteoarthritis. In other embodiments, the NRTI comprises 3TC, FTC, ABC, TDF, ZDV, or DDl. In embodiments, the method further comprises administering 3MC.

In embodiments, the PTOA results from a high-speed impact twist, or pressure-induced trauma to the articular surface, intraarticular fractures, or joint-destabilizing soft-tissue tears. In embodiments, the PTOA injury is in a joint. In some examples, the joint includes an ankle, knee, or hip.

In embodiments, the methods for treating an articulating joint disorder, for treating an aging-associated joint disorder, or for treating a post-traumatic osteoarthritis injury, comprise administering an NRTI. In embodiments, the NRTI comprises a nucleoside analogue. In other embodiments, the NRTI comprises an adenosine analogue. In embodiments, the NRTI comprises a cytidine analog.

NTRIs include nucleoside analogues. Nucleosides are glycosylamines that can be characterized as nucleotides without a phosphate group. A nucleoside consists of a nucleobase (also termed a nitrogenous base) and a five-carbon sugar (either ribose or deoxyribose), whereas a nucleotide is composed of a nucleobase, a five-carbon sugar, and one or more phosphate groups. In a nucleoside, the anomeric carbon is linked through a glycosidic bond to the N9 of a purine or the N1 of a pyrimidine. Examples of nucleosides include cytidine, uridine, adenosine, guanosine, thymidine and inosine.

Other features and advantages of the invention will be apparent from the following description of the preferred embodiments thereof, and from the claims. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, suitable methods and materials are described below.

DESCRIPTION OF THE DRAWINGS

FIG. 1A-1X are a series of figures showing that MiR-365 over-expression promotes Line-1 gene expression in human OA lesion and mouse OA model.

FIG. 1A is a graph showing the gene expression of LINE-1 at the RNA level in human OA cartilage samples assessed by RT-qPCR.

FIG. 1B is a graph showing the gene expression of ALU at the RNA level in human OA cartilage samples assessed by RT-qPCR.

FIG. 1C is a graph showing the gene expression of miR-365 at the RNA level in human OA cartilage samples assessed by RT-qPCR. LINE-1 levels were significantly elevated in 7/12 (58.33%) patients (FIG. 1A); ALU levels were significantly elevated in 3/12 (25.00%) patients, while were significantly decreased in 3/12 (25.00%) patients (FIG. 1B). MiR-365 levels were significantly elevated in ⅝ (62.50%) patients (FIG. 1C). n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to appropriate non-lesion (control) groups respectively.

FIG. 1D is a graph showing the gene expression of Line-1-ORF2 at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1E is a graph showing gene expression of Adamts5 at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1F is a graph showing gene expression of Mmp3 at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1G is a graph showing the gene expression of Ihh at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1H is a graph showing the gene expression of Col2a1 at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 was assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1I is a graph showing the gene expression of Acan at RNA level in mouse chondrocytes co-transfected with siRNAs against Line-1 (siLine-1D) as well as miR-365 assessed by RT-qPCR. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1J is a graph showing gene expression of miR-365 in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1K is a graph showing gene expression of Line-1 mRNA in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1L is a graph showing gene expression of Ihh in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1M is a graph showing gene expression of collagen type x alpha 1 chain (Col10a1) in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1N is a graph showing gene expression of Adamts5 in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1O is a graph showing gene expression of Mmp13 at RNA level in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥4. *p≤0.05, relative to age-matched control (Cre-only) groups respectively.

FIG. 1P are IHC staining images of Col10a1 and Ihh expression at protein level on joint sections from 6-month-old Cre only and miR-365 Tg mice. Both Col10a1 and Ihh protein expressions were up-regulated in the articular surface of miR-365 Tg mice.

FIG. 1Q are a series of Safranin O staining images of mouse knees harvested from 2- to 12-month-old miR-365 Tg and age-matched control (Cre only) mice, showing obvious articular cartilage degradation in miR-365 Tg mice knees since 6-month old.

FIG. 1R is a bar graph depicting results of OARSI quantification of mouse knees harvested from 2- to 12-month-old miR-365 Tg and age-matched control (Cre only) mice, showing obvious articular cartilage degradation in miR-365 Tg mice knees since 6-month old.

FIG. 1S is a schematic representation of animal procedures: 129S6/SvEv mice underwent destabilizing medial meniscus (DMM) or Sham surgeries on right legs at 2-month-old and were sacrificed at 3-month-old (1-month post-surgery).

FIG. 1T is a bar graph showing the gene expression of Line-1-ORF2 at RNA level in 12956/SvEv background mice articular cartilage was assessed by RT-qPCR. Line-1 and miR-365 levels were significantly elevated in the cartilage of DMM (right) knees at 1-month post-surgery when normalized to non-surgery (left) knees. There were 6 mice in each group

FIG. 1U is a graph showing gene expression of miR-365 at RNA level in 12956/SvEv background mice articular cartilage was assessed by RT-qPCR. Line-1 and miR-365 levels were significantly elevated in the cartilage of DMM (right) knees at 1-month post-surgery when normalized to non-surgery (left) knees. There were 6 mice in each group.

FIG. 1V is a schematic representation of animal procedures: C57BL/6 mice underwent DMM or Sham surgeries on right legs at 2-month-old and were sacrificed at 4-month-old (2 months post-surgery) 5.5-month-old (3.5 months post-surgery) and 7-month-old (5 months post-surgery).

FIG. 1W is a bar graph showing the gene expression of Line-1-ORF2 at RNA level in WT C57BL/6 background mice articular cartilage was assessed by RT-qPCR. Line-1-ORF2 and miR-365 levels were significantly augmented in the cartilage of DMM knees at 3.5- and 5-month post DMM surgery when compared with 2-month post-surgery. There were 3 mice in each group. Student t-test was used for statistics. *p≤0.05, relative to appropriate control groups respectively.

FIG. 1X is a bar graph showing the gene expression of miR-365 at RNA level in WT C57BL/6 background mice articular cartilage was assessed by RT-qPCR. Line-1-ORF2 and miR-365 levels were significantly augmented in the cartilage of DMM (destabilization of medical meniscus) knees at 3.5- and 5-month post DMM surgery when compared with 2-month post-surgery. There were 3 mice in each group. Student t-test was used for statistics. *p≤0.05, relative to appropriate control groups respectively.

FIGS. 2A-2O are a series of images indicating that MiR-365 induced Line-1 gene expression via post-transcriptional suppressions of Prkdc (protein kinase DNA-activated catalytic subunit), Dicer and Sqstm1 (sequestosome 1).

FIG. 2A is a schematic representation of Line-1 biogenesis and host mechanism of inhibition. n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to non-lesion (control) groups respectively.

FIG. 2B is a graph showing the gene expression of DICER at RNA level in human OA cartilage was assessed by RT-qPCR. The DICER level was significantly down-regulated in ⅜ (37.50%) specimens. n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to non-lesion (control) groups respectively.

FIG. 2C is a graph showing the gene expression of PRKDC at RNA level in human OA cartilage was assessed by RT-qPCR. The PRKDC level was significantly down-regulated in ⅜ (37.50%) specimens. n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to non-lesion (control) groups respectively.

FIG. 2D is a graph showing the gene expression of SQSTM1 at RNA level in human OA cartilage was assessed by RT-qPCR. The SQSTM1 level was significantly down-regulated in 4/8 (50.00%) specimens. n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to non-lesion (control) groups respectively.

FIG. 2E is a graph showing the gene expression of ZC3HAV1 (zinc finger CCCH-Type Containing, Antiviral 1) at RNA level in human OA cartilage was assessed by RT-qPCR. The ZC3HAV1 level was significantly down-regulated in ⅜ (37.50%) specimens. n varies from 1 to 3 due to the size of human specimen. Statistics are calculated in samples with n≥3. *p≤0.05, relative to non-lesion (control) groups respectively.

FIG. 2F is a bar graph showing the gene expression of Line-1 suppressor (Dicer) at RNA level in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥3. *p≤0.05, **p≤0.01 relative to age-matched control (Cre only) groups respectively.

FIG. 2G is a bar graph showing the gene expression of Line-1 suppressor (Prkdc) at RNA level in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥3. *p≤0.05, **p≤0.01 relative to age-matched control (Cre only) groups respectively.

FIG. 2H is a bar graph showing the gene expression of Line-1 suppressor (SQSTM1) at RNA level in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥3. *p≤0.05, **p≤0.01 relative to age-matched control (Cre only) groups respectively.

FIG. 2I is a bar graph showing the gene expression of Line-1 suppressor (Zc3hav1) at RNA level in Cre only and miR-365 Tg mice cartilage at 2-, 6-, 9- and 12-month of age was assessed by RT-qPCR. n≥3. *p≤0.05, **p≤0.01 relative to age-matched control (Cre only) groups respectively.

FIG. 2J is a bar graph showing the gene expression of Line-1 suppressors at RNA level in mouse primary chondrocytes transfected with miR-365 mimic assessed by RT-qPCR. Dicer, Prkdc, Sqstm1 and Zc3hav1 levels were significantly down-regulated in mouse primary chondrocytes which transiently over-express miR-365. n=3. *p≤0.05, relative to Mimic ctrl groups respectively.

FIG. 2K is a graph showing the gene expression of Line-1 suppressors at RNA level in a human chondrocyte cell line-C28 transfected with miR-365 mimic was assessed by RT-qPCR. Dicer, Prkdc, Sqstm1 and Zc3hav1 levels were significantly down-regulated in mouse primary chondrocytes which transiently over-express miR-365. n≥3. *p≤0.05, relative to Mimic ctrl groups respectively.

FIG. 2L is a graph showing the quantification of luciferase gene activity in ATDC5 cells co-transfected with miR-365 mimic as well as WT or mutated (Mut) 3′UTR response elements (REs) from Aicda, Dicer, Prkdc, Sqstm1 and Zc3hav1 was assessed by luciferase reporter assay. Luciferase activities were significantly down-regulated when WT REs in 3′UTR of Dicer1, Prkdc and Sqstm1 are down-stream of luciferase gene in ATDC5 cells which transiently over-express miR-365, while mutation of RE in Dicer1, Prkdc and Sqstm1 3′UTR completely abolished luciferase activity suppression in ATDC5 cells which transiently over-express miR-365. n≥3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 2M is a graph showing the gene expression of Line-1-ORF2 at RNA level assessed by RT-qPCR in mouse primary chondrocytes which transiently over-expressed miR-365 mimic or miR-365 inhibitor. Line-1-ORF2 expression was significantly up-regulated in mouse primary chondrocytes which transiently over-expressed miR-365 while inhibitor of miR-365 significantly down-regulated Line-1-ORF2 expression.

FIG. 2N is an image of an immunoblot showing the protein expression of Line-1-ORF1 assessed by western blots analysis in human chondrocyte cell line-C28 which transiently over-expressed miR-365 mimic or miR-365 inhibitor. Line-1-ORF1 expression was significantly up-regulated in C28 which transiently over-expressed miR-365 while inhibitor of miR-365 did not alter Line-1-ORF1 protein expression. This is a representative blot form a total of 3 repeated experiments. This is a representative blot form a total of 2 repeated experiments.

FIG. 2O is an image of an immunoblot showing the protein expression of Dicer assessed by western blots analysis in human chondrocyte cell line-C28 which transiently over-expressed miR-365 mimic or miR-365 inhibitor. Dicer protein expression was down-regulated in C28 which transiently over-expressed miR-365 while inhibitor of miR-365 up-regulated Dicer protein expression. This is a representative blot form a total of 2 repeated experiments.

FIG. 3A-3AC are a series of images depicting that 3TC suppressed Line-1 gene expression and prevented primary OA development in mice.

FIG. 3A is a bar graph showing the gene expression of Line-1 at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3B is a bar graph showing the gene expression of Ifn-α at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3C is a bar graph showing the gene expression of Adamts5 at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3D is a bar graph showing the gene expression of Mmp3 at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3E is a bar graph showing the gene expression of Col10a1 at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3F is a bar graph showing the gene expression of Col2a1 at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3G is a bar graph showing the gene expression of Acan at RNA level in mouse primary chondrocytes treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3H is an image of an immunoblot showing the protein expression of Line-1-ORF1 assessed by western blot analysis in C28 treated with 3TC. This is a representative blot from a total of 3 repeated experiments.

FIG. 3I is a bar graph showing the gene expression of LINE-1 at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3J is a bar graph showing the gene expression of IHH at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3K is a bar graph showing the gene expression of COL10A1 at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3L is a bar graph showing the gene expression of MMP13 at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3M is a bar graph showing the gene expression of ADAMTS5 at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3N is a bar graph showing the gene expression of ACAN at RNA level in C28 treated with 3TC at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 3O is a bar graph showing the gene expression of LINE-1 at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3P is a bar graph showing the gene expression of ADAMTS5 at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3Q is a bar graph showing the gene expression of COL10A1 at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3R is a bar graph showing the gene expression of MMP13 at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3S is a bar graph showing the gene expression of IHH at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3T is a bar graph showing the gene expression of ACAN at RNA level in C28 transiently over-express miR-365 with 3TC treated at various dosages. n=3 for all groups; *: p-value≤0.05, relative to control (Mimic Ctrl) groups respectively.

FIG. 3U is a schematic representation of animal procedures: age-matched miR-365 Tg and control mice (Cre Only) were treated with 3TC diluted water from 2-month-old for 4 months and were sacrificed at 6-month-old.

FIG. 3V are a series of Safranin O staining images of mouse knees harvested from 6-month-old miR-365 Tg and Cre only mice with 3TC or saline treatments respectively. 3TC treatment prevented early onset of OA in miR-365 Tg mice

FIG. 3W is a graph of OARSI quantification of mouse knees harvested from 6-month-old miR-365 Tg and Cre only mice with 3TC or saline treatments respectively. 3TC treatment prevented early onset of OA in miR-365 Tg mice.

FIG. 3X is a graph showing the gene expression of Line-1-ORF2 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 3Y is a graph showing the gene expression of Alu at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 3Z is a graph showing the gene expression of IL-6 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 3AA is a graph showing the gene expression of Col10a1 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 3AB is a graph showing the gene expression of Adamts5 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 3AC is a graph showing the gene expression of miR-365 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 4A-4W are a series of images depicting that 3TC and FTC prevented DMM induced OA.

FIG. 4A is a graph showing the gene expression of Line-1 at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4B is a graph showing the gene expression of Ifn-α at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4C is a graph showing the gene expression of P2rx7 at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4D is a graph showing the gene expression of Nlrp3 at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4E is a graph showing the gene expression of Col2a1 at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4F is a graph showing the gene expression of Acan at RNA level in mouse PC treated with FTC at various dosages was assessed by RT-qPCR. n=3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4G is a graph showing the gene expression of Line-1 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4H is a graph showing the gene expression of Mmp3 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4I is a graph showing the gene expression of Mmp13 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4J is a graph showing the gene expression of Adamts5 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4K is a graph showing the gene expression of Col10a1 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4L is a graph showing the gene expression of Col2a1 at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4M is a graph showing the gene expression of Acan at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4N is a graph showing the gene expression of Ihh at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4O is a graph showing the gene expression of Ifn-α at RNA level in mouse femurs treated with 3TC or FTC for 48 hrs was assessed by RT-qPCR. n≥3 for all groups; *: p-value≤0.05, relative to control (saline) groups respectively.

FIG. 4P is a schematic representation of animal procedures: 129S6/SvEv mice which underwent DMM or Sham surgeries were treated with Saline or 3TC or FTC diluted in water from 2-month-old for 1 month and were sacrificed at 3-month-old.

FIG. 4Q are a series of Safranin O staining images of mouse knees harvested from 3-month-old 129S6/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment with Saline or 3TC or FTC diluted water from 2-month-old for 1 month. 3TC and FTC treatments significantly prevented DMM induced OA in 129S6/SvEv mice.

FIG. 4R is a graph showing OARSI quantification of mouse knees harvested from 3-month-old 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment with Saline or 3TC or FTC diluted water from 2-month-old for 1 month. 3TC and FTC treatments significantly prevented DMM induced OA in 12956/SvEv mice.

FIG. 4S is a graph showing the gene expression of Line-1 mRNA at RNA level in 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of Saline or FTC or 3TC respectively. Student t-test and one-way ANOVA test (s-w) were used for statistics. There were 6 mice in each group. *p≤0.05, relative to appropriate control groups respectively.

FIG. 4T is a graph showing the gene expression of Col10a1 at RNA level in 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of Saline or FTC or 3TC respectively. Student t-test and one-way ANOVA test (s-w) were used for statistics. There were 6 mice in each group. *p≤0.05, relative to appropriate control groups respectively.

FIG. 4U is a graph showing the gene expression of Adamts5 mRNA at RNA level in 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of Saline or FTC or 3TC respectively. Student t-test and one-way ANOVA test (s-w) were used for statistics. There were 6 mice in each group. *p≤0.05, relative to appropriate control groups respectively.

FIG. 4V is a graph showing the gene expression of Mmp13 at RNA level in 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of Saline or FTC or 3TC respectively. Student t-test and one-way ANOVA test (s-w) were used for statistics. There were 6 mice in each group. *p≤0.05, relative to appropriate control groups respectively.

FIG. 4W is a graph showing the gene expression of miR-365 at RNA level in 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of Saline or FTC or 3TC respectively. Student t-test and one-way ANOVA test (s-w) were used for statistics. There were 6 mice in each group. *p≤0.05, relative to appropriate control groups respectively.

FIG. 5A-5F are a series of images that show characterization of human OA specimens.

FIG. 5A is a bar graph showing information of sex and age of human OA patients, from whom the OA specimens were collected. Female patients (n=8) collectively had an average age of 69 yrs whilst male patients (n=4) represented an average age of 74 yrs. Student t-test was used for statistics.

FIG. 5B is a representative picture of gross morphology of a human OA specimen. Red square indicates a lesion (OA) area and green square indicates a non-lesion (healthy) area.

FIG. 5C is an image of H&E staining of sections from a non-lesion (healthy) area and a lesion (OA) area isolated from the specimen in (FIG. 5B).

FIG. 5D are images of Safranin 0/Fast Green staining of sections from a non-lesion (healthy) area and a lesion (OA) area isolated from the specimen in (FIG. 5B).

FIG. 5E are a series of images showing senescence β-Galactosidase (β-Gal) staining of sections from a non-lesion (healthy) area and a lesion (OA) area isolated from the specimen in (FIG. 5B). Arrows indicate positive β-Gal staining in chondrocytes.

FIG. 5F is a bar graph showing the number of chondrocytes that were positively stained with β-Gal from non-lesion (healthy) areas and lesion (OA) areas isolated from the specimen were counted manually by multiple researchers blind to the experiment in terms of the ratio over total cells in the field. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 6A-6G are a series of images showing screening of siRNA against Line-1 (siLine-1).

FIG. 6A is a bar graph showing the gene expression of Line-1 expression in mouse primary chondrocytes transfected with siRNAs against Line-1 assessed by RT-qPCR. siLine-1C & D & E significantly suppressed Line-1 expression in mouse primary chondrocytes. siLine-1D was then selected for further experiments. n=3. *p≤0.05, relative to appropriate control (scramble siRNA) groups respectively. This experiment was conducted once

FIG. 6B is a bar graph showing the gene expression of Acan at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 6C is a bar graph showing the gene expression of Adamts5 at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 6D is a bar graph showing the gene expression of Col10a1 at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 6E is a bar graph showing the gene expression of IL-6 at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 6F is a bar graph showing the gene expression of Mmp13 at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 6G is a bar graph showing the gene expression of Tnf-α at RNA level in mouse primary chondrocytes transfected with siRNA against Line-1 (siLine-1D) was assessed by RT-qPCR. n=2 for each treatment groups.

FIG. 7 is a schematic showing the breeding strategy for Col2a1-Cre+/−; miR-365 fl+/−(miR-365 Tg) mice. A schematic representation of breeding strategy to achieve cartilage specific miR-365 over-expression model in mouse (miR-365 Tg mice); In brief, miR-365 fl hemizygote (+/−) mice were crossed with Col2a1-Cre hemizygote (+/−) mice which yielded four genotypes in progeny. Double positive Col2a1-Cre+/−; miR-365 fl+/− mice had miR-365 over-expressed in cartilage tissues. Cre positive only Col2a1-Cre+/−; miR-365 fl−/− mice, flox only Col2a1-Cre−/−; miR-365 fl+/− and wild type (WT) Col2a1-Cre−/−; miR-365 fl−/− mice didn't have miR-365 over-expression. “Green” circle indicates green fluorescence, “red” circle indicates red fluorescence while “black” circle indicates no fluorescence.

FIG. 8A-8G are a series of images showing the Bio-informative search of potential miR-365 target genes which serve as Line-1 biogenesis inhibitors during host mechanism.

FIG. 8A are a series of tables showing bio-informative prediction of potential miR-365 targets. Genes listed here have been previously validated for their involvement in host's mechanism of Line-1 inhibition. The genes with conserved and simultaneous potential miR-365 seeding sites for post-transcriptional regulation in human and mouse are shown in red boxes, which are Aicda, Sqstm1, Zc3hav1 (Zap), Dicer1, Prkdc.

FIG. 8B is a schematic diagrams depicting the intersections of published Line-1 suppressors, predicted miR-365 targets by Targetscan and validated miR-365 in this study.

FIG. 8C is an image depicting the demonstrations of potential miR-365 seeding sites and mutations in the 3′UTR of genes in the red boxes in (FIG. 8A).

FIG. 8D is a graph showing the gene expression of Line-1 suppressor (Prkdc mRNA) at RNA level in Cre Only and miR-365 Tg mice articular cartilage was assessed. Prkdc expression was significantly down-regulated in the cartilage of miR-365 Tg mice. Student t-test was used for statistics. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 8E is a graph showing the gene expression of Line-1 suppressor (Dicer mRNA) at RNA level in Cre Only and miR-365 Tg mice articular cartilage was assessed. Prkdc expression was significantly down-regulated in the cartilage of miR-365 Tg mice. Student t-test was used for statistics. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 8F is a graph showing the gene expression of Line-1 suppressor (Sqstm1 mRNA) at RNA level in Cre Only and miR-365 Tg mice articular cartilage was assessed. Prkdc expression was significantly down-regulated in the cartilage of miR-365 Tg mice. Student t-test was used for statistics. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 8G is a graph showing the gene expression of Line-1 suppressor (Zc3hav1 mRNA) at RNA level in Cre Only and miR-365 Tg mice articular cartilage was assessed. Prkdc expression was significantly down-regulated in the cartilage of miR-365 Tg mice. Student t-test was used for statistics. n=3. *p≤0.05, relative to appropriate control groups respectively.

FIG. 9A-9F are a series of images depicting that 3TC treatment does not change subchondral bone morphometry in miR-365 Tg mice.

FIG. 9A are images of a 3D reconstruction of knee joints of mice being treated with saline or 3TC for 4 months

FIG. 9B is a graph of a trabecular bone morphometry analysis of bone volume (BV)/total volume (TV) of subchondral bones in the knee joints of mice being treated with saline or 3TC for 4 months was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 9C is a graph of the trabecular number of subchondral bones in the knee joints of mice being treated with saline or 3TC for 4 months was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 9D is a graph of the trabecular thickness of subchondral bones in the knee joints of mice being treated with saline or 3TC for 4 months was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 9E is a graph of the trabecular separation of subchondral bones in the knee joints of mice being treated with saline or 3TC for 4 months was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 9F is a graph of the connectivity density of subchondral bones in the knee joints of mice being treated with saline or 3TC for 4 months was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 10A-10I are a series of images showing that neither DMM nor Sham nor Saline nor 3TC nor FTC affected body weight of 12956/SvEv mice.

FIG. 10A are images of a 3D reconstruction of knee joints of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively.

FIG. 10B is a graph of trabecular bone morphometry analysis of bone volume (BV)/total volume (TV).

FIG. 10C is a graph of trabecular number of subchondral bones in the knee joints of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 10D is a graph of trabecular thickness of subchondral bones in the knee joints of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 10E is a graph of trabecular separation of subchondral bones in the knee joints of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 10F is a graph of connectivity density of subchondral bones in the knee joints of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively was assessed. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

FIG. 10G is a graph of the body weight of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively at various time points was assessed. No appreciable difference was observed between different treatment groups. There were 6 mice in each group respectively.

FIG. 10H is a graph of the body weight of 129S6/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively at various time points was assessed. No appreciable difference was observed between different treatment groups. There were 6 mice in each group respectively.

FIG. 10I is a graph of the body weight of 12956/SvEv mice which underwent DMM or Sham surgeries and subsequent treatment of saline or FTC or 3TC respectively at various time points was assessed. No appreciable difference was observed between different treatment groups. There were 6 mice in each group respectively.

FIG. 11 is an image showing that MiR-365 over-expression in cartilage inhibited Line-1 suppressors expression thereby promoting Line-1 gene expression and subsequent OA development. A schematic representation showing the hypothesis that miR-365 increase in the cartilage caused by mechanical and inflammatory factors induced by aging/senescence or injury promotes Line-1 gene expression via post-transcriptional suppression of Line-1 inhibitors, including Dicer, Prkdc and Sqstm1, leading to Line-1 expression increase which eventually results in OA pathogenesis through up-regulation of Senescence Associated Secretory Phenotype (SASP) including IL-1β and IL-6 secretion, up-regulation of OA markers including Mmp13, Adamts5 and Col10a1 secretion and down-regulation of anabolic factors including Acan and Col2a1 synthesis. OA development will reciprocally drive miR-365 expression increase, forming a vicious cycle. Using siRNA against Line-1 or cytidine analogues (3TC and FTC) can suppress Line-1 gene expression and the development of OA, therefore interrupting the vicious cycle of miR-365-Line-1-OA.

FIGS. 12A-12C depict images of summary data of NRTI on OA, green (circled): inhibiting OA; red (shaded/non-circled): stimulating OA.

FIG. 12A is an image of summary data of Class I NRTIs (3TC, FTC or ABC) inhibiting strict OA only.

FIG. 12B is an image of summary data of Class II NRTIs (ZDV or TDF) inhibiting expanded OA.

FIG. 12C is an image of summary data of Class III NRTIs (DDL D4T) inhibiting expanded OA.

DETAILED DESCRIPTION

Treatment of joint degenerative disorders, as described herein, modulating retrotransposon(s) and/or its regulators and effectors, and their structural analogues are useful to achieve the purpose of inhibiting tissue degeneration and promoting regeneration of joint tissues. The data shown herein, demonstrate the use and efficacy of treatment of degenerative diseases by inhibiting microrna up-regulation of retrotransposon line-1 and use of NTRIs to treat OA and suppress Line-1 activities and prevent primary OA. Line is an acronym for (Long Interspersed Nuclear Element.)

Mechanical stress plays a pivotal role in osteoarthritis (OA) pathogenesis. In some cases, miR-365 expression is stimulated by mechanical loading in chondrocytes and is increased during OA pathogenesis. Moreover, transgenic mice in which miR-365 is specifically over-expressed in Col2a1 lineage cells develop early onset of OA. miR-365 over-expression is sufficient to elevate Line-1 expression in cartilage in vitro and in vivo, the resultant Line-1 expression increase is attributed to the suppression of its inhibitors including Dicer, Prkdc and Sqstm1, direct targets of miR-365. Furthermore, inhibiting Line-1 using NRTIs such as 3TC and FTC, as well as ABC, TDF, ZDV, or DDl rescue primary and secondary OA models in mice. Collectively the data indicate that NRTIs are useful for treatment of OA.

Compositions and methods were developed for inhibiting tissue degeneration and associated inflammation and matrix enzyme secretion by modulating retrotransposon and its regulatory pathways.

OA Pathogenesis

Mechanical stress and inflammation plays a pivotal role in OA pathogenesis. In contrast to rheumatoid arthritis, OA is not an autoimmune disease. The major components of osteoarthritis are not immune cells (contrary to rheumatoid arthritis, which is an autoimmune disease), and OA is associated with wear and tear. miR-365 expression is stimulated by mechanical loading and inflammation in chondrocytes and is increased during OA pathogenesis. Transgenic mice in which miR-365 is specifically over-expressed in Col2a1 lineage cells develop early onset of OA. Retrotransposon activation has been implicated in some aging-associated and chronic diseases, but its role in degenerative joint disease such as OA pathogenesis was not known prior to the invention.

Osteoarthritis occurs as a result of cumulative stress to a joint as a result of aging or as an aftermath of trauma such as an injury or surgical procedure performed on a joint, i.e., in some cases the development of OA is not age-related, e.g., occurs in subjects younger than 45 years old. Effectiveness of NRTIs on improvement of the clinical symptoms, e.g., pain or decreased mobility was a surprising observation in the treatment of age-related or trauma-related OA.

Disclosed herein is a data showing that the levels of retrotransposon Line-1 are significantly higher in the human OA cartilage lesions compared to normal cartilage. MiR-365 over-expression is sufficient to elevate retrotransposon Line-1 expression in cartilage in vitro and in vivo, the resultant Line-1 expression increase is attributed from the suppression of its inhibitors including Dicer, Prkdc and Sqstm1, which are direct targets of miR-365. Furthermore, inhibiting Line-1 using nucleoside reverse transcriptase inhibitors (NRTIs) including 3TC and FTC inhibits aging and trauma induced in art-recognized OA models in mice. OA cells secrete exosomes (vesicles), and Line-1 is present in those exosomes. Such Line-1 containing exosomes can infect non-OA cells.

Collectively the data indicate that OA is alleviated, e.g., effectively treated, by manipulating retrotransposon content and its related regulatory pathways in the cell. Therapeutic compositions include 1) inhibitors of miR-365, 2) Dicer, Prkdc, Sqstm1, or their agonists, 3) inhibiting the antagonists of Dicer, Prkdc, Sqstm1 and their respective pathways, 4) inhibitors or antagonists of retrotransposon including siRNA and NRTI small molecules. For example, NRTIs, which have been and are currently used for inhibiting viruses, can be re-purposed and used as a therapeutic medication to treat joint disease such as OA.

In addition, structural homologs or modified (e.g. methylated) NRTIs may also be used for OA treatment, even if they do not possess inhibitory properties against reverse transcriptase.

Osteoarthritis Markers

Exemplary osteoarthritis markers comprise collagen type X alpha 1 chain (COL10A1), A Disintegrin and Metalloproteinase with Thrombospondin Motifs 5 (ADAMTS5), matrix metallloeptidase 13 (MMP13), senescence-associated secretory phenotype interleukin-6 (SASP IL-6), Indian hedgehog (Ihh) or interferon type 1 (IFN).

Human Collagen type X alpha 1 chain (COL10A1) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_000484.2; SEQ ID NO: (99); GenBank Accession, incorporated herein by reference.

1 mlpqipflll vslnlvhgvf yaeryqmptg ikgplpntkt qffipytiks kgiavrgeqg 61 tpgppgpagp rghpgpsgpp gkpgygspgl ggepglpgpp gpsavgkpgv pglpgkpger 121 gpygpkgdvg paglpgprgp pgppgipgpa gisvpgkpgq qgptgapgpr gfpgekgapg 181 vpgmngqkge mgygapgrpg erglpgpqgp tgpsgppgvg krgengvpgq pgikgdrgfp 241 gemgpigppg pqgppgergp egigkpgaag apgqpgipgt kglpgapgia gppgppgfgk 301 pglpglkger gpaglpggpg akgeqgpagl pgkpgltgpp gnmgpqgpkg ipgshglpgp 361 kgetgpagpa gypgakgerg spgsdgkpgy pgkpgldgpk gnpglpgpkg dpgvggppgl 421 pgpvgpagak gmpghngeag prgapgipgt rgpigppgip gfpgskgdpg spgppgpagi 481 atkglngptg ppgppgprgh sgepglpgpp gppgppgqav mpegfikagq rpslsgtplv 541 sanqgvtgmp vsaftvilsk aypaigtpip fdkilynrqq hydprtgift cqipgiyyfs 601 yhvhvkgthv wvglykngtp vmytydeytk gyldqasgsa iidltendqv wlqlpnaesn 661 glysseyvhs sfsgflvapm

Exemplary landmark residues, domains, and fragments of COL10A1 include, but are not limited to residues 1-18 (signal sequence), residues 19-680 (mature protein), residues 57-519 (non-helical region), residues 155-202 (collagen triple helix repeat), or residues 520-980 (non-helical region). A fragment of a COL10A1 protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., COL10A1 residues in the case of COL10A1 above.

Human COL10A1 nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_000493.4; SEQ ID NO: (100); GenBank Accession, incorporated herein by reference.

1 accttctgca ctgctcatct gggcagagga agcttcagaa agctgccaag gcaccatctc 61 caggaactcc cagcacgcag aatccatctg agaatatgct gccacaaata ccctttttgc 121 tgctagtatc cttgaacttg gttcatggag tgttttacgc tgaacgatac caaatgccca 181 caggcataaa aggcccacta cccaacacca agacacagtt cttcattccc tacaccataa 241 agagtaaagg tatagcagta agaggagagc aaggtactcc tggtccacca ggccctgctg 301 gacctcgagg gcacccaggt ccttctggac caccaggaaa accaggctac ggaagtcctg 361 gactccaagg agagccaggg ttgccaggac caccgggacc atcagctgta gggaaaccag 421 gtgtgccagg actcccagga aaaccaggag agagaggacc atatggacca aaaggagatg 481 ttggaccagc tggcctacca ggaccccggg gcccaccagg accacctgga atccctggac 541 cggctggaat ttctgtgcca ggaaaacctg gacaacaggg acccacagga gccccaggac 601 ccaggggctt tcctggagaa aagggtgcac caggagtccc tggtatgaat ggacagaaag 661 gggaaatggg atatggtgct cctggtcgtc caggtgagag gggtcttcca ggccctcagg 721 gtcccacagg accatctggc cctcctggag tgggaaaaag aggtgaaaat ggggttccag 781 gacagccagg catcaaaggt gatagaggtt ttccgggaga aatgggacca attggcccac 841 caggtcccca aggccctcct ggggaacgag ggccagaagg cattggaaag ccaggagctg 901 ctggagcccc aggccagcca gggattccag gaacaaaagg tctccctggg gctccaggaa 961 tagctgggcc cccagggcct cctggctttg ggaaaccagg cttgccaggc ctgaagggag 1021 aaagaggacc tgctggcctt cctgggggtc caggtgccaa aggggaacaa gggccagcag 1081 gtcttcctgg gaagccaggt ctgactggac cccctgggaa tatgggaccc caaggaccaa 1141 aaggcatccc gggtagccat ggtctcccag gccctaaagg tgagacaggg ccagctgggc 1201 ctgcaggata ccctggggct aagggtgaaa ggggttcccc tgggtcagat ggaaaaccag 1261 ggtacccagg aaaaccaggt ctcgatggtc ctaagggtaa cccagggtta ccaggtccaa 1321 aaggtgatcc tggagttgga ggacctcctg gtctcccagg ccctgtgggc ccagcaggag 1381 caaagggaat gcccggacac aatggagagg ctggcccaag aggtgcccct ggaataccag 1441 gtactagagg ccctattggg ccaccaggca ttccaggatt ccctgggtct aaaggggatc 1501 caggaagtcc cggtcctcct ggcccagctg gcatagcaac taagggcctc aatggaccca 1561 ccgggccacc agggcctcca ggtccaagag gccactctgg agagcctggt cttccagggc 1621 cccctgggcc tccaggccca ccaggtcaag cagtcatgcc tgagggtttt ataaaggcag 1681 gccaaaggcc cagtctttct gggacccctc ttgttagtgc caaccagggg gtaacaggaa 1741 tgcctgtgtc tgcttttact gttattctct ccaaagctta cccagcaata ggaactccca 1801 taccatttga taaaattttg tataacaggc aacagcatta tgacccaagg actggaatct 1861 ttacttgtca gataccagga atatactatt tttcatacca cgtgcatgtg aaagggactc 1921 atgtttgggt aggcctgtat aagaatggca cccctgtaat gtacacctat gatgaataca 1981 ccaaaggcta cctggatcag gcttcaggga gtgccatcat cgatctcaca gaaaatgacc 2041 aggtgtggct ccagcttccc aatgccgagt caaatggcct atactcctct gagtatgtcc 2101 actcctcttt ctcaggattc ctagtggctc caatgtgagt acacacagag ctaatctaaa 2161 tcttgtgcta gaaaaagcat tctctaactc taccccaccc tacaaaatgc atatggaggt 2221 aggctgaaaa gaatgtaatt tttattttct gaaatacaga tttgagctat cagaccaaca 2281 aaccttcccc ctgaaaagtg agcagcaacg taaaaacgta tgtgaagcct ctcttgaatt 2341 tctagttagc aatcttaagg ctctttaagg ttttctccaa tattaaaaaa tatcaccaaa 2401 gaagtcctgc tatgttaaaa acaaacaaca aaaaacaaac aacaaaaaaa aaattaaaaa 2461 aaaaaacaga aatagagctc taagttatgt gaaatttgat ttgagaaact cggcatttcc 2521 tttttaaaaa agcctgtttc taactatgaa tatgagaact tctaggaaac atccaggagg 2581 tatcatataa ctttgtagaa cttaaatact tgaatattca aatttaaaag acactgtatc 2641 ccctaaaata tttctgatgg tgcactactc tgaggcctgt atggcccctt tcatcaatat 2701 ctattcaaat atacaggtgc atatatactt gttaaagctc ttatataaaa aagccccaaa 2761 atattgaagt tcatctgaaa tgcaaggtgc tttcatcaat gaaccttttc aaacttttct 2821 atgattgcag agaagctttt tatataccca gcataacttg gaaacaggta tctgacctat 2881 tcttatttag ttaacacaag tgtgattaat ttgatttctt taattcctta ttgaatctta 2941 tgtgatatga ttttctggat ttacagaaca ttagcacatg taccttgtgc ctcccattca 3001 agtgaagtta taatttacac tgagggtttc aaaattcgac tagaagtgga gatatattat 3061 ttatttatgc actgtactgt atttttatat tgctgtttaa aacttttaag ctgtgcctca 3121 cttattaaag cacaaaatgt tttacctact ccttatttac gacgcaataa aataacatca 3181 atagattttt aggctgaatt aatttgaaag cagcaatttg ctgttctcaa ccattctttc 3241 aaggcttttc attgttcaaa gttaataaaa aagtaggaca ataaagtgat gggtggcttt 3301 ta

Human A Disintegrin and Metalloproteinase with Thrombospondin Motifs 5 (ADAMTS5) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_008969.2; SEQ ID NO: (101); GenBank Accession, incorporated herein by reference.

1 mllgwaslll cafrlplaav gpaatpaqdk agqpptaaaa aqprrrqgee vqeraeppgh 61 phplaqrrrs kglvgnidql ysgggkvgyl vyaggrrfll dlerdgsvgi agfvpagggt 121 sapwrhrshc fyrgtvdgsp rslavfdlcg gldgffavkh arytlkpllr gpwaeeekgr 181 vygdgsaril hvytregfsf ealpprasce tpastpeahe hapahsnpsg raalasqlld 241 qsalspaggs gpqtwwrrrr rsisrarqve lllvadasma rlygrglqhy lltlasianr 301 lyshasienh irlavvkvvv lgdkdkslev sknaattlkn fckwqhqhnq lgddheehyd 361 aailftredl cghhscdtlg madvgticsp erscaviedd glhaaftvah eighllglsh 421 ddskfceetf gstedkrlms siltsidask pwskctsati teflddghgn clldlprkqi 481 lgpeelpgqt ydatqqcnlt fgpeysvcpg mdvcarlwca vvrqgqmvcl tkklpavegt 541 pcgkgriclq gkcvdktkkk yystsshgnw gswgswgqcs rscgggvqfa yrhcnnpapr 601 nngryctgkr aiyrscslmp cppngksfrh eqceakngyq sdakgvktfv ewvpkyagvl 661 padvckltcr akgtgyyvvf spkvtdgtec rlysnsvcvr gkcvrtgcdg iigsklqydk 721 cgvcggdnss ctkivgtfnk kskgytdvvr ipegathikv rqfkakdqtr ftaylalkkk 781 ngeylingky mistsetiid ingtvmnysg wshrddflhg mgysatkeil ivqilatdpt 841 kpldvrysff vpkkstpkvn svtshgsnkv gshtsqpqwv tgpwlacsrt cdtgwhtrtv 901 qcqdgnrkla kgcplsgrps afkgcllkkc

Exemplary landmark residues, domains, and fragments of ADAMTS5 include, but are not limited to residues 1-18 (signal sequence), residues 67-168 (reprolysin family propeptide), residues 207-214 (cysteine switch), or residues 570-622 (thrombospondin type 1 repeats). A fragment of a ADAMTS5 protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., ADAMTS5 residues in the case of ADAMTS5 above.

Human ADAMTS5 nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_007038.5; SEQ ID NO: (102); GenBank Accession, incorporated herein by reference.

1 acagcgctcg cgctgctctc ggcgctcgca gctgccgact ggggatgacg gcgggcagga 61 ggagaccgca gccgaaggga cacagacacg ccgcttcacc agctcgcctc aggctgcccc 121 cctgcatttt tgttttaatt tttacggctt tttcccctct ctttcttccc ttcctcctgg 181 tcccagcaga gccaaggaaa cccacaaaat aagaaaggaa gtgggccccg gagcttggaa 241 cctccacagc cggcttgtcc agcgcagcgc gggggcggga ggctgcgcgc accagttgcc 301 agcccggtgc gcggtacctt tccttacttt tcttgaaaca gcgatcgtgc ctgcatttgg 361 tggttttttg gtttttgttt ttttcctttt cccgtatttg ctgaatctcc actatccgac 421 tttttttttt taatcttttc tttccccccc cccccacccc acctctttct ggagcacgaa 481 tccaaacatt ttcccaagca acaaagaaaa gttcgcacgc tggcaccgca gcccggacag 541 gctggcgctg ctgccgggcc cccctccctc cgacacttga ctcaatcctg caagcaagtg 601 tgtgtgtgtc cccatccccc gccccgttaa cttcatagca aataacaaat acccataaag 661 tcccagtcgc gcagcccctc cccgcgggca gcgcactatg ctgctcgggt gggcgtccct 721 gctgctgtgc gcgttccgcc tgcccctggc cgcggtcggc cccgccgcga cacctgccca 781 ggataaagcc gggcagcctc cgactgctgc agcagccgcc cagccccgcc ggcggcaggg 841 ggaggaggtg caggagcgag ccgagcctcc cggccacccg caccccctgg cgcagcggcg 901 caggagcaag gggctggtgc agaacatcga ccaactctac tccggcggcg gcaaggtggg 961 ctacctcgtc tacgcgggcg gccggaggtt cctcttggac ctggagcgag atggttcggt 1021 gggcattgct ggcttcgtgc ccgcaggagg cgggacgagt gcgccctggc gccaccggag 1081 ccactgcttc tatcggggca cagtggacgg tagtccccgc tctctggctg tctttgacct 1141 ctgtgggggt ctcgacggct tcttcgcggt caagcacgcg cgctacaccc taaagccact 1201 gctgcgcgga ccctgggcgg aggaagaaaa ggggcgcgtg tacggggatg ggtccgcacg 1261 gatcctgcac gtctacaccc gcgagggctt cagcttcgag gccctgccgc cgcgcgccag 1321 ctgcgaaacc cccgcgtcca caccggaggc ccacgagcat gctccggcgc acagcaaccc 1381 gagcggacgc gcagcactgg cctcgcagct cttggaccag tccgctctct cgcccgctgg 1441 gggctcagga ccgcagacgt ggtggcggcg gcggcgccgc tccatctccc gggcccgcca 1501 ggtggagctg cttctggtgg ctgacgcgtc catggcgcgg ttgtatggcc ggggcctgca 1561 gcattacctg ctgaccctgg cctccatcgc caataggctg tacagccatg ctagcatcga 1621 gaaccacatc cgcctggccg tggtgaaggt ggtggtgcta ggcgacaagg acaagagcct 1681 ggaagtgagc aagaacgctg ccaccacact caagaacttt tgcaagtggc agcaccaaca 1741 caaccagctg ggagatgacc atgaggagca ctacgatgca gctatcctgt ttactcggga 1801 ggatttatgt gggcatcatt catgtgacac cctgggaatg gcagacgttg ggaccatatg 1861 ttctccagag cgcagctgtg ctgtgattga agacgatggc ctccacgcag ccttcactgt 1921 ggctcacgaa atcggacatt tacttggcct ctcccatgac gattccaaat tctgtgaaga 1981 gacctttggt tccacagaag ataagcgctt aatgtcttcc atccttacca gcattgatgc 2041 atctaagccc tggtccaaat gcacttcagc caccatcaca gaattcctgg atgatggcca 2101 tggtaactgt ttgctggacc taccacgaaa gcagatcctg ggccccgaag aactcccagg 2161 acagacctac gatgccaccc agcagtgcaa cctgacattc gggcctgagt actccgtgtg 2221 tcccggcatg gatgtctgtg ctcgcctgtg gtgtgctgtg gtacgccagg gccagatggt 2281 ctgtctgacc aagaagctgc ctgcggtgga agggacgcct tgtggaaagg ggagaatctg 2341 cctgcagggc aaatgtgtgg acaaaaccaa gaaaaaatat tattcaacgt caagccatgg 2401 caactgggga tcttggggat cctggggcca gtgttctcgc tcatgtggag gaggagtgca 2461 gtttgcctat cgtcactgta ataaccctgc tcccagaaac aacggacgct actgcacagg 2521 gaagagggcc atctaccgct cctgcagtct catgccctgc ccacccaatg gtaaatcatt 2581 tcgtcatgaa cagtgtgagg ccaaaaatgg ctatcagtct gatgcaaaag gagtcaaaac 2641 ttttgtggaa tgggttccca aatatgcagg tgtcctgcca gcggatgtgt gcaagctgac 2701 ctgcagagcc aagggcactg gctactatgt ggtattttct ccaaaggtga ccgatggcac 2761 tgaatgtagg ctgtacagta attccgtctg cgtccggggg aagtgtgtga gaactggctg 2821 tgacggcatc attggctcaa agctgcagta tgacaagtgc ggagtatgtg gaggagacaa 2881 ctccagctgt acaaagattg ttggaacctt taataagaaa agtaagggtt acactgacgt 2941 ggtgaggatt cctgaagggg caacccacat aaaagttcga cagttcaaag ccaaagacca 3001 gactagattc actgcctatt tagccctgaa aaagaaaaac ggtgagtacc ttatcaatgg 3061 aaagtacatg atctccactt cagagactat cattgacatc aatggaacag tcatgaacta 3121 tagcggttgg agccacaggg atgacttcct gcatggcatg ggctactctg ccacgaagga 3181 aattctaata gtgcagattc ttgcaacaga ccccactaaa ccattagatg tccgttatag 3241 cttttttgtt cccaagaagt ccactccaaa agtaaactct gtcactagtc atggcagcaa 3301 taaagtggga tcacacactt cgcagccgca gtgggtcacg ggcccatggc tcgcctgctc 3361 taggacctgt gacacaggtt ggcacaccag aacggtgcag tgccaggatg gaaaccggaa 3421 gttagcaaaa ggatgtcctc tctcccaaag gccttctgcg tttaagcaat gcttgttgaa 3481 gaaatgttag cctgtggtta tgatcttatg cacaaagata actggaggat tcagcactga 3541 tgcagtcgtg gtgaacagga ggtctaccta acgcacagaa agtcatgctt cagtgacatt 3601 gtcaacagga gtccaattat gggcagaatc tgctctctgt gaccaaaaga ggatgtgcac 3661 tgcttcacgt gacagtggtg accttgcaat atagaaaaac ttgggagtta ttgaacatcc 3721 cctgggctta caagaaacac tgatgaatgt aaaatcaggg gacatttgaa gatggcagaa 3781 ctgtctcccc cttgtcacct acctctgata gaatgtcttt aatggtatca taatcatttt 3841 cacccataat acacagtagc ttcttcttac tgtttgtaaa tacattctcc cttggtatgt 3901 cactttatat cccctggttc tattaaaata tccatatata tttctataaa aaaagtgttt 3961 gaccaaagta ggtctgcagc tatttcaact tccttccgtt tccagaaaga gctgtggata 4021 ttttactgga aattaagaac ttgctgctgt tttaataaga tgtagtatat tttctgacta 4081 caggagataa aatttcagtc aaaaaaccat tttgacagca agtatcttct gagaaatttt 4141 gaaaagtaaa tagatctcag tgtatctagt cacttaaata catacacggg ttcatttact 4201 taaacctttg actgcctgta tttttttcag gtagctagcc aaattaatgc ataatttcag 4261 atgtagaagt agggtttgcg tgtgtgtgtg tgatcatact caagagtcta aaaactagtt 4321 tccttgtgtt ggaaatttaa aaggaaaaaa atcgtatttc actgtgtttt caatttatat 4381 tttcacaact actttctctc tccagagctt tcatctgata tctcacaatg tatgatatac 4441 gtacaaaaca cacagcaagt tttctatcat gtccaacaca ttcaacactg gtatacctcc 4501 taccagcaag cctttaaaat gcatttgtgt ttgcttattt gttttgttca agggttcagt 4561 aagacctaca atgttttgta tttcttgact tattttatta gaaacattaa agatcacttg 4621 gtagttagcc acattgagaa gtggttatca ttgttaatgt ggttaatgcc aaaaagtggt 4681 taatattaat aagactgttt ccacaccata ggcaataatt tcttaattta aaaaatctaa 4741 gtatattcct attgtactaa atatttttcc caactggaaa gcacttgatt gtacccgtaa 4801 gtgtttgagt gatgacatgt gatgattttc agaaagttgt tgtttttgtt tccatagcct 4861 gtttaagtag gttgtaagtt tgaatagtta gacatggaaa ttattttata agcacacacc 4921 taaagatatc tttttagatg ataaaatgta caccccccca tcaccaacct cacaacttag 4981 aaaatctaag ttgtttgatt tctttgggat ttcttttgtt gtgaaacact gcaaagccaa 5041 tttttcttta taaaaattca tagtaatcct gccaaatgtg cctattgtta aagatttgca 5101 tgtgaagatc ttagggaacc actgtttgag ttctacaagc tcatgagagt ttatttttat 5161 tataagatgt ttttaatata aaagaattat gtaactgatc actatattac atcatttcag 5221 tgggccagga aaatagatgt cttgctgttt tcagtatttt cttaagaaat tgcttttaaa 5281 acaaataatt gttttacaaa accaataatt atcctttgaa ttttcataga ctgactttgc 5341 ttttgacgta gaaatttttt ttctcaataa attatcactt tgagaaatga ggcctgtaca 5401 aggctgataa cctatatgtg atggagatca cccaatgcca agggcagaaa gcaaacctag 5461 ttaaataggt gagaaaaaaa ataataatcc cagtgccatt tgtctgtgca aagagaatta 5521 ggagagaggt taatgttact tttttccatt ttggaaataa ttttaatcaa gtaactcaaa 5581 tgtgacaaaa tttattttta ttttttgtgg ttatattccc aacaacatta aaaaatactc 5641 gaggcataaa tgtagttgtc tcctactctg cttctcttac tatactcata catttttaat 5701 atggtttatc aatgattcat gtttccctca aatagtgatg gtttacacct gtcatggaaa 5761 caatcctaga gagctcagag caattaaacc actattccat gcttttaagt agttttctcc 5821 acctttttct tatgagtctc actagattga ctgaggaatg tatgtctaaa ttcctggaga 5881 agatgatatg gattggaaac tgaaattcag agaaatggag tgttcaatag ataccacgaa 5941 ttgtgaacaa agggaaaatt ctatacaact caatctaagt cagtccactt tgacttcgta 6001 ctgtctttca cctttccatt gttgcatctt gaatttttta aaatgtctag aattcaggat 6061 gctaggggct acttctttaa aaaaaaaaaa aaaaaagaat tcgtctgaaa atgctcaggt 6121 ttgtaagaat ctaatctcac ttacataact aagcactcca taataagttt tattaagtac 6181 aaagggagcc agaaaaaatg acatttattt cttctagatc agaaaaattt aaattaagcc 6241 ctgccttgct gtttagaaat atgtgggcat tgttataatt tattcaataa atttatgttc 6301 ctttgccttc ctgtggaaac agttttatcc cactaaacta ggaattaggg gataaatcac 6361 aaacaaaaaa aaagttgcag cactgaaaaa aagtaattta ttgtttttgc aactggtatg 6421 tgaatttgtg tgataaaatt atttattctt atttaacaaa aatatgttca aatttttcta 6481 tatttaaaat gttttgctgt tgtcctactt tttaatttat gcttcatgtt tgtgtataaa 6541 gtacactttt acactttgtg agtttacata atatacagca ctggttgctt ttgtattttt 6601 ttacagaaag ctttctgtgt gaagcaggtg tatatgtata tattcctcat gtattcttat 6661 tctgatacta tcatttttct ttccaaggaa attttaatct gtcatgacca atagtgttca 6721 ttacttgtgc ctatgataat aggtttttta catcacatta acactatttt ttccaagtca 6781 caaataagaa aaacacttat tcaatgaaac aaggtgcaag ttttaaattt gggtacacaa 6841 atagcctaga agcttcctac agacgctaag acacagccaa taatcagatc ctttcacttc 6901 atcgagaaac ttggacaagt cgatattgat gtattagatg aaagttgtct acacacaact 6961 tctgagggat acaaacgata ataaaaccaa atgttgtctg tttctccttt agaaacacct 7021 cctaaaatta atatcattta gtctctagtg tctgtaggat tctacagatg agcacaaata 7081 gattgggttt gtataacaaa tgctaatagt cataactgtt tctacaaata tggggtgtcc 7141 attaagagaa tgtgatgttt tcctactgct gttgaatccc atggggtgat tataggactt 7201 gaaataggca gagtcacctc tgatgacatc agcttgcctc tgtgatttca cagtctgatc 7261 ctggcaacaa gacaaagcac ccttggacac acagccaatc tctggttgtg atatttcccc 7321 attgattcct tccttgttaa caaggtcatt ttaatggttc aggtgaggac agcagccaga 7381 ttcaaagtcc agaatttgtg ctgttacata gagttcacac tgtcaaataa cattgaattt 7441 aataatgatc aaatttttct agtagtcttt ggcagagtgt ataatctcat tggcatgatt 7501 ggtgaatatt actaatctct ttataatgaa agatgcttta caaatacctt atatttgcta 7561 acatttcaaa actactaaat aaatgaaata gccatgtgta cagaaatggt catttaaagc 7621 tttaatagaa ccaaattcaa gacaatgtat catttagaca cacagaaaag gaacttgtat 7681 gttttcccta ttatttttct catttgccaa caatctatag ttttaggtta tcaaacagat 7741 agatcaactt aactggctag tacattgaaa aatcttccta agaatccttt gttagcataa 7801 tctatagaga taatttctca aattatatca tcatgatgca tataaactct ataatgtata 7861 attgtgtttc atttatttaa tgtatgagaa catattgaaa tacaaaacca tgcattagcc 7921 aaaaaattgg aatacaggta gtgttcagat cagcaaaaca ttcagtctgg taaatgcctg 7981 cctggggcta tgatatcatt ctcaatgcag gttttatgga aaaactaaaa gaatatgttg 8041 ttagatgatg ttggttttga aaaaaaaaag acattaacat acacattagt tagcccagtt 8101 aattgcattc tactaatata gttgcacatt agcaataatt ttgctgtctc tggtctttat 8161 tttgtggctt caactaactg gaccatgtgg actgtaaagg tcaaatggaa aaaacgagca 8221 gtggcccctc atcctgtaag gtactgctac atcagagtga cctaaaagtc taacactgtg 8281 aggaaaactg tgatttgtag gaaaaaaaaa aaaaacaaat aaaaaacagg gcatgctttt 8341 taattttttt ccactttcct ttggcacacc caatgaacaa ttctaatttt tattgaggtg 8401 ctaacatctt tcgtgaccga ctgtcaaatg tggtattttt gagttactat ttttctacat 8461 gattttacag tttgcaagaa agacctctaa gctttgtgtc acggtagggc acaacttgat 8521 actcaaaatt tgaaaaataa gcacatccaa tgattgtttt gaccaacagt ggtcagtgac 8581 gtaaactgca tgtgcatctg aggacattta aggggtcatt aaaatttgag gagcatcagg 8641 ccggagtagc agacttttag atgagtcata tttcagcatt cactaagtcc tcagcattcc 8701 attcaaactg tcgtgtatat ttggcctgat tttttttcaa gctttgcaat aatttatgtt 8761 attggtaaac acttggtgac tatatctcag ccttttcttt aacaactcac aatatattag 8821 aaacacgtct acctatactg agagtatatt tacaatagaa gaacatactg tatgtgactt 8881 tgtaaagcta gacttttgat taagaaatat ataatctctg gatgctattt ttgcattata 8941 cactcaggca caacgtaaac cttgatggct catcttgcta caattacgag ttgaaaaaca 9001 ctacttacgt atttgtatga cctattagtc agaggaaatc atacatatgc tttgtaaata 9061 gactttgcag ataactaaat agactgaaga aatatgttgc atttgataga agcaattgca 9121 taaatatttg gtttctatat tagagtctgt gagtaaagtc aagtaataaa cctaagtagg 9181 tataacagat ttttaaacct tgaaacttgc tttgatggta gagaaaatca ttgaagattt 9241 acatactgta tataagatgt aaaatgtacg ctgcttatta ccctcaattt tccagaagca 9301 atggtatata atgcagttga aaaaccaaaa atcttggaaa actaagacgg gtcttgttta 9361 aaatgtctct cagctttggc aaccttcaaa tcttaatcaa ctatttaaag cattactgtg 9421 tcttgtagcc tgcattccac aacagctctg ttattcaggt aaaagacttg aactgagccg 9481 tttgggacct atactgtaat attttcattg aggaacaata tcctattttg taaagcattt 9541 ccctatgtgt gactttaaac tgtaaaatta aacactgctt ttgtgggttc agtgggcata 9601 ataaatataa attgtaaact a

Human matrix metalloeptidase 13 (MMP13) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_002418.1; SEQ ID NO: (103); GenBank Accession, incorporated herein by reference.

  1 mhpgvlaafl flswthcral plpsggdedd lseedlqfae rylrsyyhpt nlagilkena  61 assmterlre mqsffglevt gklddntldv mkkprcgvpd vgeynvfprt lkwskmnlty 121 rivnytpdmt hsevekafkk afkvwsdvtp lnftrlhdgi adimisfgik ehgdfypfdg 181 psgllahafp pgpnyggdah fdddetwtss skgynlflva ahefghslgl dhskdpgalm 241 fpiytytgks hfmlpdddvq giqslygpgd edpnpkhpkt pdkcdpslsl daitslrget 301 mifkdrffwr lhpqqvdael fltksfwpel pnridaayeh pshdlififr grkfwalngy 361 dilegypkki selglpkevk kisaavhfed tgktllfsgn qvwryddtnh imdkdyprli 421 eedfpgigdk vdavyekngy iyffngpiqf eysiwsnriv rvmpansilw c

Exemplary landmark residues, domains, and fragments of MMP13 include, but are not limited to residues 1-19 (signal sequence), residues 32-91 (Putative peptidoglycan binding domain), or residues 112-267 (peptidase m10). A fragment of a MMP13 protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., MMP13 residues in the case of MMP13 above.

Human MMP13 nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_002427.4; SEQ ID NO: (104); GenBank Accession, incorporated herein by reference.

1 aacagtcccc aggcatcacc attcaagatg catccagggg tcctggctgc cttcctcttc 61 ttgagctgga ctcattgtcg ggccctgccc cttcccagtg gtggtgatga agatgatttg 121 tctgaggaag acctccagtt tgcagagcgc tacctgagat catactacca tcctacaaat 181 ctcgcgggaa tcctgaagga gaatgcagca agctccatga ctgagaggct ccgagaaatg 241 cagtctttct tcggcttaga ggtgactggc aaacttgacg ataacacctt agatgtcatg 301 aaaaagccaa gatgcggggt tcctgatgtg ggtgaataca atgttttccc tcgaactctt 361 aaatggtcca aaatgaattt aacctacaga attgtgaatt acacccctga tatgactcat 421 tctgaagtcg aaaaggcatt caaaaaagcc ttcaaagttt ggtccgatgt aactcctctg 481 aattttacca gacttcacga tggcattgct gacatcatga tctcttttgg aattaaggag 541 catggcgact tctacccatt tgatgggccc tctggcctgc tggctcatgc ttttcctcct 601 gggccaaatt atggaggaga tgcccatttt gatgatgatg aaacctggac aagtagttcc 661 aaaggctaca acttgtttct tgttgctgcg catgagttcg gccactcctt aggtcttgac 721 cactccaagg accctggagc actcatgttt cctatctaca cctacaccgg caaaagccac 781 tttatgcttc ctgatgacga tgtacaaggg atccagtctc tctatggtcc aggagatgaa 841 gaccccaacc ctaaacatcc aaaaacgcca gacaaatgtg acccttcctt atcccttgat 901 gccattacca gtctccgagg agaaacaatg atctttaaag acagattctt ctggcgcctg 961 catcctcagc aggttgatgc ggagctgttt ttaacgaaat cattttggcc agaacttccc 1021 aaccgtattg atgctgcata tgagcaccct tctcatgacc tcatcttcat cttcagaggt 1081 agaaaatttt gggctcttaa tggttatgac attctggaag gttatcccaa aaaaatatct 1141 gaactgggtc ttccaaaaga agttaagaag ataagtgcag ctgttcactt tgaggataca 1201 ggcaagactc tcctgttctc aggaaaccag gtctggagat atgatgatac taaccatatt 1261 atggataaag actatccgag actaatagaa gaagacttcc caggaattgg tgataaagta 1321 gatgctgtct atgagaaaaa tggttatatc tattttttca acggacccat acagtttgaa 1381 tacagcatct ggagtaaccg tattgttcgc gtcatgccag caaattccat tttgtggtgt 1441 taagtgtctt tttaaaaatt gttatttaaa tcctgaagag catttggggt aatacttcca 1501 gaagtgcggg gtaggggaag aagagctatc aggagaaagc ttggttctgt gaacaagctt 1561 cagtaagtta tctttgaata tgtagtatct atatgactat gcgtggctgg aaccacattg 1621 aagaatgtta gagtaatgaa atggaggatc tctaaagagc atctgattct tgttgctgta 1681 caaaagcaat ggttgatgat acttcccaca ccacaaatgg gacacatggt ctgtcaatga 1741 gagcataatt taaaaatata tttataagga aattttacaa gggcataaag taaatacatg 1801 catataatga ataaatcatt cttactaaaa agtataaaat agtatgaaaa tggaaatttg 1861 ggagagccat acataaaaga aataaaccaa aggaaaatgt ctgtaataat agactgtaac 1921 ttccaaataa ataattttca ttttgcactg aggatattca gatgtatgtg cccttcttca 1981 cacagacact aacgaaatat caaagtcatt aaagacagga gacaaaagag cagtggtaag 2041 aatagtagat gtggcctttg aattctgttt aattttcact tttggcaatg actcaaagtc 2101 tgctctcata taagacaaat attcctttgc atattataaa ggataaagaa ggatgatgtc 2161 tttttattaa aatatttcag gttcttcaga agtcacacat tacaaagtta aaattgttat 2221 caaaatagtc taaggccatg gcatcccttt ttcataaatt atttgattat ttaagactaa 2281 aagttgcatt ttaaccctat tttacctagc taattattta attgtccagt ttgtcttgga 2341 tatataggct attttctaaa gacttgtata gcatgaaata aaatatatct tataaagtgg 2401 aagtatgtat attaaaaaag agacatccaa attttttttt aaagcagtct actagattgt 2461 gatcccttga gatatggaag gatgcctttt tttctctgca tttaaaaaaa tcccccagca 2521 cttcccacag tgcctattga tacttgggga gggtgcttgg cacttattga atatatgatc 2581 ggccatcaag ggaagaacta ttgtgctcag agacactgtt gataaaaact caggcaaaga 2641 aaatgaaatg catatttgca aagtgtatta ggaagtgttt atgttgttta taataaaaat 2701 atattttcaa caga

Human senescence-associated secretory phenotype interleukin-6 (SASP IL-6) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_000591.1; SEQ ID NO: (105); GenBank Accession, incorporated herein by reference.

  1 mnsfstsafg pvafslglll vlpaafpapv ppgedskdva aphrgpltsseridkqiryi  61 ldgisalrke tcnksnmces skealaennl nlpkmaekdg cfqsgfneet clvkiitgll 121 efevyleylq nrfesseeqa ravqmstkvl iqflqkkakn ldaittpdpt tnaslltklq 181 aqnqwlqdmt thlilrsfke flqsslralr qm

Exemplary landmark residues, domains, and fragments of SASP IL-6 include, but are not limited to residues 30-212 (interleukin 6) or residue 73 (glycosylation). A fragment of a SASP IL-6 protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., SASP IL-6 residues in the case of SASP IL-6 above.

Human SASP IL-6 nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_000600.5; SEQ ID NO: (106); GenBank Accession, incorporated herein by reference.

1 attctgccct cgagcccacc gggaacgaaa gagaagctct atctcccctc caggagccca 61 gctatgaact ccttctccac aagcgccttc ggtccagttg ccttctccct ggggctgctc 121 ctggtgttgc ctgctgcctt ccctgcccca gtacccccag gagaagattc caaagatgta 181 gccgccccac acagacagcc actcacctct tcagaacgaa ttgacaaaca aattcggtac 241 atcctcgacg gcatctcagc cctgagaaag gagacatgta acaagagtaa catgtgtgaa 301 agcagcaaag aggcactggc agaaaacaac ctgaaccttc caaagatggc tgaaaaagat 361 ggatgcttcc aatctggatt caatgaggag acttgcctgg tgaaaatcat cactggtctt 421 ttggagtttg aggtatacct agagtacctc cagaacagat ttgagagtag tgaggaacaa 481 gccagagctg tgcagatgag tacaaaagtc ctgatccagt tcctgcagaa aaaggcaaag 541 aatctagatg caataaccac ccctgaccca accacaaatg ccagcctgct gacgaagctg 601 caggcacaga accagtggct gcaggacatg acaactcatc tcattctgcg cagctttaag 661 gagttcctgc agtccagcct gagggctctt cggcaaatgt agcatgggca cctcagattg 721 ttgttgttaa tgggcattcc ttcttctggt cagaaacctg tccactgggc acagaactta 781 tgttgttctc tatggagaac taaaagtatg agcgttagga cactatttta attattttta 841 atttattaat atttaaatat gtgaagctga gttaatttat gtaagtcata tttatatttt 901 taagaagtac cacttgaaac attttatgta ttagttttga aataataatg gaaagtggct 961 atgcagtttg aatatccttt gtttcagagc cagatcattt cttggaaagt gtaggcttac 1021 ctcaaataaa tggctaactt atacatattt ttaaagaaat atttatattg tatttatata 1081 atgtataaat ggtttttata ccaataaatg gcattttaaa aaattca

Human Indian hedgehog (Ihh) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_002172.2; SEQ ID NO: (107); GenBank Accession, incorporated herein by reference.

1 msparlrprl hfclvlllll vvpaawgcgp grvvgsrrrp prklvplayk qfspnvpekt 61 lgasgryegk iarsserfke ltpnynpdii fkdeentgad rlmtqrckdr lnslaisvmn 121 qwpgvklrvt egwdedghhs eeslhyegra vdittsdrdr nkygllarla veagfdwvyy 181 eskahvhcsv ksehsaaakt ggcfpagaqv rlesgarval savrpgdrvl amgedgsptf 241 sdvlifldre phrlrafqvi etqdpprrla ltpahllfta dnhtepaarf ratfashvqp 301 gqyvlvagvp glqparvaav sthvalgaya pltkhgtlvv edvvascfaa vadhhlaqla 361 fwplrlfhsl awgswtpgeg vhwypqllyr lgrllleegs fhplgmsgag s

Exemplary landmark residues, domains, and fragments of Ihh include, but are not limited to residues 1-27 (signal peptide), residues 28-441 (mature peptide), residues 28-202 (IHH N-product), residues 44-189 (hedgehog amino terminal signaling domain) or residues 203-411 (IHH protein C-product). A fragment of a Ihh protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., Ihh residues in the case of Ihh above.

Human Ihh nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_002181.4; SEQ ID NO: (108); GenBank Accession, incorporated herein by reference.

1 actcggcccc gggctgcgcc gcagacggca gcagctcccg ctccgcccga gccgcctgac 61 cgccgggccg gggtgctaac cgcggggccc tgcagcccgc cggcccggcc agcccagccc 121 agcccggcgg cccgcagccc cgccgcccgc cgccccccgc cgccgccgcg ttgccaaaac 181 aaacgggccg gcctatttat tggcggccgg cgagcccggc agctcagagt cgaggcgccg 241 agggggacag cgcgccgcca ccagctcggg ccctgggccc ccgccccgca cttgagtccc 301 gccggccctg gccgcaccac gccgcccatg gcgcccccgc ctggagcccc ccggagccac 361 ccggacgcct gagcccccgc agcgctcccg tcgacgcgcc tgcccatcag cccaccagga 421 gacctcgccc gccgctcccc cgggctcccc ggccatgtct cccgcccggc tccggccccg 481 actgcacttc tgcctggtcc tgttgctgct gctggtggtg ccggcggcat ggggctgcgg 541 gccgggtcgg gtggtgggca gccgccggcg accgccacgc aaactcgtgc cgctcgccta 601 caagcagttc agccccaatg tgcccgagaa gaccctgggc gccagcggac gctatgaagg 661 caagatcgct cgcagctccg agcgcttcaa ggagctcacc cccaattaca atccagacat 721 catcttcaag gacgaggaga acacaggcgc cgaccgcctc atgacccagc gctgcaagga 781 ccgcctgaac tcgctggcta tctcggtgat gaaccagtgg cccggtgtga agctgcgggt 841 gaccgagggc tgggacgagg acggccacca ctcagaggag tccctgcatt atgagggccg 901 cgcggtggac atcaccacat cagaccgcga ccgcaataag tatggactgc tggcgcgctt 961 ggcagtggag gccggctttg actgggtgta ttacgagtca aaggcccacg tgcattgctc 1021 cgtcaagtcc gagcactcgg ccgcagccaa gacgggcggc tgcttccctg ccggagccca 1081 ggtacgcctg gagagtgggg cgcgtgtggc cttgtcagcc gtgaggccgg gagaccgtgt 1141 gctggccatg ggggaggatg ggagccccac cttcagcgat gtgctcattt tcctggaccg 1201 cgagcctcac aggctgagag ccttccaggt catcgagact caggaccccc cacgccgcct 1261 ggcactcaca cccgctcacc tgctctttac ggctgacaat cacacggagc cggcagcccg 1321 cttccgggcc acatttgcca gccacgtgca gcctggccag tacgtgctgg tggctggggt 1381 gccaggcctg cagcctgccc gcgtggcagc tgtctctaca cacgtggccc tcggggccta 1441 cgccccgctc acaaagcatg ggacactggt ggtggaggat gtggtggcat cctgcttcgc 1501 ggccgtggct gaccaccacc tggctcagtt ggccttctgg cccctgagac tctttcacag 1561 cttggcatgg ggcagctgga ctccggggga gggtgtgcat tggtaccccc agctgctcta 1621 ccgcctgggg cgtctcctgc tagaagaggg cagcttccac ccactgggca tgtccggggc 1681 agggagctga aaggactcca ccgctgccct cctggaactg ctgtactggg tccagaagcc 1741 tctcagccag gagggagctg gccctggaag ggacctgagc tgggggacac tggctcctgc 1801 catctcctct gccatgaaga tacaccattg agacttgact gggcaacacc agcgtccccc 1861 acccccgtcg tggtgtagtc atagagctgc aagctgagct ggcgagggga tggttgttga 1921 cccctctctc ctagagacct tgaggctggc acggcgactc ccaactcagc ctgctctcac 1981 tacgagtttt catactctgc ctcccccatt ggggagggcc cattccatcc atcttaggcc 2041 cctttgggtg ggcttgcgcc tcagttgatg ctgctaaatt ccctgggagc cagcatggat 2101 ctggctggac ccgatgctgt ccagaactgg gaaggccaca ggggtggggc agccatcccg 2161 gccattctga ggtatgacat tcctccccgg ccacactcct caagacacat ccagagactg 2221 ttgctgtctg tgggcagagt tctgtgttct ggccaatgtg accgtagtgc cggggactgg 2281 gggaggtggg ttggatgtgc ttgccacccc cccggctaag ctcccccttc tgctgaacca 2341 tgatccccac cccctccgcc ggtcagtctc ccatacctta tttattggag tggaggggga 2401 agcccatggg agaattttgg ggatgttttg gtcttttctt ccttttgtaa taaaaattat 2461 ttaagttgtt aga

Human interferon type 1 (IFN) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_000407.1; SEQ ID NO: (109); GenBank Accession, incorporated herein by reference.

  1 mallfllplv mqgvsraemg tadlgpssvp tptnvtiesy nmnpivywey qimpqvpvft  61 vevknygvkn sewidacini shhycnisdh vgdpsnslwv rvkarvgqke sayakseefa 121 vcrdgkigpp kldirkeekq imidifhpsv fvngdeqevd ydpettcyir vynvyvrmng 181 seiqykiltq keddcdeiqc qlaipvssln sqycvsaegv lhvwgvttek skevcitifn 241 ssikgslwip vvaalllflv lslvficfyi kkinplkeks iilpkslisv vrsatletkp 301 eskyvslits yqpfslekev vceeplspat vpgmhtednp gkvehteels sitevvttee 361 nipdvvpgsh ltpieresss plssnqsepg sialnsyhsr ncsesdhsrn gfdtdsscle 421 shsslsdsef ppnnkgeikt egqelitvik aptsfgydkp hvlvdllvdd sgkesligyr 481 ptedskefs

Exemplary landmark residues, domains, and fragments of IFN include, but are not limited to residues 1-77 (signal peptide), residues 18-489 (mature peptide), or residues 161-317 (Interferon gamma receptor (IFNGR1)). A fragment of a IFN protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., IFN residues in the case of IFN above.

Human IFN nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_000416.2; SEQ ID NO: (110); GenBank Accession, incorporated herein by reference.

1 acagaccccg gtgacggaag tgacgtaagg ccggggctgg agggcagtgc tgggctggtc 61 ccgcaggcgc tcggggttgg agccagcgac cgtcggtagc agcatggctc tcctctttct 121 cctacccctt gtcatgcagg gtgtgagcag ggctgagatg ggcaccgcgg atctggggcc 181 gtcctcagtg cctacaccaa ctaatgttac aattgaatcc tataacatga accctatcgt 241 atattgggag taccagatca tgccacaggt ccctgttttt accgtagagg taaagaacta 301 tggtgttaag aattcagaat ggattgatgc ctgcatcaat atttctcatc attattgtaa 361 tatttctgat catgttggtg atccatcaaa ttctctttgg gtcagagtta aagccagggt 421 tggacaaaaa gaatctgcct atgcaaagtc agaagaattt gctgtatgcc gagatggaaa 481 aattggacca cctaaactgg atatcagaaa ggaggagaag caaatcatga ttgacatatt 541 tcacccttca gtttttgtaa atggagacga gcaggaagtc gattatgatc ccgaaactac 601 ctgttacatt agggtgtaca atgtgtatgt gagaatgaac ggaagtgaga tccagtataa 661 aatactcacg cagaaggaag atgattgtga cgagattcag tgccagttag cgattccagt 721 atcctcactg aattctcagt actgtgtttc agcagaagga gtcttacatg tgtggggtgt 781 tacaactgaa aagtcaaaag aagtttgtat taccattttc aatagcagta taaaaggttc 841 tctttggatt ccagttgttg ctgctttact actctttcta gtgcttagcc tggtattcat 901 ctgtttttat attaagaaaa ttaatccatt gaaggaaaaa agcataatat tacccaagtc 961 cttgatctct gtggtaagaa gtgctacttt agagacaaaa cctgaatcaa aatatgtatc 1021 actcatcacg tcataccagc cattttcctt agaaaaggag gtggtctgtg aagagccgtt 1081 gtctccagca acagttccag gcatgcatac cgaagacaat ccaggaaaag tggaacatac 1141 agaagaactt tctagtataa cagaagtggt gactactgaa gaaaatattc ctgacgtggt 1201 cccgggcagc catctgactc caatagagag agagagttct tcacctttaa gtagtaacca 1261 gtctgaacct ggcagcatcg ctttaaactc gtatcactcc agaaattgtt ctgagagtga 1321 tcactccaga aatggttttg atactgattc cagctgtctg gaatcacata gctccttatc 1381 tgactcagaa tttcccccaa ataataaagg tgaaataaaa acagaaggac aagagctcat 1441 aaccgtaata aaagccccca cctcctttgg ttatgataaa ccacatgtgc tagtggatct 1501 acttgtggat gatagcggta aagagtcctt gattggttat agaccaacag aagattccaa 1561 agaattttca tgagatcagc taagttgcac caactttgaa gtctgatttt cctggacagt 1621 tttctgcttt aatttcatga aaagattatg atctcagaaa ttgtatctta gttggtatca 1681 accaaatgga gtgacttagt gtacatgaaa gcgtaaagag gatgtgtggc attttcactt 1741 ttggcttgta aagtacagac tttttttttt ttttaaacaa aaaaagcatt gtaacttatg 1801 aacctttaca tccagatagg ttaccagtaa cggaacagta tccagtactc ctggttccta 1861 ggtgagcagg tgatgcccca gggacctttg tagccacttc actttttttc ttttctctgc 1921 cttggtatag catatgtttt tgtaagttta tgcatacagt aattttaagt aatttcagaa 1981 gaaattctgc aagcttttca aaattggact taaaatctaa ttcaaactaa tagaattaat 2041 ggaatatgta aatagaaacg tgtatatttt ttatgaaaca ttacagttag agatttttaa 2101 ataaagaatt ttaaaactcg aaaaaaaaaa aaaaaaaa

Anabolic Markers

Exemplary osteoarthritis markers comprise aggrecan (ACAN) and Collagen, type II, alpha 1 (COL2A1).

Human aggrecan (ACAN) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_001126.3; SEQ ID NO: (111); GenBank Accession, incorporated herein by reference.

1 mttllwvfvt lrvitaavtv etsdhdnsls vsipqpsplr vllgtsltip cyfidpmhpv 61 ttapstapla prikwsrvsk ekevvllvat egrvrvnsay qdkvslpnyp aipsdatlev 121 qslrsndsgv yrcevmhgie dseatlevvv kgivfhyrai strytldfdr aqraclqnsa 181 iiatpeqlqa ayedgfhqcd agwladqtvr ypihtpregc ygdkdefpgv rtygirdtne 241 tydvycfaee megevfyats pekftfqeaa necrrlgarl attgqlylaw qagmdmcsag 301 wladrsvryp iskarpncgg nllgvrtvyv hanqtgypdp ssrydaicyt gedfvdipen 361 ffgvggeedi tvqtvtwpdm elplprnite geargsvilt vkpifevsps plepeepftf 421 apeigatafa evenetgeat rpwgfptpgl gpataftsed lvvqvtavpg qphlpggvvf 481 hyrpgptrys ltfeeaqqac lrtgaviasp eqlqaayeag yeqcdagwlr dqtvrypivs 541 prtpcvgdkd sspgvrtygv rpstetydvy cfvdrlegev ffatrleqft fqealefces 601 hnatlattgq lyaawsrgld kcyagwladg slrypivtpr pacggdkpgv rtvylypnqt 661 glpdplsrhh afcfrgisav pspgeeeggt ptspsgveew ivtqvvpgva avpveeetta 721 vpsgettail efttepenqt ewepaytpvg tsplpgilpt wpptgaatee stegpsatev 781 psaseepsps evpfpseeps pseepfpsvr pfpsvelfps eepfpskeps pseepsasee 841 pytpsppvps wtelpssgee sgapdvsgdf tgsgdvsghl dfsgqlsgdr asglpsgdld 901 ssgltstvgs glpvesglps gdeeriewps tptvgelpsg aeilegsasg vgdlsglpsg 961 evletsasgv gdlsglpsge vlettapgve disglpsgev lettapgved isglpsgevl 1021 ettapgvedi sglpsgevle ttapgvedis glpsgevlet tapgvedisg lpsgevlett 1081 apgvedisgl psgevletaa pgvedisglp sgevletaap gvedisglps gevletaapg 1141 vedisglpsg evletaapgv edisglpsge vletaapgve disglpsgev letaapgved 1201 isglpsgevl etaapgvedi sglpsgevle taapgvedis glpsgevlet aapgvedisg 1261 lpsgevleta apgvedisgl psgevletaa pgvedisglp sgevletaap gvedisglps 1321 gevletaapg vedisglpsg evletaapgv edisglpsge vletaapgve disglpsgev 1381 letaapgved isglpsgevl ettapgveei sglpsgevle ttapgvdeis glpsgevlet 1441 tapgveeisg lpsgevlets tsavgdlsgl psggevleis vsgvedisgl psgevvetsa 1501 sgiedvselp sgegletsas gvedlsrlps geevleisas gfgdlsglps ggegletsas 1561 evgtdlsglp sgregletsa sgaedlsglp sgkedlvgsa sgdldlgklp sgtlgsgqap 1621 etsglpsgfs geysgvdlgs gppsglpdfs glpsgfptvs lvdstivevv tastaseleg 1681 rgtigisgag eisglpssel disgrasglp sgtelsgqas gspdvsgeip glfgvsgqps 1741 gfpdtsgets gvtelsglss gqpgisgeas gvlygtsqpf gitdlsgets gvpdlsgqps 1801 glpgfsgats gvpdlvsgtt sgsgessgit fvdtslveva pttfkeeegl gsvelsglps 1861 geadlsgksg mvdvsgqfsg tvdssgftsq tpefsglpsg iaevsgessr aeigsslpsg 1921 ayygsgtpss fptvslvdrt lvesvtqapt aqeagegpsg ilelsgahsg apdmsgehsg 1981 fldlsglqsg liepsgeppg tpyfsgdfas ttnvsgessv amgtsgeasg lpevtlitse 2041 fvegvtepti sgelggrppv thtpqlfess gkvstagdis gatpvlpgsg vevssvpess 2101 setsaypeag fgasaapeas redsgspdls ettsafhean lerssglgvs gstltfgege 2161 asaapevsge stttsdvgte apglpsatpt asgdrteisg dlsghtsqlg vvistsipes 2221 ewtqqtqrpa ethleiesss llysgeetht vetatsptda sipaspewkr esestaadqe 2281 vceegwnkyq ghcyrhfpdr etwvdaerrc reqqshlssi vtpeeqefvn nnagdygwig 2341 lndrtiegdf rwsdghpmqf enwrpnqpdn ffaagedcvv miwhekgewn dvpcnyhlpf 2401 tckkgtatty krrlqkrssr hprrsrpsta h

Exemplary landmark residues, domains, and fragments of ACAN include, but are not limited to residues 1-16 (signal sequence), residues 20-2431 (mature protein), residues 43-154 (IG Aggrecan), residues 153-247 (link domain), or residues 579-674 (link domain CSPGs). A fragment of a ACAN protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., ACAN residues in the case of ACAN above.

Human ACAN nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_001135.3; SEQ ID NO: (112); GenBank Accession, incorporated herein by reference.

1 cacctacctc cccgccgctc cagagggggc tcgcagagct gaggacgcgc gcagcgctgc 61 tcaaggtctc tctctctcag caccctcgcc ggccggcgtc tgacgcgggt gccagggtct 121 ccgggcacct ttcagtgtcc attccctcag ccagccagga ctccgcaacc cagcagttgc 181 cgctgcggcc acagcccgag gggacctgcg gacaggacgc cggcaggagg aggggtgcgc 241 agcgcccgcg cagagcgtct ccctcgctac gcagcgagac ccgggcctcc cggccccagg 301 agcccccagc tgcctcgcca ggtgtgtggg actgaagttc ttggagaagg gagtccaact 361 cttcaaggtg aactatgacc actttactct gggttttcgt gactctgagg gtcatcactg 421 cagctgtcac tgtagaaact tcagaccatg acaactcgct gagtgtcagc atcccccaac 481 cgtccccgct gagggtcctc ctggggacct ccctcaccat cccctgctat ttcatcgacc 541 ccatgcaccc tgtgaccacc gccccttcta ccgccccact ggccccaaga atcaagtgga 601 gccgtgtgtc caaggagaag gaggtagtgc tgctggtggc cactgaaggg cgcgtgcggg 661 tcaacagtgc ctatcaggac aaggtctcac tgcccaacta cccggccatc cccagtgacg 721 ccaccttgga agtccagagc ctgcgctcca atgactctgg ggtctaccgc tgcgaggtga 781 tgcatggcat cgaggacagc gaggccaccc tggaagtcgt ggtgaaaggc atcgtgttcc 841 attacagagc catctctaca cgctacaccc tcgactttga cagggcgcag cgggcctgcc 901 tgcagaacag tgccatcatt gccacgcctg agcagctgca ggccgcctac gaagacggct 961 tccaccagtg tgacgccggc tggctggctg accagactgt cagatacccc atccacactc 1021 cccgggaagg ctgctatgga gacaaggatg agtttcctgg tgtgaggacg tatggcatcc 1081 gagacaccaa cgagacctat gatgtgtact gcttcgccga ggagatggag ggtgaggtct 1141 tttatgcaac atctccagag aagttcacct tccaggaagc agccaatgag tgccggcggc 1201 tgggtgcccg gctggccacc acgggccagc tctacctggc ctggcaggct ggcatggaca 1261 tgtgcagcgc cggctggctg gccgaccgca gcgtgcgcta ccccatctcc aaggcccggc 1321 ccaactgcgg tggcaacctc ctgggcgtga ggaccgtcta cgtgcatgcc aaccagacgg 1381 gctaccccga cccctcatcc cgctacgacg ccatctgcta cacaggtgaa gactttgtgg 1441 acatcccaga aaacttcttt ggagtggggg gtgaggagga catcaccgtc cagacagtga 1501 cctggcctga catggagctg ccactgcctc gaaacatcac tgagggtgaa gcccgaggca 1561 gcgtgatcct taccgtaaag cccatcttcg aggtctcccc cagtcccctg gaacccgagg 1621 agcccttcac gtttgcccct gaaatagggg ccactgcctt cgctgaggtt gagaatgaga 1681 ctggagaggc caccaggccc tggggctttc ccacacctgg cctgggccct gccacggcat 1741 tcaccagtga ggacctcgtc gtgcaggtga ccgctgtccc tgggcagccg catttgccag 1801 ggggggtcgt cttccactac cgcccgggac ccacccgcta ctcgctgacc tttgaggagg 1861 cacagcaggc ctgcctgcgc acgggggcgg tcattgcctc gccggagcag ctccaggccg 1921 cctacgaagc aggctatgag cagtgtgacg ccggctggct gcgggaccag accgtcagat 1981 accccattgt gagcccccgg accccatgcg tgggtgacaa ggacagcagc ccaggggtca 2041 ggacctatgg cgtgcgccca tcaacagaga cctacgatgt ctactgcttt gtagacagac 2101 ttgaggggga ggtgttcttc gccacacgcc ttgagcagtt caccttccag gaagcactgg 2161 agttctgtga atctcacaat gctacgctgg ccaccacggg ccagctctac gccgcctgga 2221 gccgcggcct ggacaagtgc tatgccggct ggctggccga cggcagcctc cgctacccca 2281 tcgtcacccc aaggcctgcc tgcggtgggg acaagccagg cgtgagaacg gtctacctct 2341 accctaacca gacgggcctc ccagacccac tgtcccggca ccatgccttc tgcttccgag 2401 gcatttcagc ggttccttct ccaggagaag aagagggtgg cacacccaca tcaccctctg 2461 gtgtggagga gtggatcgtg acccaagtgg ttcctggtgt ggctgctgtc cccgtagaag 2521 aggagacaac tgctgtaccc tcaggggaga ctactgccat cctagagttc accaccgagc 2581 cagaaaacca gacagaatgg gaaccagcct ataccccagt gggcacatcc ccgctgccag 2641 ggatccttcc tacttggcct cccactggcg cagcaacaga ggaaagtaca gaaggccctt 2701 ctgcaactga agtgccctct gcctcagagg aaccatcccc ctcagaggtg ccattcccct 2761 cagaggagcc atccccctca gaggaaccat tcccctcagt gaggccattc ccctcagtgg 2821 agctgttccc ctcagaggag ccattcccct ccaaggagcc atccccctca gaggaaccat 2881 cagcctcgga agagccgtat acaccttcac cccccgtgcc cagctggact gagctgccca 2941 gctctgggga ggaatctggg gcccctgatg tcagtggtga cttcacaggc agtggagatg 3001 tttcaggaca ccttgacttc agtgggcagc tgtcagggga cagggcaagt ggactgccct 3061 ctggagacct ggactccagt ggtcttactt ccacagtggg ctcaggcctg cctgtggaaa 3121 gtggactacc ctcaggggat gaagagagaa ttgagtggcc cagcactcct acggttggtg 3181 aactgccctc tggagctgag atcctagagg gctctgcctc tggagttggg gatctcagtg 3241 gacttccttc tggagaagtt ctagagacct ctgcctctgg agtaggagac ctcagtgggc 3301 ttccttctgg agaagttcta gagaccactg cccctggagt agaggacatc agcgggcttc 3361 cttctggaga agttctagag accactgccc ctggagtaga ggacatcagc gggcttcctt 3421 ctggagaagt tctagagacc actgcccctg gagtagagga catcagcggg cttccttctg 3481 gagaagttct agagaccact gcccctggag tagaggacat cagcgggctt ccttctggag 3541 aagttctaga gaccactgcc cctggagtag aggacatcag cgggcttcct tctggagaag 3601 ttctagagac cactgcccct ggagtagagg acatcagcgg gcttccttct ggagaagttc 3661 tagagaccgc tgcccctgga gtagaggaca tcagcgggct tccttctgga gaagttctag 3721 agaccgctgc ccctggagta gaggacatca gcgggcttcc ttctggagaa gttctagaga 3781 ccgctgcccc tggagtagag gacatcagcg ggcttccttc tggagaagtt ctagagaccg 3841 ctgcccctgg agtagaggac atcagcgggc ttccttctgg agaagttcta gagaccgctg 3901 cccctggagt agaggacatc agcgggcttc cttctggaga agttctagag accgctgccc 3961 ctggagtaga ggacatcagc gggcttcctt ctggagaagt tctagagacc gctgcccctg 4021 gagtagagga catcagcggg cttccttctg gagaagttct agagactgct gcccctggag 4081 tagaggacat cagcgggctt ccttctggag aagttctaga gactgctgcc cctggagtag 4141 aggacatcag cgggcttcct tctggagaag ttctagagac tgctgcccct ggagtagagg 4201 acatcagcgg gcttccttct ggagaagttc tagagactgc tgcccctgga gtagaggaca 4261 tcagcgggct tccttctgga gaagttctag agactgctgc ccctggagta gaggacatca 4321 gcgggcttcc ttctggagaa gttctagaga ctgctgcccc tggagtagag gacatcagcg 4381 ggcttccttc tggagaagtt ctagagactg ctgcccctgg agtagaggac atcagcgggc 4441 ttccttctgg agaagttcta gagactgctg cccctggagt agaggacatc agcgggcttc 4501 cttctggaga agttctagag actgctgccc ctggagtaga ggacatcagc gggcttcctt 4561 ctggagaagt tctagagact actgcccctg gagtagagga gatcagcggg cttccttctg 4621 gagaagttct agagactact gcccctggag tagatgagat cagtgggctt ccttctggag 4681 aagttctaga gactactgcc cctggagtag aggagatcag cgggcttcct tctggagaag 4741 ttctagagac ttctacctct gcggtagggg acctcagtgg acttccttct ggaggagaag 4801 ttctagagat ttctgtctct ggagtagagg acatcagtgg gcttccttct ggagaggttg 4861 tagagacttc tgcctctgga atagaggatg tcagtgaact tccttcagga gaaggtctag 4921 agacctctgc ttctggagta gaggacctca gcaggctccc ttctggagaa gaagttctag 4981 agatttctgc ctctggattt ggggacctca gtggacttcc ttctggagga gaaggtctag 5041 agacctctgc ttctgaagta gggactgacc tcagtgggct tccttctgga agggagggtc 5101 tagagacttc agcttctgga gctgaggacc tcagtgggtt gccttctgga aaagaagact 5161 tggtggggtc agcttctgga gacttggact tgggcaaact gccttctgga actctaggaa 5221 gtgggcaagc tccagaaaca agtggtcttc cctctggatt tagtggtgag tattctgggg 5281 tggaccttgg aagtggccca ccctctggcc tgcctgactt tagtggactt ccatctggat 5341 tcccaactgt ttccctagtg gattctacat tggtggaagt ggtcacagcc tccactgcaa 5401 gtgaactgga agggagggga accattggca tcagtggtgc aggagaaata tctggactgc 5461 cctccagtga gctggacatt agtgggagag ctagtggact cccttcagga actgaactca 5521 gtggccaagc atctgggtct cctgatgtca gtggggaaat acctggactc tttggtgtca 5581 gtggacagcc atcagggttt cctgacacta gtggggaaac atctggagtg actgagctta 5641 gcgggctgtc ctctggacaa ccaggtatta gtggagaagc atctggagtt ctttatggca 5701 ctagtcaacc ctttggcata actgatctga gtggagaaac atctggggtc cctgatctca 5761 gtgggcagcc ttcagggtta ccagggttca gtggggcaac atcaggagtc cctgacctgg 5821 tttctggtac cacgagtggc agcggtgaat cttctgggat tacatttgtg gacaccagtt 5881 tggttgaagt ggcccctact acatttaaag aagaagaagg cttagggtct gtggaactca 5941 gtggcctccc ttccggagag gcagatctgt caggcaaatc tgggatggtg gatgtcagtg 6001 gacagttttc tggaacagtc gattccagtg ggtttacatc ccagactccg gaattcagtg 6061 gcctaccaag tggcatagct gaggtcagtg gagaatcctc cagagctgag attgggagca 6121 gcctgccctc gggagcatat tatggcagtg gaactccatc tagtttcccc actgtctctc 6181 ttgtagacag aactttggtg gaatctgtaa cccaggctcc aacagcccaa gaggcaggag 6241 aagggccttc tggcatttta gaactcagtg gtgctcattc tggagcacca gacatgtctg 6301 gggagcattc tggatttctg gacctaagtg ggctgcagtc cgggctgata gagcccagcg 6361 gagagccacc aggtactcca tattttagtg gggattttgc cagcaccacc aatgtaagtg 6421 gagaatcctc tgtagccatg ggcaccagtg gagaggcctc aggacttcca gaagttactt 6481 taatcacttc tgagttcgtg gagggtgtta ctgaaccaac tatttctcag gaactaggcc 6541 aaaggccccc tgtgacacac acaccccagc tttttgagtc cagtggaaaa gtctccacag 6601 ctggggacat tagtggagct accccagtgc tccctgggtc tggagtagaa gtatcatcag 6661 tcccagaatc tagcagtgag acgtccgcct atcctgaagc tgggttcggg gcatctgccg 6721 cccctgaggc cagcagagaa gattctgggt cccctgatct gagtgaaacc acctctgcat 6781 tccacgaagc taaccttgag agatcctctg gcctaggagt gagcggcagc actttgacat 6841 ttcaagaagg cgaggcgtcc gctgccccag aagtgagtgg agaatccacc accaccagtg 6901 atgtggggac agaggcacca ggcttgcctt cagccactcc cacggcttct ggagacagga 6961 ctgaaatcag cggagacctg tctggtcaca cctcgcagct gggcgttgtc atcagcacca 7021 gcatcccaga gtctgagtgg acccagcaga cccagcgccc tgcagagacg catctagaaa 7081 ttgagtcctc aagcctcctg tactcaggag aagagactca cacagtcgaa acagccacct 7141 ccccaacaga tgcttccatc ccagcttctc cggaatggaa acgtgaatca gaatcaactg 7201 ctgcagacca ggaggtatgt gaggagggct ggaacaagta ccagggccac tgttaccgcc 7261 acttcccgga ccgcgagacc tgggtggatg ctgagcgccg gtgtcgggag cagcagtcac 7321 acctgagcag catcgtcacc cccgaggagc aggagtttgt caacaacaat gcccaagact 7381 accagtggat cggcctgaac gacaggacca tcgaagggga cttccgctgg tcagatggac 7441 accccatgca atttgagaac tggcgcccca accagcctga caactttttt gccgctggag 7501 aggactgtgt ggtgatgatc tggcacgaga agggcgagtg gaatgatgtt ccctgcaatt 7561 accacctccc cttcacgtgt aaaaagggca cagccaccac ctacaaacgc agactacaga 7621 agcggagctc acggcaccct cggaggagcc gccccagcac agcccactga gaagagcttc 7681 caggacgcac ccaggacgct gagcccagga gcctgccagg ctgacgtgca tcccacccag 7741 acggtgtcct cttcttgtcg ctttttgtca tataaggaat cccattaaag aaggaaaaaa 7801 ataaatccca catttgtgta tgcacccact cacccctcca aatcagcaaa accgcatcta 7861 atttgtccgc cgaatgccaa agcaaagcaa acttattata acccttggac tgagtttaga 7921 gacatttctt caatttccca tcgtgccttt ccagggacca gtgcagggac agggggagaa 7981 ggggaggggt taagttaaat aaagaagatt atttttgttt cctgacttta tccaagagca 8041 gtgcaatcgt tggttatttc acctccaggg agagctaggg aggagggagg agggctccaa 8101 aggagctgga aggagcagag gcctgagagc aggaagaact cggaaccgca gctgaatgta 8161 ttggatgaga aggagccagg agggctacac catctgtatg agggaaaagc cttgggggag 8221 aggggtgggt tcctgcctcc tgccgagggt aagccggcag gagagagcca tcagagggac 8281 ctccgctgcc tgggagttgg gttccctcca agggtccctc tttcagtgtc ctctctctca 8341 cctgggtctg ccaccctaac aggtggcaac tcggcagggc tgctgggggc acttcctgcc 8401 cagtgggggg tgccgcccaa ccttctcccc tccccacccc cgcccccggg accgtgcagg 8461 caccagggtt ccgtgcacct atttatattt ttgaaaactg aagattataa tattataata 8521 ataataaaga cattggaaga gat

Human Collagen, type II, alpha 1 (COL2A1) amino acid sequence is publicly available and can be found under GenBank Accession Number: NP_001835.3; SEQ ID NO: (113); GenBank Accession, incorporated herein by reference.

1 mirlgapqtl vlltllvaav lrcqgqdvqe agscvqdgqr yndkdvwkpe pericvcdtg 61 tvlcddiice dvkdclspei pfgeccpicp tdlatasgqp gpkgqkgepg dikdivgpkg 121 ppgpqgpage qgprgdrgdk gekgapgprg rdgepgtpgn pgppgppgpp gppglggnfa 181 aqmaggfdek aggaqlgvmq gpmgpmgprg ppgpagapgp qgfqgnpgep gepgvsgpmg 241 prgppgppgk pgddgeagkp gkagergppg pqgargfpgt pglpgvkghr gypgldgakg 301 eagapgvkge sgspgengsp gpmgprglpg ergrtgpaga agargndgqp gpagppgpvg 361 paggpgfpga pgakgeagpt gargpegaqg prgepgtpgs pgpagasgnp gtdgipgakg 421 sagapgiaga pgfpgprgpp gpqgatgplg pkgqtgepgi agfkgeqgpk gepgpagpqg 481 apgpageegk rgargepggv gpigppgerg apgnrgfpgq dglagpkgap gergpsglag 541 pkgangdpgr pgepglpgar gltgrpgdag pqgkvgpsga pgedgrpgpp gpqgargqpg 601 vmgfpgpkga ngepgkagek glpgapglrg lpgkdgetga agppgpagpa gergeqgapg 661 psgfqglpgp pgppgeggkp gdqgvpgeag apglvgprge rgfpgergsp gagglqgprg 721 lpgtpgtdgp kgasgpagpp gaggppglqg mpgergaagi agpkgdrgdv gekgpegapg 781 kdggrgltgp igppgpagan gekgevgppg pagsagarga pgergetgpp gpagfagppg 841 adgqpgakge ggeagqkgda gapgpqgpsg apgpqgptgv tgpkgargaq gppgatgfpg 901 aagrvgppgs ngnpgppgpp gpsgkdgpkg argdsgppgr agepglqgpa gppgekgepg 961 ddgpsgaegp pgpqglagqr givglpgqrg ergfpglpgp sgepgkqgap gasgdrgppg 1021 pvgppgltgp agepgregsp gadgppgrdg aagvkgdrge tgavgapgap gppgspgpag 1081 ptgkqgdrge agaqgpmgps gpagargiqg pqgprgdkge agepgerglk ghrgftglqg 1141 lpgppgpsgd qgasgpagps gprgppgpvg psgkdgangi pgpigppgpr grsgetgpag 1201 ppgnpgppgp pgppgpgidm safaglgpre kgpdplqymr adqaagglrq hdaevdatlk 1261 slnnqiesir spegsrknpa rtcrdlklch pewksgdywi dpnqgctlda mkvfcnmetg 1321 etcvypnpan vpkknwwssk skekkhiwfg etinggfhfs ygddnlapnt anvqmtflrl 1381 lstegsgnit yhcknsiayl deaagnlkka lliqgsndve iraegnsrft ytalkdgctk 1441 htgkwgktvi eyrsqktsrl piidiapmdi ggpeqefgvd igpvcfl

Exemplary landmark residues, domains, and fragments of COL2A1 include, but are not limited to residues 1-25 (signal sequence), residues 26-1487 (mature protein), residues 201-1214 (triple helical region), or residue 1388 (glycosylation). A fragment of a COL2A1 protein is less than the length of the full length protein, e.g., a fragment is at least 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200 or more residues in length, but less than e.g., COL2A1 residues in the case of COL2A1 above.

Human COL2A1 nucleic acid sequence is depicted below with start and stop codons underlined. The sequence is publicly available and can be found under GenBank Accession Number: NM_001844.5; SEQ ID NO: (114); GenBank Accession, incorporated herein by reference.

1 gcagagcgct gctgggctgc cgggtctccc gcttccccct cctgctccaa gggcctcctg 61 catgagggcg cggtagagac ccggacccgc gccgtgctcc tgccgtttcg ctgcgctccg 121 cccgggcccg gctcagccag gccccgcggt gagccatgat tcgcctcggg gctccccaga 181 cgctggtgct gctgacgctg ctcgtcgccg ctgtccttcg gtgtcagggc caggatgtcc 241 aggaggctgg cagctgtgtg caggatgggc agaggtataa tgataaggat gtgtggaagc 301 cggagccctg ccggatctgt gtctgtgaca ctgggactgt cctctgcgac gacataatct 361 gtgaagacgt gaaagactgc ctcagccctg agatcccctt cggagagtgc tgccccatct 421 gcccaactga cctcgccact gccagtgggc aaccaggacc aaagggacag aaaggagaac 481 ctggagacat caaggatatt gtaggaccca aaggacctcc tgggcctcag ggacctgcag 541 gggaacaagg acccagaggg gatcgtggtg acaaaggtga aaaaggtgcc cctggacctc 601 gtggcagaga tggagaacct gggacccctg gaaatcctgg cccccctggt cctcccggcc 661 cccctggtcc ccctggtctt ggtggaaact ttgctgccca gatggctgga ggatttgatg 721 aaaaggctgg tggcgcccag ttgggagtaa tgcaaggacc aatgggcccc atgggacctc 781 gaggacctcc aggccctgca ggtgctcctg ggcctcaagg atttcaaggc aatcctggtg 841 aacctggtga acctggtgtc tctggtccca tgggtccccg tggtcctcct ggtccccctg 901 gaaagcctgg tgatgatggt gaagctggaa aacctggaaa agctggtgaa aggggtccgc 961 ctggtcctca gggtgctcgt ggtttcccag gaaccccagg ccttcctggt gtcaaaggtc 1021 acagaggtta tccaggcctg gacggtgcta agggagaggc gggtgctcct ggtgtgaagg 1081 gtgagagtgg ttccccgggt gagaacggat ctccgggccc aatgggtcct cgtggcctgc 1141 ctggtgaaag aggacggact ggccctgctg gcgctgcggg tgcccgaggc aacgatggtc 1201 agccaggccc cgcagggcct ccgggtcctg tcggtcctgc tggtggtcct ggcttccctg 1261 gtgctcctgg agccaagggt gaagccggcc ccactggtgc ccgtggtcct gaaggtgctc 1321 aaggtcctcg cggtgaacct ggtactcctg ggtcccctgg gcctgctggt gcctccggta 1381 accctggaac agatggaatt cctggagcca aaggatctgc tggtgctcct ggcattgctg 1441 gtgctcctgg cttccctggg ccacggggcc ctcctggccc tcaaggtgca actggtcctc 1501 tgggcccgaa aggtcagacg ggtgaacctg gtattgctgg cttcaaaggt gaacaaggcc 1561 ccaagggaga acctggccct gctggccccc agggagcccc tggacccgct ggtgaagaag 1621 gcaagagagg tgcccgtgga gagcctggtg gcgttgggcc catcggtccc cctggagaaa 1681 gaggtgctcc cggcaaccgc ggtttcccag gtcaagatgg tctggcaggt cccaagggag 1741 cccctggaga gcgagggccc agtggtcttg ctggccccaa gggagccaac ggtgaccctg 1801 gccgtcctgg agaacctggc cttcctggag cccggggtct cactggccgc cctggtgatg 1861 ctggtcctca aggcaaagtt ggcccttctg gagcccctgg tgaagatggt cgtcctggac 1921 ctccaggtcc tcagggggct cgtgggcagc ctggtgtcat gggtttccct ggccccaaag 1981 gtgccaacgg tgagcctggc aaagctggtg agaagggact gcctggtgct cctggtctga 2041 ggggtcttcc tggcaaagat ggtgagacag gtgctgcagg accccctggc cctgctggac 2101 ctgctggtga acgaggcgag cagggtgctc ctgggccatc tgggttccag ggacttcctg 2161 gccctcctgg tcccccaggt gaaggtggaa aaccaggtga ccagggtgtt cccggtgaag 2221 ctggagcccc tggcctcgtg ggtcccaggg gtgaacgagg tttcccaggt gaacgtggct 2281 ctcccggtgc ccagggcctc cagggtcccc gtggcctccc cggcactcct ggcactgatg 2341 gtcccaaagg tgcatctggc ccagcaggcc cccctggggc tcagggccct ccaggtcttc 2401 agggaatgcc tggcgagagg ggagcagctg gtatcgctgg gcccaaaggc gacaggggtg 2461 acgttggtga gaaaggccct gagggagccc ctggaaagga tggtggacga ggcctgacag 2521 gtcccattgg cccccctggc ccagctggtg ctaatggcga gaagggagaa gttggacctc 2581 ctggtcctgc aggaagtgct ggtgctcgtg gcgctccggg tgaacgtgga gagactgggc 2641 cccccggacc agcgggattt gctgggcctc ctggtgctga tggccagcct ggggccaagg 2701 gtgagcaagg agaggccggc cagaaaggcg atgctggtgc ccctggtcct cagggcccct 2761 ctggagcacc tgggcctcag ggtcctactg gagtgactgg tcctaaagga gcccgaggtg 2821 cccaaggccc cccgggagcc actggattcc ctggagctgc tggccgcgtt ggacccccag 2881 gctccaatgg caaccctgga ccccctggtc cccctggtcc ttctggaaaa gatggtccca 2941 aaggtgctcg aggagacagc ggcccccctg gccgagctgg tgaacccggc ctccaaggtc 3001 ctgctggacc ccctggcgag aagggagagc ctggagatga cggtccctct ggtgccgaag 3061 gtccaccagg tccccagggt ctggctggtc agagaggcat cgtcggtctg cctgggcaac 3121 gtggtgagag aggattccct ggcttgcctg gcccgtcggg tgagcccggc aagcagggtg 3181 ctcctggagc atctggagac agaggtcctc ctggccccgt gggtcctcct ggcctgacgg 3241 gtcctgcagg tgaacctgga cgagagggaa gccccggtgc tgatggcccc cctggcagag 3301 atggcgctgc tggagtcaag ggtgatcgtg gtgagactgg tgctgtggga gctcctggag 3361 cccctgggcc ccctggctcc cctggccccg ctggtccaac tggcaagcaa ggagacagag 3421 gagaagctgg tgcacaaggc cccatgggac cctcaggacc agctggagcc cggggaatcc 3481 agggtcctca aggccccaga ggtgacaaag gagaggctgg agagcctggc gagagaggcc 3541 tgaagggaca ccgtggcttc actggtctgc agggtctgcc cggccctcct ggtccttctg 3601 gagaccaagg tgcttctggt cctgctggtc cttctggccc tagaggtcct cctggccccg 3661 tcggtccctc tggcaaagat ggtgctaatg gaatccctgg ccccattggg cctcctggtc 3721 cccgtggacg atcaggcgaa accggccctg ctggtcctcc tggaaatcct ggaccccctg 3781 gtcctccagg tccccctggc cctggcatcg acatgtccgc ctttgctggc ttaggcccga 3841 gagagaaggg ccccgacccc ctgcagtaca tgcgggccga ccaggcagcc ggtggcctga 3901 gacagcatga cgccgaggtg gatgccacac tcaagtccct caacaaccag attgagagca 3961 tccgcagccc cgagggctcc cgcaagaacc ctgctcgcac ctgcagagac ctgaaactct 4021 gccaccctga gtggaagagt ggagactact ggattgaccc caaccaaggc tgcaccttgg 4081 acgccatgaa ggttttctgc aacatggaga ctggcgagac ttgcgtctac cccaatccag 4141 caaacgttcc caagaagaac tggtggagca gcaagagcaa ggagaagaaa cacatctggt 4201 ttggagaaac catcaatggt ggcttccatt tcagctatgg agatgacaat ctggctccca 4261 acactgccaa cgtccagatg accttcctac gcctgctgtc cacggaaggc tcccagaaca 4321 tcacctacca ctgcaagaac agcattgcct atctggacga agcagctggc aacctcaaga 4381 aggccctgct catccagggc tccaatgacg tggagatccg ggcagagggc aatagcaggt 4441 tcacgtacac tgccctgaag gatggctgca cgaaacatac cggtaagtgg ggcaagactg 4501 ttatcgagta ccggtcacag aagacctcac gcctccccat cattgacatt gcacccatgg 4561 acataggagg gcccgagcag gaattcggtg tggacatagg gccggtctgc ttcttgtaaa 4621 aacctgaacc cagaaacaac acaatccgtt gcaaacccaa aggacccaag tactttccaa 4681 tctcagtcac tctaggactc tgcactgaat ggctgacctg acctgatgtc cattcatccc 4741 accctctcac agttcggact tttctcccct ctctttctaa gagacctgaa ctgggcagac 4801 tgcaaaataa aatctcggtg ttctatttat ttattgtctt cctgtaagac cttcgggtca 4861 aggcagaggc aggaaactaa ctggtgtgag tcaaatgccc cctgagtgac tgcccccagc 4921 ccaggccaga agacctccct tcaggtgccg ggcgcaggaa ctgtgtgtgt cctacacaat 4981 ggtgctattc tgtgtcaaac acctctgtat tttttaaaac atcaattgat attaaaaatg 5041 aaaagattat tggaaagta

NTRIs for Treatment of OA

Nucleoside Analog Reverse-Transcriptase Inhibitors

Nucleoside analog reverse-transcriptase inhibitors (NARTIs or NRTIs) are a class of antiretroviral drugs. To be incorporated into the viral DNA, NRTIs must be activated in the cell by the addition of three phosphate groups to their deoxyribose moiety, to form NRTI triphosphates. This phosphorylation step is carried out by cellular kinase enzymes. Exemplary NRTIs are listed below:

Zidovudine, also called AZT, ZDV, and azidothymidine, has the trade name Retrovir.

Zidovudine was the first antiretroviral drug approved by the FDA for the treatment of HIV.

Didanosine, also called ddl, with the trade names Videx and Videx EC, was the second FDA-approved antiretroviral drug. It is an analog of adenosine.

Zalcitabine, also called ddC and dideoxycytidine, has the trade name Hivid.

Stavudine, also called d4T, has trade names Zerit and Zerit XR.

Lamivudine, also called 3TC, has the trade name Zeffix and Epivir. It is approved for the treatment of both HIV and hepatitis B.

Abacavir, also called ABC, has the trade name Ziagen, is an analog of guanosine.

Emtricitabine, also called FTC, has the trade name Emtriva (formerly Coviracil). Structurally similar to lamivudine, it is approved for the treatment of HIV and undergoing clinical trials for hepatitis B.

Entecavir, also called ETV, is a guanosine analog used for hepatitis B under the trade name Baraclude. It is not approved for HIV treatment.

Truvada, made of emtricitabine and tenofovir disoproxil fumarate, is used to treat and prevent HIV. It is approved for HIV prevention in the US and manufactured by Gilead.

Another exemplary NRTI includes Tenofovir also known as TDF is a prodrug with the active compound deactivated by a molecular side chain that dissolves in the human body allowing a low dose of tenofovir to reach the site of desired activity.

NRTIs for Treatment of Strict OA

In one example NRTIs can be used for the treatment of strict osteoarthritis (“category one” or “class one”). An exemplary NRTIs include, 3TC, a cytidine analog depicted below. 3TC is commonly referred to as lamivudine, and can be formulated in tablet form (Epivir or Zeffix).

In another example, the treatment for osteoarthritis can include administration with FTC, a cytidine analog depicted below. FTC is also referred to as emtricitabine, 2′,3′-dideoxy-5-fluoro-3′-thiacytidine, Emtriva or Coviracil. FTC can also be administered with tenofovir disoproxil (sold under trade name Viread).

In another example, the treatment for osteoarthritis can include administration of ABC, a guanosine analog. ABC is also referred to as abacavir, or the trade name Ziagen. The structure of ABC is provided below:

Summary data of NRTI on OA is shown in FIG. 12A. All NRTIs inhibited strict OA in age (older than 50) and dosage dependent and sex independent manner (successful for both male and female) in HIV patients. NRTIs for inhibiting strict OA were 3TC, FTC and ABC.

NRTIs for Treatment of Strict OA and Expanded OA

In another example, NRTIs can be used for the treatment of strict OA and expanded OA, e.g., partially inhibiting expanded OA (“category 2” or “class 2”). An exemplary NRTI includes, ZDV (a thymidine analog). In examples, ZDV is administered to female patients. ZDV is also commonly referred to as azidothmidine, AZT, Retrovir or Zidovudine. The structure of ZDV is provided below:

In another example, the treatment of strict OA and expanded OA comprises administering TDF (an adenosine analogue). TDF is also referred to as tenofovir, 9-(2-Phosphonyl-methoxypropyly)adenine (PMPA), Viread (Gilead Sciences). The structures of TDF, and Tenofovir dispoproxil are shown below. TDF can also be administered with FTC, which is also referred to as emtricitabine, 2′,3′-dideoxy-5-fluoro-3′-thiacytidine, Emtriva or Coviracil.

Summary data of NRTI on OA is shown in FIG. 12B. All NRTIs inhibited strict OA in age (older than 50) and dosage dependent and sex independent manner (successful for both male and female) in HIV patients. NRTIs for inhibiting strict OA and partially inhibiting expanded OA were ZDV and TDF, which was better than category one.

NRTIs for Treatment of Strict OA and Expanded OA.

In other examples, both strict OA and expanded OA are treated by administration of Didanosine, an adenosine analog (commonly referred to as DDl, ddl, Videx, Videx EC, 2′,3′-dideoxyinosine) (“category 3” or “class 3”). No toxicity in a group of less than 40 years old was observed. The structure of didanosine is provided below:

In other examples, both strict OA and expanded OA are treated by administration of Stavudine, a thymidine analog (commonly referred to as d4T, Zerit, Zerit XR, 2′,3′-didehydro-2′,3′-dideoxythymidine). Stavudine was the highest extent of inhibition. The structure of Stavudine is shown below:

Summary data of NRTI on OA is shown in FIG. 12C. All NRTIs inhibited strict OA in age (older than 50) and dosage dependent and sex independent manner (successful for both male and female) in HIV patients. NRTIs for inhibiting both strict OA and expanded OA were DDL and D4T, which was better than category one and category 2, described above.

Osteoarthritis (OA)

Osteoarthritis is a form of arthritis that features the breakdown and eventual loss of the cartilage in one or more joints. OAs can affect the hands, feet, ankle, spine, and large weight-hearing joints, such as the hips and knees.

OA that develops secondary to a wide variety of joint injury is often grouped into a sub-category of OA called post-traumatic osteoarthritis (PTOA). Common injuries that can lead to PTOA include, but are not limited to, high-speed impact trauma to the articular surface, intraarticular fractures, and joint-destabilizing soft-tissue tears. Although the end-stage pathophysiology of PTOA may be similar, there is evidence to suggest that the early biological and mechanical events that initiate and perpetuate disease are distinct between different joints, injury types, and patient populations. The ankle, knee, and hip are the most commonly injured joints in PTOA.

The most common injury precipitating end-stage ankle OA is a severe ankle sprain, when rapid ankle inversion causes the distal tibia to impact the medial aspect of the talar dome, often resulting in an osteochondral lesion. Ligamentous injuries commonly accompany severe ankle sprains and may result in joint instability. The magnitude of the initial cartilage trauma is an important factor in development of ankle PTOA.

There is evidence implicating trauma with the likelihood of developing joint degeneration and OA. PTOA is a degenerative joint disease secondary to injury that may lead to OA years later. It is particularly prevalent in young and active individuals such as those involved in sport during which there is increased risk of sustaining such injury. It can therefore be defined as the presence of a normal joint prior to injury, structural damage at the time of injury and the joint not being compromised by systemic disease. Joint trauma affects all joint tissues leading to physiological, biomechanical and biochemical changes that may progress toward joint degeneration and subsequent development of OA.

Treatment generally involves a combination of exercise, lifestyle modification, and analgesics. If pain becomes debilitating, joint replacement surgery may be necessary to improve the quality of life. Surgical intervention is sometimes recommended after joint injury to correct abnormal joint biomechanics, reducing the risk of secondary injuries, and ideally reducing the risk of OA. Unfortunately, surgical interventions (e.g. AU (gold) reconstruction, meniscectomy, meniscal replacement) do not restore normal joint biomechanics or prevent knee OA. Therefore, it is important to understand which of these patients will develop early-onset knee OA and if this onset of knee OA can be prevented or delayed. Whilst pain management and surgery are current options, currently there are no approved therapies to address post-traumatic arthritis and its prevention.

Stages of OA

Stage 1: Minor

Small lumps of bone called osteophytes may grow in the knee area. There may be slight damage to the cartilage. There will be no apparent narrowing of the space between the bones to indicate that the cartilage is breaking down. People with stage 1 OA are unlikely to feel pain or experience discomfort. The joint will appear normal on an X-ray.

Stage 2: Mild

During this stage, a person may start to notice symptoms, and doctors can see some signs of wear. X-rays and other scans of the knee joints will clearly show more osteophyte growth, and the cartilage will begin to thin. The space between the bones will still appear normal, but the area where the bones and the tissues meet will start to harden. When the tissues harden, this makes the bone thicker and denser. A thin layer of bone will also develop beneath the cartilage in the joints. The person may experience stiffness or joint pain. The area around the knee joint may start to feel particularly stiff and uncomfortable after a person has been sitting for extended periods. Though there may be some minor damage, the bones are not rubbing or scraping against each other. Synovial fluid is present, and it helps to reduce friction and support the movement of the knee.

Stage 3: Moderate

The damage to the cartilage has progressed, the gap between the bones has narrowed, and X-rays will show cartilage loss. Pain and discomfort may occur while performing daily activities, such as running, walking, kneeling, and bending. There may be early signs of joint inflammation.

As OA progresses, the cartilage will continue to thin and break down. The bones will respond by thickening and growing outward to form lumps. The tissue that lines the joint will become inflamed, and it may produce extra synovial fluid, resulting in increased swelling. This is called synovitis, and it is commonly known as water on the knee.

Stage 4—Severe

Knee replacement surgery for OA of the knee. Knee replacement surgery may be the only option for late-stage OA of the knee. This is the most advanced stage of OA, and the symptoms are very visible. The space between the bones in the joint has continued to narrow, causing the cartilage to break down further. As a result, there is stiffness in the joint, constant inflammation, and less fluid around the joint. There is more friction in the joint and more significant pain and discomfort while moving. X-rays will show bone on bone, meaning that either the cartilage has completely worn away or there is very little left. The individual will likely develop more bone lumps and experience pain that is often intense during simple activities, such as walking. In severe cases, the bones may become deformed and angulated because of asymmetric loss of cartilage. At this stage, surgical treatment is often the only option.

Medical provider diagnoses of ICD-9-CM 715 [osteoarthrosis and allied disorders] include the following definitions: 1) strict=ICD-9-CM 715; 2) expanded=ICD-9-CM 715, 716 [other and unspecified arthropathies], OR 719 [other and unspecified disorders of joint]); and 3) probable=strict OR expanded+respondent-reported prior diagnosis of OA or other arthritis excluding rheumatoid arthritis (RA).

Mechanisms of Resistance to Reverse Transcriptase Inhibitors

While NRTIs are effective at terminating DNA synthesis and HIV replication, HIV can and eventually does develop mechanisms that confer the virus resistance to the drugs. HIV-1 RT does not have proof-reading activity. This, combined with selective pressure from the drug, leads to mutations in reverse transcriptase that make the virus less susceptible to NRTIs and NNRTIs.

NRTI Resistance

There are two major mechanisms of NRTI resistance. The first being reduced incorporation of the nucleotide analog into DNA over the normal nucleotide. This results from mutations in the N-terminal polymerase domain of the reverse transcriptase that reduce the enzyme's affinity or ability to bind to the drug. A prime example for this mechanism is the that confers resistance to lamivudine (3TC) and emtricitabine (FTC). Another well characterized set of mutations are found in multi-drug resistant HIV which decreases reverse transcriptase's efficiency at incorporating NRTIs, but does not affect natural nucleotide incorporation. A virus with the mutation is intermediately resistant to zidovudine (AZT), didanosine (ddl), zalcitabine (ddC), stavudine (d4T), and slightly resistant to abacavir (ABC). A virus with the mutation complexed with the other four mutations becomes highly resistant to the above drugs, and is additionally resistant to lamivudine (3TC) and emtricitabine (FTC).

The second mechanism is the excision or the hydrolytic removal of the incorporated drug or pyrophosphorlysis. This is a reverse of the polymerase reaction in which the pyrophosphate/PPI released during nucleotide incorporation reacts with the incorporated drug (monophosphate) resulting in the release of the triphosphate drug.

NTRIs and Treatment of OA

Osteoarthritis (OA) is an age-associated or post-traumatic degenerative joint disease involving articular cartilage degradation, chronic inflammation, and bone remodeling (Berenbaum, F. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 21, 16-21 (2013)). While aging is a primary cause, it can also be caused by post-traumatic joint injury (PTOA) (Gelber, A. C., et al. Ann Intern Med 133, 321-328 (2000) and Lohmander, L. S., et al. Am J Sports Med 35, 1756-1769 (2007)). Although OA is a leading cause of disability in the elderly, there is no FDA approved disease modifying osteoarthritis drugs (DMOADs) currently. Transposons were first discovered in plant and defined as “jumping genes” (Mc, C. B. Proc Natl Acad Sci USA 36, 344-355 (1950)). They were subsequently discovered in all eukaryotes including animals and human (de Koning, A. P., et al. PLoS Genet 7, e1002384 (2011)). While human functional protein-coding exons consist merely 1% of our genome, transposons make nearly half of our genome (de Koning, A. P., et al. PLoS Genet 7, e1002384 (2011)). L1, comprising 17% of entire genome, is the only active retrotransposon (Ostertag, E. M. & Kazazian, H. H., Annu Rev Genet 35, 501-538 (2001), Hancks, D. C. & Kazazian, H. H., Jr. Curr Opin Genet Dev 22, 191-203 (2012), Levin, H. L. & Moran, J. V. Nat Rev Genet 12, 615-627 (2011), Burns, K. H. & Boeke, J. D. Cell 149, 740-752 (2012), and Roman-Gomez, J., et al Oncogene 24, 7213-7223 (2005)). While it is active in germlines causing 124 genetic diseases, it is normally repressed in somatic cells and hence its function remains largely unknown (O'Donnell, K. A et al. Developmental cell 15, 179-181 (2008), Metzner, M., et al. PloS one 7, e49358 (2012), Faulkner, G. J. PLoS Genet 9, e1003944 (2013), Morrish, T. A., et al. Nature 446, 208-212 (2007), Morrish, T. A., et al. Nature genetics 31, 159-165 (2002), Guo, H., et al. Nature communications 5, 5276 (2014), and Moldovan, J. B. et al. PLoS Genet 11, e1005121 (2015)). Recently, it has been proposed that L1 plays a role in cell senescence, organism aging and neoplasia (Hancks, D. C. & Kazazian, H. H., Jr. Curr Opin Genet Dev 22, 191-203 (2012), De Cecco, M., et al. Aging Cell 12, 247-256 (2013), De Cecco, M., et al. Aging (Albany N.Y.) 5, 867-883 (2013), Marco De Cecco, et al. Nature in press (2018), and Hancks, D. C. & Kazazian, H. H., Jr. Mob DNA 7, 9 (2016)). Thus, as an aging associated disease, OA was hypothesized to be correlated with L1 activation in cartilage joint.

The invention provides a solution to obstacles associated with prevention and treatment of cartilage degenerative diseases. Accordingly, the invention includes methods using NRTIs to prevent, alleviate and treat cartilage degenerative diseases. Also provided herein are methods of using NRTIs for treatment of injury induced OA (also known as post-traumatic OA).

Accordingly, in some aspects, provided herein are methods for characterization of pharmaceutic efficacy in regards to alleviation OA markers and inflammatory markers. For example, the individual is diagnosed with OA, post-traumatic OA, rheumatoid arthritis, chondromatosis, costochondritis, relapsing polychondritis, herniation, chondrolysis, achondroplasia, chondrodysplasia, chondroma, chondrosarcoma, growth plate fracture and deformity, bone fracture, bone cyst, bone spur (osteophytes), bone tumor, craniosynostosis, fibrodysplasia, ossificans progressive, fibrous dysplasia, hypophosphatasia, metabolic bone disease, Paget's disease of bone, osteochondritis dissecans, osteogenesis imperfect, osteomalacia, osteopenia, osteoporosis. In experiments described herein, NRTIs are dissolved using autoclaved double distilled water. The individual to be treated is a human being; however, other subjects such as a mouse, rat, companion animals, such as a dog or a cat or working/performance animals such as a horse or a cow is also treated using the methods. RTIs suppress Long interspersed nuclear elements 1 (LINE-1, LINE1) (also, L1, Line1 and Line-1), Interferon (Inf-α) and Interleukin-6 (also IL6 and IL-6) in chondrocytes.

3TC suppresses Line-1 activities and prevent primary OA development in mice since miR-365/Line-1 axis correlates with OA development in both human OA samples and art-recognized mouse OA models Inhibition of Line-1 activity prevents and/or rescue OA onset. The class of drugs termed NRTIs are useful to treat OA pathogenesis.

To test whether NRTIs can inhibit OA markers via suppressing Line-1 in chondrocytes, human and mouse chondrocytes were treated with various concentrations of 3TC. qPCR analysis shows 3TC suppresses Line-1, Inf-α, Adamts5, Col10 expressions yet promotes Col2 expression in mouse chondrocytes. In human chondrocytes, whilst 3TC inhibits LINE-1, IHH, COL10 and ADAMTS5 expressions, 3TC promotes ACAN expression. Since Col10, Ihh and Mmp13 are induced in the articular cartilage of miR-365 Tg mice, human chondrocytes that already over-express miR-365 were treated with various concentrations of 3TC. Upon transfection, 3TC completely abolishes the miR-365 induced up-regulation of LINE-1, ADAMTS5, IHH and COL10 and rectifies ACAN suppression by miR-365.

Experiments were carried out to determine whether 3TC treatment rescues miR-365 induced Line-1 OA markers up-regulation and to determine whether 3TC can rescue OA phenotypes in primary OA model observed in miR-365 Tg mice. Starting at 2-month old, miR-365 Tg and age matched control mice (Cre only) were treated with 3TC dilution water or saline diluted water for 4 months before sacrifice. Consistently, proteoglycan loss was observed in the articular surface of miR-365 treated with saline but not of 3TC treatment. Furthermore, Line-1, Inf-α, Col10 and Adamts5 expression were significantly inhibited by 3TC treatment in miR-365 Tg mice. However, IL-6 or Acan levels are unchanged. miR-365 expression is also suppressed by oral 3TC treatment specifically in miR-365 Tg mice. Taken together, the data elucidates 3TC treatment, by inhibiting Line-1 activity, reverses Col2 lineage cell specific miR-365 over-expression induced OA markers including Col10 and Adamts5 in vivo.

3TC and FTC Prevent DMM (Destabilization of Medical Meniscus) Induced OA

Another cytidine analogue, FTC was tested. Although FTC suppresses Line-1 and Inf-α as well as inflammasome pathway like P2rx7 and Nlrp3, it induces Mmp3, Mmp13, Adamts5 and Col10 expressions whilst promotes Col2 and Acan expressions in mouse PC. 3TC was found to preferably inhibit OA markers while promoting ECM synthesis while FTC promotes both OA markers and ECM synthesis simultaneously in vitro.

The effects of 3TC and FTC using ex vivo femur organ cultures were tested. Intact femur was isolated from 21-day old WT mice into complete medium containing 3TC or FTC and was performed qPCR analysis using RNAs peeled from femur articular cartilages after 48 hrs incubation. While 3TC inhibits Line-1, Mmp13, Adamts5 and Col10, FTC inhibits Mmp13 and Adamts5 expressions. 3TC induced Col2 and Acan expressions when FTC induces the latter. Collectively, the data indicates that 3TC and/or FTC is useful to treat OA.

To test whether NRTIs can rescue secondary OA model, 12956 mice underwent either DMM or Sham surgeries with 3TC or FTC diluted water respectively from 8 weeks old for a total of 4 weeks. No appreciable difference of body weights between drug and control treatment groups are noticed. During histology assessment, treatment with 3TC and/or FTC treatments effectively prevented DMM induced proteoglycan loss in surgical knees. Meanwhile, qPCR analysis confirmed Line-1 inhibition introduced by 3TC and FTC. Chondrolytic markers including Mmp13, Adamts5 and hypertrophic maker Col10 were significantly repressed in 3TC and FTC treated DMM groups comparing with Saline treatment. Both 3TC and/or FTC treatments significantly prohibited miR-365 induction by DMM, indicating that NRTIs acts up-stream of miR-365. The data indicate that NTRIs such as 3TC and FTC prevent secondary OA onset by inhibiting Line-1 up-regulation and repressing OA markers.

miR-365 was found to target retrotransposable element suppressors including Dicer, Prkdc and Sqstm1. Through this circuit, miR-365 controls Line-1 expression thereby promoting cartilage degradation. Suppressing Line-1 expression using NRTIs, for example 3TC and FTC, through their anti-reverse transcriptional functions, prevents cartilage degradation and results in OA phenotype rescue.

The following materials and methods were used to generate the data and observations described herein.

Animals

To over-express miR-365 in cartilage tissues, C57BL/6 background miR-365fl/wt transgenic mice are crossed with Col2a1-Cre+/wt (Cre-only) mice to generate Col2a1-Cre+/wt; miR-365fl/wt mice (miR-365 Tg) (Yang, K., et al. Connect Tissue Res 58, 103-115 (2017)).

12956/SvEv strain male mice are purchased from Taconic (https://www.taconic.com/mouse-model/129s6) at their age of 7-week-old. At least 3-day (72-hrs) acclimation period must be given to mice before any further procedures occurred to them.

All strains of mice are housed with ad libitum access to food and water unless otherwise stated.

Genotyping

Genomic DNA is extracted from mouse toes or tails within 7 days after birth and performed by conventional PCR using Hot start Taq polymerase (New England BioLabs, Cat. M049S/L) using primers designed specific to miR-365 insertion or Col2a1-Cre constructs.

Mouse Model of Destabilization of Medial Meniscus (DMM)

129S6/SvEv male mice are chosen for experimental subjects at their age of 8-week-old. To create mouse injury/trauma induced osteoarthritis model, medial meniscus ligament is transected using a previously described. 8-week-old male mice are anesthetized using either intraperitoneal (IP) injection of Ketamine/Dexmedetomidine or isoflurane to carry out medial parapatellar arthrotomy. Transection is made with a stab knife (Sharpoint™, Cat. 72-1551). At Weeks 12, mice are euthanized and dissected for histological examination as well as cartilage RNA extraction. 12 mice are used for each group/time point.

Human Specimens

Cartilages are obtained from individuals diagnosed with OA and underwent total knee replacement. Samples are harvested freshly after surgeries. Pictures of specimens are taken for recording purpose. OA lesion and non-lesion areas are empirically identified by orthopedic surgeons based on direct observation. For each site of interest, a 1×1 mm2 tissue with a depth ranging from 4-8 mm is harvested using sterile, RNase free Rib-Back® scalpels (Bard-Parker®, Cat. 371115) manually. Care must be taken to avoid any subchondral bone. To obtain maximal digestion efficacy, resected specimens are further minced by scalpels before submerging into 350 mL QIAzol Lysis Reagent (Qiagen, Cat No./ID: 79306). Specimens can either be stored at −80° C. or be accessed using diverse methods.

Femur Explant Organ Culture

Femurs are obtained from 21-day-old WT C57BL/6 mice. Femurs with intact articular surface and periosteum is sterilely dissected under microscope. All animal procedures are reviewed and approved by IACUC. Upon harvesting, femurs are rinsed with HB SS (Gibco®, Grand Island, N.Y. 14072 USA) and then submerged into DMEM (Gibco®, Grand Island, N.Y. 14072 USA) medium supplemented with 10% fetal bovine serum (FBS, Gibco®, Grand Island, N.Y. 14072 USA) in 12-well culture dishes. 3TC or FTC is added into the medium with desired concentrations. After a total of 48 hrs incubation at 37° C. in an atmosphere of 5% CO2, femurs are rinsed with HBSS and articular cartilage is peeled off using surgical scalpels under dissecting microscope for RNA extraction.

Histology, Immunohistochemistry (IHC), and Immunofluorescence

Human cartilage tissues are fixed in 4% Paraformaldehyde (PFA) for 24 hrs at 4° C., followed by 30% DEPC-sucrose (Sigma, Cat. 50289-500G, St. Louis, Mo. 63103 USA) at 4° C. until the specimens are sunken to the bottom of the containers. Tissues are embedded in optimal cutting temperature compound (O.C.T., SAKURA FINETEK USA INC, Tissue-Tek® O.C.T. Compound, Cat. 4583). A cryo-section microtome (Model: CM3050, Leica, Germany) is used to cut 6-μm-thick sections. The sections are stained by H&E staining to assess morphology. Mouse tissues are fixed in 10% formalin for 24-48 hrs depending on tissue size, followed by de-calcification process using DEPC de-calcification reagents (Ethylenediaminetetraacetic acid, Sigma, Cat. EDS-1KG, St. Louis, Mo. 63103 USA) at room temperature for 10-14 days. After de-calcification, tissues are dehydrated in ethanol before embedded in paraffin with routine procedures. A microtome (Model: FINESSE ME, Thermo Shandon, UK) is used to cut 6-μm-thick sections. For every 80 μm interval, 5 sister sections are harvested to make a total of 13-16 slices from one knee of a fully-grown mouse. Number of slides form one knee may vary due to varying sizes of the specimens. Slides are then de-paraffinized and stained GAG with Alcian blue (Sigma, Cat. A3157-10G) or Safranin O (Sigma, Cat. 58884-25G, St. Louis, Mo. 63103 USA). Morphology is assessed by H&E staining. For IHC, paraffin sections are processed with routine procedures instructed by Histostain® Plus 3rd Gen IHC Detection Kit (Life Technologies, Cat. 859673, Frederick, Md. 21704 USA). Rabbit or mouse antibodies specifically against antigens of interest are used, followed by incubation of HRP-conjugated secondary antibodies against rabbit or mouse IgG (provided by the kit). Primary and secondary antibodies are listed herein. Signals are then visualized by a DAB-Plus Substrate Kit (Life Technologies, Cat. 002020, Frederick, Md. 21704 USA).

Safranin O Staining

Paraffin sections are de-paraffinized in 2 changes of xylene, 10 mins each, followed by re-hydration in 2 changes of 100% alcohol, 5 mins each; 2 changes of 95% alcohol, 5 mins each; 70% alcohol for 5 mins. Sections are then rinsed in running tap water for 2 mins before stained with 0.4% fast green solution (Sigma, Cat. F-7258, St. Louis, Mo. 63103 USA) for 2 mins however the latter timing must be empirically controlled to assure desired coloration. Stained sections are then quickly rinsed with 1% acetic acid solution (Sigma, Cat. 695092-500ML-GL, St. Louis, Mo. 63103 USA) for no more than 10-15 sec. 0.1% Safranin O Solution is used for staining proteoglycan however the actual timing must be carefully determined based on actual coloring condition, for maximally 10 mins. After Safranin O staining, sections are submerged in 2 changes of 95% alcohol, 2 mins each, 2 changes of 100% alcohol, 2 mins each for de-hydration. Lastly, sections are cleared in 2 changes of xylene, 2 mins each, and mounted using resinous mounting medium (ACRYMOUNT™, Cat. SL80-4, McKinney, Tex. 75069 USA).

OARSI Scoring

To histologically evaluate OA severity, we quantified Safranin O stained knee sections according to OARSI semi-quantitative system as previously described (Sato, S., et al. TheScientificWorldJournal 2014, 685854 (2014)).

Hematoxylin and Eosin (H&E) Staining

Paraffin sections are de-paraffinized in 2 changes of xylene, 10 mins each, followed by re-hydration in 2 changes of 100% alcohol, 5 mins each; 2 changes of 95% alcohol, 5 mins each; 70% alcohol for 5 mins. Sections are then rinsed in running tap water for 2 mins before stained in Mayer's Hematoxylin solution (NovaUltra™ H&E Stain Kit, IHCWORLD, Cat. IW-3100) for 2 mins however the latter timing must be empirically controlled to assure desired coloration. Stained sections are then rinsed in running tap water for 5 mins before dipped into 95% alcohol for 10 times or 30 sec based on performer's preference. Eosin Solution (NovaUltra™ H&E Stain Kit, IHCWORLD, Cat. IW-3100) is used for counterstaining however the actual timing must be carefully determined based on actual coloring condition. After counterstaining, sections are dipped in 95% alcohol for 2 times before transferred through 2 changes of 100% alcohol, 5 mins each for de-hydration. Lastly, sections are cleared in 2 changes of xylene, 5 mins each, and mounted with resinous mounting medium.

For frozen sections, procedures are similar with the exception between Eosin counterstaining and 95% alcohol dipping steps. Instead, during these two steps, frozen sections must be air dried for 30 mins at room temperature and fixed in 10% formalin for 10 mins. Then the sections are taken out for another 30 mins air dry at room temperature before rinsed in water.

Homogenization

A PowerGen 125 (Fisher Scientific, Cat. 03.349248) is used to homogenize samples for RNA exaction. A cycle of 45″ homogenization at speed of 5, followed by a cool down step of 15″ is repeated for 5 cycles before switching to a finer drill for the same cycles. Drills/PowerGen Generator (Fisher Scientific, Cat. 14-261-15) are rinsed in DEPC-water followed by 100% ethanol rinse between different specimens to avoid cross contamination. All procedures are taken place on ice to avoid RNA degradation due to heat.

Primary Growth Plate/Articular Chondrocytes (PCs) Culture

Rib cages are sterilely isolated from neonatal mice (within 7-day-old) of desired genotypes and rinsed with HBSS for five times. To remove unspecific tissues, rib cages are digested in Collagenase D (3 μg/mL, Roche, Cat. 11088882001, Mannheim, Germany) for 2-4 hrs at 37° C. and rinsed with HBSS (Gibco®, Grand Island, N.Y. 14072 USA) for five times to remove detached unspecific tissues. To detach chondrocytes from rib cages, the samples undergo secondary digestion in Collagenase D (3 μg/mL) for at least 4 hrs at 37° C. with constant agitation (200 rpm). Detached chondrocytes are palleted to remove excessive Collagenase D and resuspended in complete medium of DMEM (Gibco®, Grand Island, N.Y. 14072 USA) which contains 10% FBS, 100 U/mL penicillin and 100 μg/mL streptomycin (Gibco®, Grand Island, N.Y. 14072 USA). Growth plate PCs are grown at 37° C. in an atmosphere of 5% CO2. The media is changed on the following day to remove remaining Collagenase D and every 3 days thereafter.

Similarly, articular cartilages are sterilely isolated under dissection microscope from neonatal mice (within 7-day-old) of desired genotypes and rinsed with HBSS for five times. To remove unspecific tissues, articular cartilages are minced and digested in Collagenase D (3 μg/mL) for 2 hrs at 37° C. and rinsed with HBSS for five times to remove detached unspecific tissues. To detach chondrocytes from cartilage matrix, the samples underwent secondary digestion in Collagenase D (3 μg/mL) for at least 4 hrs at 37° C. with constant agitation (200 rpm). Detached chondrocytes are palleted to remove excessive Collagenase D and resuspended in complete medium of DMEM which contains 10% FBS, 100 U/mL penicillin and 100 μg/mL streptomycin. Articular PCs are grown at 37° C. in an atmosphere of 5% CO2. The media is changed on the following day to remove remaining Collagenase D and every 3 days thereafter.

Transient Transfection

Cells are seeded onto desired size plates to reach 70-90% confluence and transfected with miR-365 mimic or miRNA mimic negative control or miR-365 inhibitor or inhibitor negative control (Dharmacon®, Lafayette, Colo., USA). Lipofectamine 3000 (Invitrogen®, Waltham, Mass., USA) is used as transfection reagents. Medium is changed 24 hrs after transfection. 48 hrs post transfection, cells are lysated in either QIAzol for RNA purification and real-time PCR analysis or ice-cold lysis buffer containing protease inhibitor and phosphatase inhibitor for western blot analysis. MiR-365 mimic, miRNA mimic negative control, miR-365 inhibitor and inhibitor negative control are typically used at a final concentration of 25 nM unless otherwise stated.

Quantitative Real-Time PCR (qPCR)

Both miRNA and mRNA are extracted using miRNeasy Mini Kit (Qiagen®, Germantown, Md., USA) and reversely transcribed using miScriptIIRT Kit (Qiagen®, Germantown, Md., USA) according to manufacturer's instruction. qPCR is performed using SYBR Green PCR master mix (Qiagen®, Germantown, Md., USA) on a Bio-Rad CFX96 real-time PCR detection system (Bio-Rad®, Hercules, Calif., USA). Amplification conditions are as follows: 95° C. for 10 min, 40 cycles of 95° C. for 10 sec, 55° C. for 30 sec, and 72° C. for 30 sec. Sense and antisense primers are provided herein. 18S ribosomal or Gapdh RNA is used as an internal control gene to normalize the mRNAs level. The ubiquitously expressed snRNA U6 is used as an endogenous control for miRNAs level. Primers are synthesized by Integrated DNA Technologies (http://www.idtdna.com). The primers for miR-365 are purchased from Qiagen. Fold changes of mRNA and miRNAs are calculated by the 2{circumflex over ( )}(−ΔΔCt) method and normalized to 18S/Gapdh or U6 snRNA, respectively.

Prediction of miR-E365 Target Genes

Targets of miR-365-5p and miR-365-3p were identified using the TargetScan (http://www.targetscan.org/) and miRanda/mirSVR (http://34.236.212.39/microrna/home.do) target prediction algorithms.

Plasmid Construction

WT Aicda, Dicer1, Prkdc, Sqstm1 and Zc3hav1 3′UTRs bearing potential response elements (REs) serving as miR-365 seeding sites predicted by microrna.org are cloned from mouse genomic DNA (50 ng-250 ng) using primers designed to introduce ideal restriction enzyme cleavage sites according to the backbone plasmid pmirGLO construct (Promega, Madison, Wis., USA). Detailed thermal cycles are: 98° C. for 30 sec, 25-35 cycles of 98° C. for 10 sec, 55-60° C. for 30 sec, and 72° C. for 15 sec and final extension at 72° C. for 10 min before holding at 4° C. Designed primers are provided herein. PmeI and XhoI are enzymes used to cleave for sticky ends. After restriction enzymes cleavage, approximately 500 bp 3′UTR sequences are annealed into pmirGLO construct (1 pg-10 ng). REs are mutated according to QuikChange Lightning Multi Site-Directed Mutagenesis Kit's instruction (Agilent, Cat. 210513/210515, Santa Clare, Calif. 95051 USA).

Luciferase Assays

ATDC5 cells are cultured at 2.5×104 cells/well in 24-well plates. The cells are co-transfected with miR-365 mimic (25 nM) or miRNA mimic negative control (25 nM) and 500 ng of pmirGLO-Dicer1/Zap/Sqstm1/Prkdc/Aicda 3′-UTR WT or Mut plasmids. Transfection is performed using Lipofectamine 3000 (Invitrogen, Cat. L3000-008, Carlsbad, Calif. 92008 USA) reagent. The assays are performed in triplicate unless otherwise stated. 24 hrs after transfection, cells are collected, and luciferase activity is determined using the Dual-Luciferase reporter assay system (Promega, Madison, Wis., USA) with the GLOMAX 20/20 luminometer (Model: 2031_000, Turner BioSystems, Sunnyvale, Calif. USA). Briefly, cells are rinsed with PBS and incubated with Passive Lysis Buffer (provided by the kit) for 15 mins with constant agitation at room temperature. Lysates are scraped into 1.5 mL Eppendorf tubes. 20 μl of lysates are fixed with 50 μl Luciferase Assay Buffer II to measure Firefly luciferase luminescence. 50 μl Stop & Glo buffer is then added to measure Renilla luminescence. The luciferase activity is represented by the ratio of Firefly/Renilla measurements.

Western Blot (WB)

All pre-treated samples are washed with ice-cold PBS and lysated in RIPA buffer (M-PER, Pierce, Ill.) plus protease inhibitor phenylmethylsulfonyl fluoride [Halt™, Thermo Scientific, Protease Inhibitor Single-Use Cocktail (100×), Cat. 78430] for 30 min on ice with constant agitation. The lysates are centrifuged at 12,000 g for 15 min at 4° C. The supernatants are collected, and the protein concentrations are determined using Pierce™ BCA assay (Thermo Scientific, Cat. 23225). Samples are mixed with equal volume 2× Laemmli sample buffer (Bio-Rad, Cat. 161-0737) which contains 2-Mercaptoethanol (Bio-Rad, Cat. 161-0710) and heated for 5 min at 100° C. to denature. Equal amount of proteins for each sample are separated by 8-12% SDS polyacrylamide gel depending on protein size of interest and then transferred to nitrolcellulous membrane (Bio-Rad, Cat. 162-0112) for 70 min at 100 V. The membrane is blocked with 5% bovine serum albumin (BSA, Sigma, Cat. A7906-50G) in 0.1% Tris-Buffered Saline-Tween 20 (TBS-T, BBP, Cat. IBB-581X) for 1 hr at room temperature, followed by incubation with primary antibodies against proteins of interest at 4° C. overnight. On the following day, the membrane is rinsed with TBS-T for 10 min for a total of 5 times and incubated with anti-rabbit-Alexa Fluor 680 (Molecular Probes, Eugene, Oreg., USA) for 1 hr at room temperature followed by TBS-T rinse for 10 min for a total of 5 times. The blots are then scanned using an Odyssey fluorescence scanner (LI-COR Biosciences, Lincoln, Nebr., USA) and quantitatively analyzed by ImageJ (https://imagej.nih.gov/ij/index.html).

Statistical Analysis

Data represents mean values SD (error bars). Statistical significance is calculated using student's t-test (unpaired) or ANOVA one-way test. There is a minimum of n≥3 for all groups unless otherwise stated.

MiR-365 Over-Expression Promotes Line-1 Activation in Human OA Lesion and Mouse OA Model

Human long interspersed element-1 (Line-1) has been an emerging biomarker of many human cancers and chronic diseases (Ostertag, E. M. & Kazazian, H. H., Jr. Annu Rev Genet 35, 501-538 (2001) and Birren, S. J., Lo, L. & Anderson, D. J. S. Development 119, 597-610 (1993)). Line-1 activation may be associated with cellular senescence (De Cecco, M., et al. Aging Cell 12, 247-256 (2013), and Ali, M., et al. Annals of the rheumatic diseases 62, 663-666 (2003)). Since OA is an aging associated chronic disease, studies were carried out to determine whether OA pathogenesis is companied by Line-1 activation.

qPCR analysis of RNA extracted from both lesion and non-lesion areas of human cartilages specimens shows Line-1 activities are significantly up-regulated in OA lesion areas in majority of the OA patients. Yet another abundant transposable element in human genome, Alu, which exploits the machinery encoded by Line-1 to transpose itself, exhibits no uniformed trends between lesion and non-lesion areas of human OA specimens. miR-365 expressions were up-regulated in 50% of samples, indicating an association between Line-1 and miR-365 up-regulation in OA.

To test whether miR-365 is sufficient to induce Line-1, we transfected mouse primary chondrocytes (PC) with miR-365 mimic. Upon transfection, the expression of Line-1 and Ihh, a chondrocyte hypertrophic marker, are significantly induced. siRNA against Line-1 successfully rescued the miR-365 led induction of Line-1 and Ihh, indicating that not only miR-365 is sufficiently to induce Line-1, but also Ihh could act downstream of induced Line-1 activity by miR-365.

To study the relationship between miR-365 and Line-1 in cartilage in vivo, we created transgenic mice of which miR-365 is specifically over-expressed in Col2 lineage cells (miR-365 Tg mice) (Yang, K., et al. Connect Tissue Res 58, 103-115 (2017))). We observed that miR-365 Tg mice manifest advanced onset of OA as early as at 6-month-old (Hug, B. A. Cell 119, 448-449 (2004)). Therefore, studies were carried out to determine whether Line-1 is elevated in miR-365 Tg mice. In alignment with miR-365 over-expression in cartilage, Line-1 RNA expressions are significantly up-regulated 4- and 6-month old. Besides promoting Line-1 expression, miR-365 cartilage over-expression also induces Ihh, Col10 and Mmp13 expressions in miR-365 Tg mice (Hug, B. A. Cell 119, 448-449 (2004)). Collectively, the in vivo data indicate miR-365 over-expression in cartilage drives long-term Line-1 and OA markers up-regulation which temporarily associates with OA phenotypic onset.

To test whether this causal relationship between miR-365 up-regulation and Line-1 activation exists in secondary OA model, we built injury induced OA model by performing DMM surgery on the right knees of 12956/SvEv male mice at 2 months old. One month post DMM surgery, Line-1 activities are significantly up-regulated in the destabilized right knees comparing with Sham knees. Same pattern of miR-365 increase is observed in the same knees. Consistently, significant proteoglycan loss quantified by blinded grades using OARSI scores (Sato, S., et al. TheScientificWorldJournal 2014, 685854 (2014)) is observed in DMM knees, corroborating that Line-1 activation is associated with miR-365 up-regulation as well as cartilage degradation. In addition, in C57BL/6 background WT mice which underwent DMM surgeries, Line-1 activation is tightly associated with miR-365 increase and such association is further augmented as post-surgical mice age. Hence the association between miR-365 and Line-1 up-regulation is valid in secondary OA models in mice.

MiR-365 Induces Line-1 Expression via Post-Transcriptional Suppressions of Prkdc, Dicer and Sqstm1

Bio-informatic search revealed five candidates (Aicda, Dicer, Prkdc, Sqstm1 and Zc3hav1) of potential miR-365 targets that are both conserved across species and involved in Line-1 suppression. As Line-1 activation can be induced by miR-365 over-expression in cartilage and such activation has been tightly associated with primary and secondary OA in human and mice, we are interested in whether above candidates' expressions are altered in OA tissues. qPCR analysis using human OA cartilage RNA showed DICER, PRKDC, SQSTM1 and ZAP expressions are decreased in majority of OA specimens while AICDA is not detectable in human cartilage. Only Prkdc is down-regulated at the RNA level in miR-365 Tg mice articular cartilage. To further confirm in vitro, we over-expressed miR-365 in mouse PC, to evaluate wither miR-365 increase in cartilage induces Line-1 activation via post-transcriptional suppression of Line-1 inhibitors.

Aicda (Faulkner, G. J. PLoS Genet 9, e1003944 (2013)), Dicer (Morrish, T. A., et al. Nature genetics 31, 159-165 (2002)V), Prkdc (Guo, H., et al. Nature communications 5, 5276 (2014)), Sqstm1 (Moldovan, J. B. & Moran, J. V. PLoS Genet 11, e1005121 (2015)) and Zc3hav1 (Erwin, J. A., et al. Nat Rev Neurosci 15, 497-506 (2014)) are shown to be involved in inhibition of Line-1 at various biogenesis stages. WB using proteins isolated from primary mouse chondrocytes transfected with miR-365 mimic and Sqstm1 cDNA demonstrates Line-1 is significantly induced by miR-365 transient over-expression and rescued by Sqstm1 over-expression, indicating Sqstm1 is involved in miR-365 over-expression induced Line-1 activation in cartilage. Furthermore, WB shows while Dicer protein expression is suppressed by miR-365 transfection, it is induced by miR-365 inhibitor, indicating that miR-365 affects Dicer expression at post-transcriptional level.

To further test whether Prkdc, Dicer and Sqstm1 are authentic targets of miR-365, we co-transfected ATDC5 cells with luciferase genes bearing predicted binding sites of WT 3′UTR of Aicda, Dicer, Prkdc, Sqstm1 and Zc3hav1 at 3′ ends as well as miR-365 mimic or mimic control respectively. Dicer, Prkdc and Sqstm1 WT 3′UTR luciferase reporter genes showed significant reduction of activities regarding to miR-365 over-expression and those reduction are completely abolished via site-directed mutagenesis of the predicted seeding sites. Hence Dicer, Prkdc and Sqstm1 are authentic targets of miR-365 in chondrocytes.

3TC Suppresses Line-1 Activities and Prevent Primary OA Development in Mice

Since miR-365/Line-1 axis snugly correlates with OA development in both human OA samples and mouse OA models, experiments were carried out to determine whether inhibition of Line-1 activity prevents or rescues OA onset. A class of drugs termed Reverse-transcriptase inhibitor (NRTI), which are popularly prescribed for controlling HIV and HBV infections attributing to their anti-retroviral function, can suppress retrotransposable elements activities in various models (Patnala, R., et al. Breast Cancer Res Treat 143, 239-253 (2014), Jones, R. B., et al PloS one 3, e1547 (2008), and Guilak, F. Best practice & research. Clinical rheumatology 25, 815-823 (2011)). However, prior to the invention, NRTI used to rescue OA pathogenesis had not been described.

To test whether NRTIs can inhibit OA markers via suppressing Line-1 in chondrocytes, we treated human and mouse chondrocytes with various concentrations of 3TC. qPCR analysis shows 3TC suppresses Line-1, Inf-α, Adamts5, Col10 expressions yet promotes Col2 expression in mouse chondrocytes. In human chondrocytes, whilst 3TC inhibits LINE-1, IHH, COL10 and ADAMTS5 expressions, 3TC promotes ACAN expression. Since Col10, Ihh and Mmp13 are induced in the articular cartilage of miR-365 Tg mice, we treated human chondrocytes that already over-express miR-365 with various concentrations of 3TC. Upon transfection, 3TC completely abolishes the miR-365 induced up-regulation of LINE-1, ADAMTS5, IHH and COL10 and rectifies ACAN suppression by miR-365.

Because 3TC treatment rescues miR-365 induced Line-1 OA markers up-regulation, we tested whether 3TC can rescue OA phenotypes in primary OA model observed in miR-365 Tg mice. Starting at 2-month old, miR-365 Tg and age matched control mice (Cre only) are treated with 3TC dilution water or saline diluted water for 4 months before sacrifice. Consistently, proteoglycan loss is observed in the articular surface of miR-365 treated with saline but not of 3TC treatment. Furthermore, Line-1, Inf-α, Col10 and Adamts5 expressions are significantly inhibited by 3TC treatment in miR-365 Tg mice. However, IL-6 or Acan levels are unchanged. miR-365 expression is also suppressed by oral 3TC treatment specifically in miR-365 Tg mice. The data elucidates 3TC treatment, by inhibiting Line-1 activity, can appreciably reverse Col2 lineage cell specific miR-365 over-expression induced OA markers including Col10 and Adamts5 in vivo.

3TC and FTC Prevent DMM Induced OA

In the light of the promising anti-OA activity of 3TC, we evaluated another widely prescribed cytidine analogue, FTC. Although FTC suppresses Line-1 and Inf-α as well as inflammasome pathway like P2rx7 and Nlrp3, it induces Mmp3, Mmp13, Adamts5 and Col10 expressions whilst promotes Col2 and Acan expressions in mouse PC. Taken together, 3TC preferably inhibits OA markers while promoting ECM synthesis, while FTC promotes both OA markers and ECM synthesis simultaneously in vitro.

Next, we tested the effects of 3TC and FTC using ex vivo femur organ cultures. We incubated intact femur isolated from 21-day old WT mice into complete medium containing 3TC or FTC and performed qPCR analysis using RNAs peeled from femur articular cartilages after 48 hrs incubation. While 3TC consistently does a promising job in terms in inhibiting Line-1, Mmp13, Adamts5 and Col10, FTC inhibits Mmp13 and Adamts5 expressions. 3TC induces Col2 and Acan expressions when FTC induces the latter. Collectively, the data further indicates the potential anti-OA role of 3TC and FTC.

To test whether NRTIs can rescue secondary OA model, we treated 12956 mice which underwent either DMM or Sham surgeries with 3TC or FTC diluted water respectively from 8 weeks old for a total of 4 weeks. No appreciable difference of body weights between drug and control treatment groups were noticed. During histology assessment, we found both 3TC and FTC treatments effectively prevent DMM induced proteoglycan loss in surgical knees. Meanwhile, qPCR analysis confirmed Line-1 inhibition introduced by 3TC and FTC. Chondrolytic markers including Mmp13, Adamts5 and hypertrophic maker Col10 are significantly repressed in 3TC and FTC treated DMM groups comparing with Saline treatment. Both 3TC and FTC treatments significantly prohibit miR-365 induction by DMM, providing intriguing hints that NRTIs may act up-stream of miR-365. Therefore, 3TC and FTC prevents secondary OA onset by inhibiting Line-1 up-regulation and repressing OA markers.

The data indicate that miR-365 targets retrotransposable element suppressors including Dicer, Prkdc and Sqstm1. Through this circuit, miR-365 controls Line-1 expression thereby promoting cartilage degradation. Suppressing Line-1 expression using NRTIs, for example 3TC and FTC, through their anti-reverse transcriptional functions, prevents cartilage degradation and results in OA phenotype rescue.

Osteoarthritis is Treated by Inhibiting MicroRNA Up-Regulation of Retrotransposon LINE-1

Prior to the invention, retrotransposable element activation has not been associated with OA pathogenesis. Our results for the first time unearth the correlation between OA development and Line-1 activation in both human OA specimens and mouse in vivo models.

OA is a multi-factor as well as polygenic disease as etiology indicates there is no single cause of OA pathogenesis (Birren, et al. Development 119, 597-610 (1993)). Human OA specimens are of heterogeneous etiologies as the entire information of human donors are difficult to trace back. The up-regulation of miR-365 and activation of Line-1 are consistent in majority of the human OA specimens, indicating the strong association between these two exists in most human cases. As Line-1 activation may also correlate with aging (De Cecco, M., et al. Aging Cell 12, 247-256 (2013), Ali, M., et al. Annals of the rheumatic diseases 62, 663-666 (2003)), given that the human donors are of various ages, the basal Line-1 levels are difficult to unify. Yet OA development in WT mouse hardly occur. miR-365 Tg mice represent mono-factor OA model which is specifically triggered by the over-expression of miR-365 in Col2-lineage cells, which comprise the most population in cartilage. In addition, all mouse experimental subjects are age- and gender-matched, thus making rodent results more uniform and more consistent between individual subjects. The art recognized mouse models described herein are indicative of the human disease/disorder.

Data from miR-365 Tg mice treated with 3TC indicates 3TC inhibits Col10 and Adamts5 expressions specifically via suppressing Line-1 pathways as IL-6 expressions, which is a down-stream gene of miR-365, are left unchanged. miR-365 and Line-1 expressions are significantly suppressed by 3TC specifically in miR-365 Tg. miR-365 expression is significantly suppressed by 3TC and FTC in DMM induced OA models. The data indicate that NRTIs affect miR-365 expression. For example 3TC and FTC treatments specifically suppress supra-physical miR-365/Line-1 expressions in non-injury OA model, because physical miR-365 expression is required during mechanical signal transduction, which is a good indicator for the effective usage of 3TC and FTC in treating both primary and secondary OA without delivering adverse effects.

Both siLine-1 and 3TC suppress not only Line-1 but also Ihh in vitro while 3TC suppresses only Line-1 but not Ihh in vivo. This difference may be attributed to contrast between in vitro condition and in vivo environment. For instance, PC are isolated from neonatal mice while in vivo 3TC treatment are conducted in near fully developed mice from 2-month old till 6-month old when the qPCRs are performed. The effect of Line-1 inhibition in chondrocytes at different stages might be various. Furthermore, while the former experiment is transient, the latter is a long-term treatment. Last but only least, 3TC treatment, beyond inhibiting Line-1 specifically, might alter other pathways. Ihh pathway might parallel with Line-1 pathway in cartilage in vivo, at least during long-term 3TC treatment. Similar explanation may also underly miR-365 induced Mmp13 results.

In this study, we have demonstrated a regulatory role for miR-365 through inducing retrotransposable element, Line-1, to promote OA pathogenesis. In order to reduce the severity of and/or prevent OA, feasible methods to suppress Line-1 including administration of 3TC and FTC and siRNA against Line-1 are useful as therapeutic approaches in counteracting osteoarthritis.

Pharmaceutical Compositions

The present invention provides also pharmaceutical compositions comprising a nucleoside reverse transcriptase inhibitor (NRTI) (e.g., 3TC or FTC) and at least one pharmaceutically acceptable excipient or carrier. In examples, the pharmaceutical composition comprises an effective amount of the NRTI (e.g., 3TC or FTC) as described herein in connection with the methods of the invention.

In one embodiment, the composition (e.g., a composition comprising an NRTI) is further combined with at least one additional therapeutic agent in a single dosage form.

The term “pharmaceutically acceptable” refers to those compounds, materials, compositions, carriers, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.

“Pharmaceutically acceptable excipient” means an excipient that is useful in preparing a pharmaceutical composition that is generally safe, non-toxic and neither biologically nor otherwise undesirable, and includes excipient that is acceptable for veterinary use as well as human pharmaceutical use. Examples of pharmaceutically acceptable excipients include, without limitation, sterile liquids, water, buffered saline, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol and the like), oils, detergents, suspending agents, carbohydrates (e.g., glucose, lactose, sucrose or dextran), antioxidants (e.g., ascorbic acid or glutathione), chelating agents, low molecular weight proteins, or suitable mixtures thereof.

A pharmaceutical composition can be provided in bulk or in dosage unit form. It is especially advantageous to formulate pharmaceutical compositions in dosage unit form for ease of administration and uniformity of dosage. The term “dosage unit form” as used herein refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier. The specification for the dosage unit forms of the invention are dictated by and directly dependent on the unique characteristics of the active compound and the particular therapeutic effect to be achieved. A dosage unit form can be an ampoule, a vial, a suppository, a dragee, a tablet, a capsule, an IV bag, or a single pump on an aerosol inhaler.

For treatment of articulating joint disorders such as OA (or RA-rheumatoid arthritis), the NRTIs are administered intra-articularly (directly into a joint), intravenously, orally, or transcutaneously.

The parenteral and/or intra-articular preparation can be enclosed in ampules, disposable syringes or multiple dose vials made of glass or plastic. Intra-articular administration is useful for local treatment of disease and flare-up, e.g. pain in joints, osteoarthritis, synovitis and the like. A complex of the present invention may also be administered as a bolus, electuary or paste. Exemplary administrations include: Intra-articular, Peri-articular, Intra-bursal, Intra-muscular, or Soft tissue—tendon ruptures. Exemplary administration volumes for adult human are shown below, and are proportionally smaller for a human child.

Joint Volume Shoulder 10 ml  Elbow 5 ml Wrist/thumb 2 ml Fingers 1 ml Hip 5 ml Knee 10 ml  Ankle, foot 5 ml Toes 1 ml

In therapeutic applications, the dosages vary depending on the agent, the age, weight, and clinical condition of the recipient patient, and the experience and judgment of the clinician or practitioner administering the therapy, among other factors affecting the selected dosage. Generally, the dose should be a therapeutically effective amount. Dosages can be provided in mg/kg/day units of measurement (which dose may be adjusted for the patient's weight in kg, body surface area in m2, and age in years). Exemplary doses and dosages regimens for the compositions in methods of treating muscle diseases or disorders are described herein.

The pharmaceutical compositions can take any suitable form (e.g., liquids, aerosols, solutions, inhalants, mists, sprays; or solids, powders, ointments, pastes, creams, lotions, gels, patches and the like) for administration by any desired route (e.g., pulmonary, inhalation, intranasal, oral, buccal, sublingual, parenteral, subcutaneous, intravenous, intramuscular, intraperitoneal, intrapleural, intrathecal, transdermal, transmucosal, rectal, and the like). For example, a pharmaceutical composition of the invention may be in the form of an aqueous solution or powder for aerosol administration by inhalation or insufflation (either through the mouth or the nose), in the form of a tablet or capsule for oral administration; in the form of a sterile aqueous solution or dispersion suitable for administration by either direct injection or by addition to sterile infusion fluids for intravenous infusion; or in the form of a lotion, cream, foam, patch, suspension, solution, or suppository for transdermal or transmucosal administration.

In embodiments, the pharmaceutical composition comprises an injectable form.

A pharmaceutical composition can be in the form of an orally acceptable dosage form including, but not limited to, capsules, tablets, buccal forms, troches, lozenges, and oral liquids in the form of emulsions, aqueous suspensions, dispersions or solutions. Capsules may contain mixtures of a compound of the present invention with inert fillers and/or diluents such as the pharmaceutically acceptable starches (e.g., corn, potato or tapioca starch), sugars, artificial sweetening agents, powdered celluloses, such as crystalline and microcrystalline celluloses, flours, gelatins, gums, etc.

A pharmaceutical composition can be in the form of a sterile aqueous solution or dispersion suitable for systemic administration.

A pharmaceutical composition can be in the form of a sterile aqueous solution or dispersion suitable for administration by either direct injection or by addition to sterile infusion fluids for intravenous infusion, and comprises a solvent or dispersion medium containing, water, ethanol, a polyol (e.g., glycerol, propylene glycol and liquid polyethylene glycol), suitable mixtures thereof, or one or more vegetable oils. Solutions or suspensions of the compound of the present invention as a free base or pharmacologically acceptable salt can be prepared in water suitably mixed with a surfactant. Examples of suitable surfactants are given below. Dispersions can also be prepared, for example, in glycerol, liquid polyethylene glycols and mixtures of the same in oils.

The pharmaceutical compositions for use in the methods of the present invention can further comprise one or more additives in addition to any carrier or diluent (such as lactose or mannitol) that is present in the formulation. The one or more additives can comprise or consist of one or more surfactants. Surfactants typically have one or more long aliphatic chains such as fatty acids which enables them to insert directly into the lipid structures of cells to enhance drug penetration and absorption. An empirical parameter commonly used to characterize the relative hydrophilicity and hydrophobicity of surfactants is the hydrophilic-lipophilic balance (“HLB” value). Surfactants with lower HLB values are more hydrophobic, and have greater solubility in oils, while surfactants with higher HLB values are more hydrophilic, and have greater solubility in aqueous solutions. Thus, hydrophilic surfactants are generally considered to be those compounds having an HLB value greater than about 10, and hydrophobic surfactants are generally those having an HLB value less than about 10. However, these HLB values are merely a guide since for many surfactants, the HLB values can differ by as much as about 8 HLB units, depending upon the empirical method chosen to determine the HLB value.

All percentages and ratios used herein, unless otherwise indicated, are by weight. Other features and advantages of the present invention are apparent from the different examples. The provided examples illustrate different components and methodology useful in practicing the present invention. The examples do not limit the claimed invention. Based on the present disclosure the skilled artisan can identify and employ other components and methodology useful for practicing the present invention.

Kits Comprising the NRTI

In aspects, a kit for an NRTI is provided. In embodiments, the kit comprises the NRTI and reagents.

In embodiments, components of the kit are suitable for delivery (e.g., systemic administration) to a subject.

The present invention also provides packaging and kits comprising pharmaceutical compositions for use in the methods of the present invention. The kit can comprise one or more containers selected from the group consisting of a bottle, a vial, an ampoule, a blister pack, and a syringe. The kit can further include one or more of instructions for use in treating and/or preventing a disease, condition or disorder of the present invention (e.g., a joint diseases such as osteoarthritis), one or more syringes, one or more applicators, or a sterile solution suitable for reconstituting a pharmaceutical composition of the present invention.

General Definitions

Unless specifically defined otherwise, all technical and scientific terms used herein shall be taken to have the same meaning as commonly understood by one of ordinary skill in the art (e.g., in cell culture, molecular genetics, and biochemistry).

As used herein, the term “about” in the context of a numerical value or range means ±10% of the numerical value or range recited or claimed, unless the context requires a more limited range.

In the descriptions above and in the claims, phrases such as “at least one of” or “one or more of” may occur followed by a conjunctive list of elements or features. The term “and/or” may also occur in a list of two or more elements or features. Unless otherwise implicitly or explicitly contradicted by the context in which it is used, such a phrase is intended to mean any of the listed elements or features individually or any of the recited elements or features in combination with any of the other recited elements or features. For example, the phrases “at least one of A and B;” “one or more of A and B;” and “A and/or B” are each intended to mean “A alone, B alone, or A and B together.” A similar interpretation is also intended for lists including three or more items. For example, the phrases “at least one of A, B, and C;” “one or more of A, B, and C;” and “A, B, and/or C” are each intended to mean “A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together.” In addition, use of the term “based on,” above and in the claims is intended to mean, “based at least in part on,” such that an unrecited feature or element is also permissible

It is understood that where a parameter range is provided, all integers within that range, and tenths thereof, are also provided by the invention. For example, “0.2-5 mg” is a disclosure of 0.2 mg, 0.3 mg, 0.4 mg, 0.5 mg, 0.6 mg etc. up to and including 5.0 mg.

A small molecule is a compound that is less than 2000 daltons in mass. The molecular mass of the small molecule is preferably less than 1000 daltons, more preferably less than 600 daltons, e.g., the compound is less than 500 daltons, 400 daltons, 300 daltons, 200 daltons, or 100 daltons.

As used herein, an “isolated” or “purified” nucleic acid molecule, polynucleotide, polypeptide, or protein, is substantially free of other cellular material, or culture medium when produced by recombinant techniques, or chemical precursors or other chemicals when chemically synthesized. Purified compounds are at least 60% by weight (dry weight) the compound of interest. Preferably, the preparation is at least 75%, more preferably at least 90%, and most preferably at least 99%, by weight the compound of interest. For example, a purified compound is one that is at least 90%, 91%, 92%, 93%, 94%, 95%, 98%, 99%, or 100% (w/w) of the desired compound by weight. Purity is measured by any appropriate standard method, for example, by column chromatography, thin layer chromatography, or high-performance liquid chromatography (HPLC) analysis. A purified or isolated nucleoside, nucleoside analog, e.g., NRTI, polynucleotide (ribonucleic acid (RNA) or deoxyribonucleic acid (DNA)) of nucleotides or nucleosides that flank it in its naturally occurring states. A purified or isolated polypeptide is free of the amino acid sequences that flank it in its naturally-occurring state. Purified also defines a degree of sterility that is safe for administration to a human subject, e.g., lacking infectious or toxic agents.

Similarly, by “substantially pure” is meant a nucleotide or polypeptide that has been separated from the components that naturally accompany it. Typically, the nucleotides and polypeptides are substantially pure when they are at least 60%, 70%, 80%, 90%, 95%, or even 99%, by weight, free from the proteins and naturally-occurring organic molecules with they are naturally associated.

The transitional term “comprising,” which is synonymous with “including,” “containing,” or “characterized by,” is inclusive or open-ended and does not exclude additional, unrecited elements or method steps. By contrast, the transitional phrase “consisting of” excludes any element, step, or ingredient not specified in the claim. The transitional phrase “consisting essentially of” limits the scope of a claim to the specified materials or steps “and those that do not materially affect the basic and novel characteristic(s)” of the claimed invention.

The terms “subject,” “patient,” “individual,” and the like as used herein are not intended to be limiting and can be generally interchanged. That is, an individual described as a “patient” does not necessarily have a given disease, but may be merely seeking medical advice.

The term “subject” as used herein includes a human or animal diagnosed with an osteoarthritic disorder.

As used herein, the singular forms “a,” “an,” and “the” include the plural reference unless the context clearly dictates otherwise. Thus, for example, a reference to “a disease,” “a disease state”, or “a nucleic acid” is a reference to one or more such embodiments, and includes equivalents thereof known to those skilled in the art and so forth.

As used herein, “treating” encompasses, e.g., inhibition, regression, or stasis of the progression of a disorder. Treating also encompasses the prevention or amelioration of any symptom or symptoms of the disorder. As used herein, “inhibition” of disease progression or a disease complication in a subject means preventing or reducing the disease progression and/or disease complication in the subject.

As used herein, a “symptom” associated with a disorder includes any clinical or laboratory manifestation associated with the disorder, and is not limited to what the subject can feel or observe.

As used herein, “effective” when referring to an amount of a therapeutic compound refers to the quantity of the compound that is sufficient to yield a desired therapeutic response without undue adverse side effects (such as toxicity, irritation, or allergic response) commensurate with a reasonable benefit/risk ratio when used in the manner of this disclosure.

As used herein, “pharmaceutically acceptable” carrier or excipient refers to a carrier or excipient that is suitable for use with humans and/or animals without undue adverse side effects (such as toxicity, irritation, and allergic response) commensurate with a reasonable benefit/risk ratio. It can be, e.g., a pharmaceutically acceptable solvent, suspending agent or vehicle, for delivering the instant compounds to the subject.

Examples are provided below to facilitate a more complete understanding of the invention. The following examples illustrate the exemplary modes of making and practicing the invention. However, the scope of the invention is not limited to specific embodiments disclosed in these Examples, which are for purposes of illustration only, since alternative methods can be utilized to obtain similar results.

“Percentage of sequence identity” is determined by comparing two optimally aligned sequences over a comparison window, wherein the portion of the polynucleotide or polypeptide sequence in the comparison window may comprise additions or deletions (i.e., gaps) as compared to the reference sequence (which does not comprise additions or deletions) for optimal alignment of the two sequences. The percentage is calculated by determining the number of positions at which the identical nucleic acid base or amino acid residue occurs in both sequences to yield the number of matched positions, dividing the number of matched positions by the total number of positions in the window of comparison and multiplying the result by 100 to yield the percentage of sequence identity.

The term “identical” or percent “identity,” in the context of two or more nucleic acids or polypeptide sequences, refer to two or more sequences or subsequences that are the same or have a specified percentage of amino acid residues or nucleotides that are the same (e.g., 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or more identity over a specified region, e.g., of an entire polypeptide sequence or an individual domain thereof), when compared and aligned for maximum correspondence over a comparison window, or designated region as measured using a sequence comparison algorithm or by manual alignment and visual inspection. Such sequences that are at least about 80% identical are said to be “substantially identical.” In some embodiments, two sequences are 100% identical. In certain embodiments, two sequences are 100% identical over the entire length of one of the sequences (e.g., the shorter of the two sequences where the sequences have different lengths). In various embodiments, identity may refer to the complement of a test sequence. In some embodiments, the identity exists over a region that is at least about 10 to about 100, about 20 to about 75, about 30 to about 50 amino acids or nucleotides in length. In certain embodiments, the identity exists over a region that is at least about 50 amino acids in length, or more preferably over a region that is 100 to 500, 100 to 200, 150 to 200, 175 to 200, 175 to 225, 175 to 250, 200 to 225, 200 to 250 or more amino acids in length.

For sequence comparison, typically one sequence acts as a reference sequence, to which test sequences are compared. In various embodiments, when using a sequence comparison algorithm, test and reference sequences are entered into a computer, subsequence coordinates are designated, if necessary, and sequence algorithm program parameters are designated. Preferably, default program parameters can be used, or alternative parameters can be designated. The sequence comparison algorithm then calculates the percent sequence identities for the test sequences relative to the reference sequence, based on the program parameters.

A the “comparison window” refers to a segment of any one of the number of contiguous positions (e.g., least about 10 to about 100, about 20 to about 75, about 30 to about 50, 100 to 500, 100 to 200, 150 to 200, 175 to 200, 175 to 225, 175 to 250, 200 to 225, 200 to 250) in which a sequence may be compared to a reference sequence of the same number of contiguous positions after the two sequences are optimally aligned. In various embodiments, a comparison window is the entire length of one or both of two aligned sequences. In some embodiments, two sequences being compared comprise different lengths, and the comparison window is the entire length of the longer or the shorter of the two sequences. Methods of alignment of sequences for comparison are well-known in the art. Optimal alignment of sequences for comparison can be conducted, e.g., by the local homology algorithm of Smith & Waterman, Adv. Appl. Math. 2:482 (1981), by the homology alignment algorithm of Needleman & Wunsch, J. Mol. Biol. 48:443 (1970), by the search for similarity method of Pearson & Lipman, Proc. Nat'l. Acad. Sci. USA 85:2444 (1988), by computerized implementations of these algorithms (GAP, BESTFIT, FASTA, and TFASTA in the Wisconsin Genetics Software Package, Genetics Computer Group, 575 Science Dr., Madison, Wis.), or by manual alignment and visual inspection (see, e.g., Current Protocols in Molecular Biology (Ausubel et al., eds. 1995 supplement)).

In various embodiments, an algorithm that is suitable for determining percent sequence identity and sequence similarity are the BLAST and BLAST 2.0 algorithms, which are described in Altschul et al., Nuc. Acids Res. 25:3389-3402 (1977) and Altschul et al., J. Mol. Biol. 215:403-410 (1990), respectively. BLAST and BLAST 2.0 may be used, with the parameters described herein, to determine percent sequence identity for nucleic acids and proteins. Software for performing BLAST analyses is publicly available through the National Center for Biotechnology Information, as known in the art. This algorithm involves first identifying high scoring sequence pairs (HSPs) by identifying short words of length W in the query sequence, which either match or satisfy some positive-valued threshold score T when aligned with a word of the same length in a database sequence. T is referred to as the neighborhood word score threshold (Altschul et al., supra). These initial neighborhood word hits act as seeds for initiating searches to find longer HSPs containing them. The word hits are extended in both directions along each sequence for as far as the cumulative alignment score can be increased. Cumulative scores are calculated using, for nucleotide sequences, the parameters M (reward score for a pair of matching residues; always >0) and N (penalty score for mismatching residues; always <0). For amino acid sequences, a scoring matrix is used to calculate the cumulative score. Extension of the word hits in each direction are halted when: the cumulative alignment score falls off by the quantity X from its maximum achieved value; the cumulative score goes to zero or below, due to the accumulation of one or more negative-scoring residue alignments; or the end of either sequence is reached. The BLAST algorithm parameters W, T, and X determine the sensitivity and speed of the alignment. The BLASTN program (for nucleotide sequences) uses as defaults a wordlength (W) of 11, an expectation (E) of 10, M=5, N=−4 and a comparison of both strands. For amino acid sequences, the BLASTP program uses as defaults a wordlength of 3, and expectation (E) of 10, and the BLOSUM62 scoring matrix (see Henikoff & Henikoff, Proc. Natl. Acad. Sci. USA 89:10915 (1989)) alignments (B) of 50, expectation (E) of 10, M=5, N=−4, and a comparison of both strands.

EXAMPLES

The following examples illustrate certain specific embodiments of the invention and are not meant to limit the scope of the invention.

Embodiments herein are further illustrated by the following examples and detailed protocols. However, the examples are merely intended to illustrate embodiments and are not to be construed to limit the scope herein. The contents of all references and published patents and patent applications cited throughout this application are hereby incorporated by reference.

Compared to other methods, an illustrative non-limiting method in the Example that follows uses three commercially available mediums to generate beige adipocytes, which are largely serum/xeno free, which resulted in more consistent results. These beige adipocytes were functionally similar to brown adipocytes, but are developmentally distinct. In embodiments, serum characteristics can change from lot to lot, and mediums that are highly quality controlled are preferably used.

Example 1: Activation of L1 in OA and its Dependency on miR-365

To determine whether L1 levels were elevated in OA joint, RNA was extracted from an OA lesion and non-lesion area (FIG. 5B) in the same human OA cartilage specimen collected from joint replacement surgery of aged patients (Female: 68±12; Male: 73±5) (FIG. 5A). This eliminated individual variations of LI levels in different patients. OA lesions exhibited fissures (FIG. 5C), more pronounced loss of proteoglycan (FIG. 5D), and significant increase of the percentage of senescent cells (FIG. 5E) compared to non-lesions.

L1 levels were significantly up-regulated in the OA lesion area than a non-lesion area in the majority of OA patients (FIG. 1A). In contrast, another abundant transposon in human genome, Arthrobacter luteus elements (Alu), exhibited no uniformed up-regulation in human OA lesions (FIG. 1B). MiRNA-365, a mechanical and inflammation sensitive microRNA (Yang, X., et al. Int J Mol Sci 17, 436 (2016), and Guan, Y. J., et al. FASEB journal 25, 4457-4466 (2011)), was up-regulated in the majority of OA patients (FIG. 1C), suggesting an association between L1 and miR-365 in OA cartilage.

To test this association, mouse primary chondrocytes were transfected with miR-365 mimic. MiR-365 significantly induced L1 (FIG. 1D), OA markers Indian hedgehog (Ihh) and ADAMTS-5 (FIGS. 1E and 1G), and senescence associated secretory phenotype (SASP) marker MMP-3 (FIG. 1F). It also significantly decreased anabolic extracellular matrix (ECM) Col2a1 and Acan (FIGS. 1H and 1I). To determine whether miR-365-elicited gene expression changes depend on L1, siRNA was screened against L1 (FIG. 6A). Knocking down L1 with L1 siRNA (siLine-1D) abolished miR-365-elicited gene expression changes (FIG. 1D-1I). Therefore, L1 activation depended on miR-365 in vitro.

To determine whether L1 activation also depends on miR-365 in vivo, mice were generated harboring the miR-365-Flox transgene in an intergenic region on chromosome 4 (Yang, K., et al. Connect Tissue Res 58, 103-115 (2017)). Crossing of miR-356-Flox mice with Col2a1 Cre mice generated transgenic mice (miR-365 Tg) in which miR-365 transgene was specifically expressed in cartilage (FIG. 7) (Yang, K., et al. Connect Tissue Res 58, 103-115 (2017)). These mice had up to six-fold increase of miR-365 levels in cartilage in comparison to their littermates Cre only (FIG. 1J). L1 RNA levels were consistently up-regulated for up to three-fold increase in cartilage throughout adulthood (FIG. 1K). The cartilage in these mice was phenotypically normal until 6 months old, when they developed early onset of OA, characterized by thinning and loss of articular cartilage (FIGS. 1Q and 1R) and expression of OA markers Col10a1 and Mmp13 (FIG. 1P). Real-time PCR analysis indicated that the mRNA levels of OA markers Ihh, Col10a1, Adamts5, and Mmp13 were up-regulated in cartilage (FIG. 11O). Thus, miR-365 activated L1 and caused early onset of OA in vivo.

To determine whether L1 activation was also associated with injury induced PTOA, joint injury was generated by performing destabilizing medial meniscus (DMM) surgery in two genetic strains of mice (129s6/SvEv and C57BL/6) that have different OA development periods (FIGS. 1S and 1V). Joint injury significantly increased both L1 and miR-365 levels in the injured knee during PTOA onset (3-month-old) in comparison to the non-injured knee of 129s6/SvEv mice (FIGS. 1T and 1U). Thus joint injury induced L1 and miR-365 levels in cartilage.

To determine the effects of aging process on L1 levels, DMM surgery was performed on C57BL/6 mice and let them age for additional five months (FIG. 1V). While the L1 level almost doubled in the first 1.5 months period (4-5.5 months) following the onset of OA at 4-month-old, it increased almost 200 fold in the subsequent 1.5 months period (5.5-7 months) (FIG. 1W). This was in contrast to miR-365, which had linear accumulation during these two periods (FIG. 1X). It indicated that L1 were amplified during OA progression. Thus, L1 is activated by injury and amplified during aging.

Example 2: Mechanisms of miR-Dependent L1 Activation

MiR365 could be induced by mechanical stress and inflammatory cytokines (Yang, X., et al. Int J Mol Sci 17, 436 (2016), and Guan, Y. J., et al. FASEB journal 25, 4457-4466 (2011)), however, it was not known how it could activate L1. It was hypothesized that miR-365 activated L1 by targeting L1 inhibitors in the host defense pathways in a post-transcription manner. Through bioinformatics analysis of 40 L1 inhibitors based on published literature (Goodier, J. L. Mob DNA 7, 16 (2016)), five L1 inhibitors were identified that harbored potential miR-365 binding sites in its 3′ UTR of mRNA in both human and mouse (FIG. 8A). They are Prkdc of DNA repair (Morrish, T. A., et al. Nature 446, 208-212 (2007) and Morrish, T. A., et al. Nature genetics 31, 159-165 (2002)), Aicda of DNA editing (Metzner, M., et al. PloS one 7, e49358 (2012)), Dicer of RNA interference (Faulkner, G. J. PLoS Genet 9, e1003944 (2013)), Sqstm1 of autophagy (Guo, H., et al. Nature communications 5, 5276 (2014)), and Zc3hav1 of viral inhibition (Moldovan, J. B. et al. PLoS Genet 11, e1005121 (2015)) (FIG. 2A).

These targets were further screened in three ways (FIG. 8B). First, their expression in human and mouse OA cartilage was quantified. The mRNA of DICER, PRKDC, SQSTM1, and ZC3HAV1 were uniformly down-regulated in human OA cartilage lesions (FIG. 2B-2E), while Dicer, Prkdc, Sqstm1 and Zc3hav1 were down-regulated in miR-365 Tg mouse cartilage (FIG. 2F-2I). However, AICDA was not detected in human cartilage and expressed at very low levels in mouse chondrocytes (FIG. 2J). Thus, multiple L1 inhibitors including DICER, PRKDC, SQSTM1, and ZC3HAV1 in the host defense pathway were suppressed in OA cartilage. Second, miR-365 was transfected in both mouse and human chondrocytes. MiR-365 inhibited mRNAs of DICER, PRKDC, SQSTM1, and ZC3HAV1 in both mouse and human cells, while it did not inhibit AICDA mRNA in either species (FIGS. 2J and 2K). Thus, miR-365 induction was sufficient to suppress multiple L1 inhibitors including DICER, PRKDC, SQSTM1, and ZC3HAV1 simultaneously. Third, luciferase reporter constructs were made harboring putative miR-365 binding site in the 3′UTR of these five mRNA. Transfection of miR-365 inhibited the 3′UTR reporter activity of Dicer, Prkdc, and Sqstm1, but not that of Aicda and Zc3hav1 (FIG. 2L). Mutation of the miR-365 binding site in the 3′UTR region of Dicer, Prkdc, and Sqstm1 abolished the miR-365 inhibition of the reporter activity (FIG. 2L). Thus, miR-365 inhibited multiple L1 inhibitors including DICER, PRKDC, SQSTM1 through a post-transcriptional mechanism. Based on these data, it was concluded that 1) among L1 inhibitors, DICER, PRKDC, SQSTM1, and ZC3HAV1 were targets of miR-365; and 2) miR-365 inhibits DICER, PRKDC, SQSTM1 through its binding site in the 3′UTR of mRNAs.

miR-365 activated L1 through inhibiting Dicer and Sqstm1. While transfection of miR-365 mimic stimulated L1 at both RNA and protein levels (FIGS. 2M and 2N), it inhibited Dicer protein (FIG. 2O). Conversely, transfection of miR-365 inhibitor repressed L1 (FIGS. 2M and 2N), but increased Dicer protein levels (FIG. 2O). Thus, miR-365 regulated L1 and Dicer protein levels.

Example 3: Repressing L1 Inhibits Early Onset of OA

L1 can be repressed by nucleoside reverse transcriptase inhibitors (NRTIs) (Dai, L., Huang, Q. & Boeke, J. D. BMC Biochem 12, 18 (2011), Patnala, R., et al. Breast Cancer Res Treat 143, 239-253 (2014), and Jones, R. B., et al. PLoS One 3, e1547 (2008)). To determine whether repressing L1 by NRTI is sufficient to inhibit OA gene expression, chondrocytes were treated with Lamivudine (3TC) in a series of concentrations (FIG. 3A-3AC). 3TC inhibited L1 expression at both RNA and protein levels in mouse (FIGS. 3A and 3H) and human (FIG. 3I) chondrocytes. Repressing L1 with 3TC inhibited expression of OA markers including COL10A1, ADAMTS5, and MMP13 and stimulated anabolic markers including ACAN and COL2A1 in mouse (FIG. 3B-3G) and human (FIG. 3J-3N) chondrocytes. To determine whether 3TC could abolish the effect of miR-365 on chondrocytes, miR-365 was treated with transfected human chondrocytes with 3TC. Transfection of miR-365 significantly increased L1 as well as OA markers ADAMTS5, IHH, and COL10A1, and decreased ACAN levels (FIG. 3O-3T). 3TC treatment abolished and in some cases even reversed the effect of miR-365 (FIG. 3O-3T). Thus, 3TC treatment was sufficient to suppress OA gene expression in vitro.

The gene expression of Prkdc at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

Also, the gene expression of Dicer at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

The gene expression of Sqstm1 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

The gene expression of Zc3hav1 at RNA level in mouse articular cartilage treated with 3TC for 4 months was assessed by RT-qPCR. Line-1-ORF2, Alu, IL-6, Col10a1, Adamts5 and miR-365 expression was significantly suppressed in miR-365 Tg mice treated with 3TC comparing with elevated Line-1 expression in Saline treated miR-365 Tg mice. 3TC treatment significantly up-regulated Sqstm1 and Zac3hav1 expression in miR-365 Tg mice. Student t-test and one-way ANOVA test (x-ac) were used for statistics. n≥4. *p≤0.05, **p≤0.01 relative to appropriate control groups respectively.

To determine whether 3TC was sufficient to suppress OA pathogenesis in vivo, miR-365 Tg mice were treated with oral administration of 3TC for four months starting from 2-months old (FIG. 3U). While saline-treated miR-365 Tg mice had elevated L1 levels (FIG. 3X) and developed early onset of OA at 6 months old (FIGS. 3V and 3W), 3TC treatment abolished L1 elevation (FIG. 3X) and OA pathogenesis (FIGS. 3V and 3W). 3TC treatment inhibited the expression of OA markers Col10a1 and Adamts5 (FIGS. 3AA and 3AB) and SASP IL-6 (FIG. 3Z). 3TC treatment also abolished the elevation of miR-365 levels in OA cartilage (FIG. 3AC), suggesting NRTI treatment inhibited OA pathogenesis by breaking the vicious cycle of miR-365-induced L1 that results in OA pathogenesis, which in turn stimulates miR-365 in cartilage (FIG. 11).

To determine whether 3TC treatment abolished the miR-365 inhibition of L1 inhibitors, the mRNA levels of Dicer, Prkdc, Sqstm1, and Zc3hav1 were quantified in miR-365 Tg mice after 3TC treatment for four months. While the expression levels of these inhibitors were inhibited in the 6-months old miR-365 Tg mice (FIG. 2F-2I), such inhibition was abolished by 3TC treatment (FIG. 8D). Thus, 3TC stimulated multiple host defense molecules against L1 by overcoming the effect of miR-365 (FIG. 11).

NRTIs may decrease bone mineral density (BMD) in human HIV patients (Hoy, J. F., et al. J Bone Miner Res 32, 1945-1955 (2017)). OA pathogenesis can be associated with increased BMD in subchondral bone (Hochberg, M. C., Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 12 Suppl A, S45-48 (2004) and Hardcastle, S. A., et al., Bonekey Rep 4, 624 (2015)). To determine whether 3TC affected BMD in miR-365 Tg mice, microCT was performed to quantify subchondral bone properties. Although tibial subchondral BV/TV was increased in miR-365 Tg mice (FIG. 9B), 3TC treatment did not alter BV/TV significantly in either Cre control mice or miR-365 Tg mice (FIG. 9B). 3TC treatment increased trabecular number (FIG. 9C) and connectivity density (FIG. 9F) and decreased trabecular separation (FIG. 9E) in the Cre mice, but had no effect on miR-365 Tg mice (FIG. 9B-9C and FIG. 9E-9F). Thus, 3TC inhibited cartilage degeneration without decreasing subchondral BMD in miR-365 Tg mice.

Example 4: NRTIs Inhibit OA Pathogenesis in Mice

To determine whether other NRTIs also inhibited OA gene expression, mouse chondrocytes were treated with Emtricitabine (FTC) in a series of concentrations (FIG. 4A-4F). FTC treatment significantly inhibited L1 levels (FIG. 4A) and the expression of inflammasome Nlrp3, P2rx7 and Ifn-α mRNA (FIG. 4B-4D). FTC treatment at lower than 100 μM concentrations also increased anabolic ECM Col2a1 and Acan levels in chondrocytes (FIGS. 4E and 4F). To compare the effect of different NRTIs, tibia cartilage was treated with either 10 μM 3TC or 25 μM FTC in bone organ culture (FIG. 4G-4O). 3TC or FTC treatment significantly inhibited L1 levels (FIG. 4G), OA markers Adamts5, Col10a1, Ihh, and Mmp13, and SASP Mmp3 and Ifn-α mRNA levels (FIG. 4H-4M). 3TC or FTC treatment also increased Col 2a1 and Acan mRNA levels (FIGS. 4N and 4O). Thus, NRTIs inhibited OA gene expression and promoted anabolic gene expression in cartilage.

To determine whether NRTIs inhibited PTOA, DMM surgery was performed to induce PTOA in 129s6/SvEv mice (FIG. 4P). Oral administration of 3TC or FTC for a month significantly inhibited cartilage joint degeneration (FIGS. 4Q and 4R). NRTIs inhibited L1 levels and ADAMTS-5, Col 10a1, Mmp13 mRNA levels in cartilage (FIG. 4S-4V). They also inhibited miR-365, which was elevated in OA cartilage (FIG. 4W).

Whether NRTIs inhibited subchondral bone mineral density in PTOA mice was also determined. Local bone sclerosis could be seen under the cartilage OA lesion in DMM mice (FIG. 10A). BV/TV, trabecular number and thickness, and connectivity density were increased (FIGS. 10B-10D and 10F) while trabecular separation was decreased in DMM mice (FIG. 10E). NRTIs treatment abolished bone sclerosis and the increase of BV/TV, trabecular number and thickness, and connectivity density in DMM mice (FIG. 10A-10F). Thus, NRTIs inhibited both cartilage degeneration and subchondral bone sclerosis during PTOA.

The de-repression of endogenous L1 in cartilage lesions, as disclosed herein, is a mechanism responsible for initiation and progression of OA, a common human degenerative joint disease (Berenbaum, F. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 21, 16-21 (2013), and Helmick, C. G., et al. Arthritis and rheumatism 58, 15-25 (2008), Lawrence, R. C., et al. Arthritis and rheumatism 58, 26-35 (2008), Michaud, C. M., et al. Popul Health Metr 4, 11 (2006), Andrianakos, A. A., et al. The Journal of rheumatology 33, 2507-2513 (2006), and D'Ambrosia, R. D. Orthopedics 28, s201-205 (2005)). The data suggested that it is at least a two-step pathogenic process. L1, the only cell autonomous retrotransposon, could be activated initially by mechanical and/or inflammation stress signals in tissue wound due to joint injury (FIG. 11S). Time, as during aging, appears to be critical for amplifying the cellular L1 content (FIG. 1V) and eliciting an inflammatory response including SASP IL-6 and IL-113 (Coppe, J. P., et al. Annu Rev Pathol 5, 99-118 (2010), Meyer, P., et al. PLoS Comput Biol 13, e1005741 (2017), and Ortiz-Montero, P., et al. Cell Commun Signal 15, 17 (2017)) and interferon-α (Marco De Cecco, et al. Nature Medicine (2018)). Such aging dependent “sterile inflammation” (Freund, A., et al. Trends Mol Med 16, 238-246 (2010) and Lopez-Otin, C., et al. The hallmarks of aging. Cell 153, 1194-1217 (2013)) leads to progression of OA pathogenesis including activation of matrix degradation proteases MMP-13 and ADMTS-5, suppression of anabolic ECM COL II and ACAN, and degradation of cartilage joint (Lotz, M. & Loeser, R. F. Bone 51, 241-248 (2012)). Repression of L1 using anti-retroviral drug NRTIs that block reverse transcriptase required for biogenesis and amplification of L1 (Dai, L., Huang, Q. & Boeke, J. D. BMC Biochem 12, 18 (2011), Patnala, R., et al. Breast Cancer Res Treat 143, 239-253 (2014), and Jones, R. B., et al. PLoS One 3, e1547 (2008)), reversed the tissue degeneration process by suppressing matrix degradation proteases, stimulating ECM synthesis, and inhibiting joint degradation (FIG. 3A-3AC).

The efficacy of NRTIs for the treatment of joint degeneration has been demonstrated at cell and tissue levels, in vitro and in vivo, for OA and PTOA, in mice and human, and by basic and clinical research approaches (FIG. 4A-4W) in this study.

Activation of L1 in senescent cells during aging was a recent discovery and its mechanisms to cause aging associated disease were largely unknown Belancio, V. P., et al. Nucleic acids research 38, 3909-3922 (2010), Erichsen, L., et al. Saudi J Biol Sci 25, 1220-1226 (2018), Shi, X., Seluanov, A. & Gorbunova, V. Molecular and cellular biology 27, 1264-1270 (2007), Cho, Y. H., et al PloS one 10, e0133909 (2015), St Laurent, G., 3rd, Hammell, N. & McCaffrey, Mech Ageing Dev 131, 299-305 (2010), Carlini, F., et al. PloS one 5, e14221 (2010), Ogino, S., et al. J Natl Cancer Inst 100, 1734-1738 (2008), and Ogino, S., et al. Cancer Epidemiol Biomarkers Prev 18, 2513-2521 (2009)). Herein, it was shown that miR-365 could be an activator of L1 in response to mechanical and inflammatory stress signals during tissue injury in vivo (FIG. 1A-1X). MiR-365 was the first mechano-sensitive microRNA identified in chondrocytes (Guan, Y. J., et al. FASEB journal 25, 4457-4466 (2011)). Its expression was exquisitely sensitive to inflammatory cytokines including IL-6 (Xu, Z., et al. The Journal of biological chemistry 286, 21401-21412 (2011)) and IL-1 (Yang, X., et al. Int J Mol Sci 17, 436 (2016)), correlated with cell hypertrophy24, and quiescence and senescence (Maes, O. C., JBC Journal of cellular physiology 221, 109-119 (2009)). MiR-365 was one of the top microRNAs identified to play a critical role in chromatin modification and oncogenesis (Moss, T. J., et al. NPJ Syst Biol Appl 1, 15001 (2015)).

Herein, miR-365 induced L1 by targeting multiple cellular surveillance molecules responsible for repressing L1 in cell defense pathways post-transcriptionally (FIG. 2A-2Q). They included PRKDC in DNA repair (Morrish, T. A., et al. Nature 446, 208-212 (2007) and Morrish, T. A., et al. Nature genetics 31, 159-165 (2002)), DICER in RNA interference (Faulkner, G. J. PLoS Genet 9, e1003944 (2013)), and SQSTM1 in autophagy (Guo, H., et al. Nature communications 5, 5276 (2014)). Recently published literatures support the notion that these pathways are critical to maintaining cartilage health and preventing OA pathogenesis (Chen, A. F. et al Journal of cellular physiology 217, 828-833 (2008), Davies, C. M., et al. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 16, 624-630 (2008), Botter, S. M., et al. Age (Dordr) 33, 247-260 (2011), Kobayashi, T., et al. PNAS 105, 1949-1954 (2008), Kobayashi, T., et al. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 23, 1214-1220 (2015), Lotz, M. K. & Carames, B. Nature reviews. Rheumatology 7, 579-587 (2011)). DNA damage has been identified in OA patient samples (Duarte, J. H. Nature reviews. Rheumatology 11, 260 (2015), Loeser, R. F., et al. Nature reviews. Rheumatology 12, 412-420 (2016), Onuora, S. Nature reviews. Rheumatology 8, 502 (2012) and Lepetsos, P. & Papavassiliou, A. G. Biochim Biophys Acta 1862, 576-591 (2016)). DICER null mice have cartilage defects during development and adulthood (Kobayashi, T., et al. PNAS 105, 1949-1954 (2008)). Autophagy appears to be an important mechanism to inhibit cartilage and bone degeneration, and the mutations in SQSTM1 results in Paget's disease, an inflammatory bone disease, and osteoarthritis (Hiruma, Y., et al. Hum Mol Genet 17, 3708-3719 (2008), Hocking, L. J., et al. Hum Mol Genet 11, 2735-2739 (2002) and Laurin, N., et al. Am J Hum Genet 70, 1582-1588 (2002))

Thus, this study has revealed a molecular mechanism by which L1 retrotransposons are activated by stress signals, amplified during aging, and resulting in tissue degeneration. OA is the first degenerative disease associated with L1 activation.

The following materials and methods were used to generate data described herein.

Animals

The use of animals is approved by Lifespan IACUC animal studies committee and all animal studies were performed in accordance with institutional guidelines. To over-express miR-365 in cartilage tissues, C57BL/6 background miR-365fl+/− transgenic mice were crossed with miR-365 fl−/−; Col2a1-cre+/− (Cre-only) mice to generate miR-365 fl+/−; Col2a1-cre+/− mice (miR-365 Tg)1. Cre-only and miR-365 Tg mice were used in the studies regardless of their sexes as OA is not a sex-specific disease.

12956/SvEv strain male mice were purchased from Taconic (https://www.taconic.com/mouse-model/129s6) at their age of 7-week-old. At least 3-day (72-hrs) acclimation period must be given to mice before any further procedures occurred to them. All 12956/SvEv strain mice throughout the studies were male.

All strains of mice were housed with ad libitum access to food and water unless otherwise stated.

Genotyping

Genomic DNA was extracted from mouse toes or tails within 7 days after birth and conventional PCR was performed using Hot start Taq polymerase (New England BioLabs, Cat. M049S/L) using primers designed specific to miR-365 insertion or Col2a1-Cre constructs (Table 1, below) (Berenbaum, F. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 21, 16-21 (2013)).

TABLE 1 Primer List GENES DIRECTION SEQUENCES (5′ TO 3′) Mouse GAPDH Forward CGGCCGCATCTTCTTGTG (SEQ ID NO: 1) Reverse GTGACCAGGCGCCCAATA (SEQ ID NO: 2) 18S Forward CGGCTACCACATCCAAGGAA (SEQ ID NO: 3) Reverse GCTGGAATTACCGCGGCT (SEQ ID NO: 4) COL2-CRE Forward TCCAATTTACTGACCGTACACCAA (SEQ ID NO: 5) Reverse CCTGATCCTGGCAATTTCGGCTA (SEQ ID NO: 6) MIR-365 Forward AGACCCACAAGGCCCTGAAGCTGA (SEQ ID NO: 7) INSERTION Reverse CACATCTGCCCCCAAAAGTC (SEQ ID NO: 8) LINE-1 Forward TGAGTGGAACACAACTTCTGC (SEQ ID NO: 9) Reverse CAGGCAAGCTCTCTTCTTGC (SEQ ID NO: 10) ALU Forward GAGGCTGAGGCAGGAGAATCG (SEQ ID NO: 11) Reverse TGTCGCCCAGGCTGGAGTG (SEQ ID NO: 12) 5S Forward CTCGTCTGATCTCGGAAGCTAAG (SEQ ID NO: 13) Reverse GCGGTCTCCCATCCAAGTAC (SEQ ID NO: 14) MMP13 Forward GGACCTTCTGGTCTTCTGGC (SEQ ID NO: 15) Reverse GGATGCTTAGGGTTGGGGTC (SEQ ID NO: 16) MMP3 Forward GACTCAAGGGTGGATGCTGT (SEQ ID NO: 17) Reverse CCAACTGCGAAGATCCACTG (SEQ ID NO: 18) COLX Forward CTGCTGCTAATGTTCTTGAC (SEQ ID NO: 19) Reverse ACTGGAATCCCTTTACTCTTT (SEQ ID NO: 20) IHH Forward GCTCGTGCCTCTTGCCTACA (SEQ ID NO: 21) Reverse CGTGTTCTCCTCGTCCTTGA (SEQ ID NO: 22) IL-1B Forward AACCTGCTGGTGTGTGACGTTC (SEQ ID NO: 23) Reverse CAGCACGAGGCTTTTTTGTTGT (SEQ ID NO: 24) IL-6 Forward TCCAGTTGCCTTCTTGGGAC (SEQ ID NO: 25) Reverse GTACTCCAGAAGACCAGAGG (SEQ ID NO: 26) P2RX7 Forward CAACTATGAACGGCTCTTGTACCT (SEQ ID NO: 27) Reverse TCGATACCCATGATTCCTCCCT (SEQ ID NO: 28) NLRP3 Forward CAGCGATCAACAGGCGAGAC (SEQ ID NO: 29) Reverse AGAGATATCCCAGCAAACCTATCCA (SEQ ID NO: 30) IFN-A Forward TCTGATGCAGCAGGTGGG (SEQ ID NO: 31) Reverse AGGGCTCTCCAGACTTCTGCTCTG (SEQ ID NO: 32) AICDA Forward TTGTTGTTCCTACGCTACATCTC (SEQ ID NO: 33) Reverse CCGGGCACAGTCATAGCAC (SEQ ID NO: 34) DICER Forward GAAGACGTTCATCGCGGTC (SEQ ID NO: 35) Reverse GCTGACACTTGTTGAGCAACC (SEQ ID NO: 36) PRKDC Forward AGCCATTGCTATTCGCGGATA (SEQ ID NO: 37) Reverse CGGAACCGTGTCAAGGTAAAG (SEQ ID NO: 38) SQSTM1 Forward GAGGCACCCCGAAACATGG (SEQ ID NO: 39) Reverse ACTTATAGCGAGTTCCCACCA (SEQ ID NO: 40) ZC3HAV1 Forward CCCGAAGCGCAACTCTACG (SEQ ID NO: 41) Reverse CGCTGGGACTGTGCATAGTG (SEQ ID NO: 42) AICDA Forward GCGCGCGTTTAAACGAACAAGACTTAAAGGAGCC (SEQ 3′UTR ID NO: 43) Reverse CGCGCTCGAGTCTATGTTGGTTTCCTACAT (SEQ ID NO: 44) DICER Forward GCGCGTTTAAACTAGATGCCCGGTTTTCCTCA (SEQ ID 3′UTR NO: 45) Reverse CGCGCGCTCGAGCCATACAGCATTTTTAAATG (SEQ ID NO: 46) PRKDC Forward GCGCGTTTAAACAGTCTGTGGTGTCACCAATC (SEQ ID 3′UTR NO: 47) Reverse CGCGCGCGCGCTCGAGAGAAATATTTGTCATATTCT (SEQ ID NO: 48) SQSTM1 Forward CCAGTGTCTTTTAATTCTTGTAGAATCTTCAGG (SEQ ID 3′UTR NO: 49) Reverse CCTGAAGATTCTACAAGAATTAAAAGACACTGG (SEQ ID NO: 50) ZC3HAV1 Forward GCGCGTTTAAACCAGTGTGACATAACTGAAAG (SEQ ID 3′UTR NO: 51) Reverse CGCGCTCGAGCGAACAATGAGATTTTACTG (SEQ ID NO: 52) DICER Forward GTAAAGCTGTTTATTAATTTGCTGAAGGTCTCGC (SEQ ID 3′UTR MUT NO: 53) Reverse GCGAGACCTTCAGCAAATTAATAAACAGCTTTAC (SEQ ID NO: 54) PRKDC Forward GTCAGATAAATTAATTTGTTACCAATGCTAATGGC (SEQ 3′UTR MUT ID NO: 55) Reverse GCCATTAGCATTGGTAACAAATTAATTTATCTGAC (SEQ ID NO: 56) SQSTM1 Forward CCAGTGTCTTTTAATTCTTGTAGAATCTTCAGG (SEQ ID 3′UTR MUT NO: 57) Reverse CCTGAAGATTCTACAAGAATTAAAAGACACTGG (SEQ ID NO: 58) ACAN Forward TGCTACTTCATCGACCCCAT (SEQ ID NO: 59) Reverse AAAGACCTCACCCTCCATCT (SEQ ID NO: 60) ADAMTS5 Forward TCAGCCACCATCACAGAA (SEQ ID NO: 61) Reverse CCAGGGCACACCGAGTA (SEQ ID NO: 62) COL2* Forward CTCCCAGAACATCACCTACCA (SEQ ID NO: 63) Reverse CGTGAACCTGCTATTGCCCT (SEQ ID NO: 64) Human IHH Forward GGAGAACACAGGCGCCGACC (SEQ ID NO: 65) Reverse CGGTCACCCGCAGCTTCACA (SEQ ID NO: 66) ACAN Forward CCATCATTGCCACGCCTGAG (SEQ ID NO: 67) Reverse TCCTTGTCTCCATAGCAGCCTTC (SEQ ID NO: 68) COLX Forward GCCCACAGGCATAAAAGGCCC (SEQ ID NO: 69) Reverse GCCCACAGGCATAAAAGGCCC (SEQ ID NO: 70) MMP13 Forward ATGCGGGGTTCCTGATGTGG (SEQ ID NO: 71) Reverse GGCCCAGGAGGAAAAGCATG (SEQ ID NO: 72) ADAMTS5 Forward GGCCGTGGTGAAGGTGGTGG (SEQ ID NO: 73) Reverse GCTGCGTGGAGGCCATCGTC (SEQ ID NO: 74) 18S Forward CGGCTACCACATCCAAGGAA (SEQ ID NO: 75) Reverse GCTGGAATTACCGCGGCT (SEQ ID NO: 76) LINE-1 Forward CAAACACCGCATATTCTCACTCA (SEQ ID NO: 77) Reverse CTTCCTGTGTCCATGTGATCTCA (SEQ ID NO: 78) ALU Forward GAGGCTGAGGCAGGAGAATCG (SEQ ID NO: 79) Reverse TGTCGCCCAGGCTGGAGTG (SEQ ID NO: 80) ZC3HAV1 Forward TCACGAACTCTCTGGACTGAA (SEQ ID NO: 81) Reverse ACTTTTGCATATCTCGGGCATAA (SEQ ID NO: 82) SQSTM1 Forward GCACCCCAATGTGATCTGC (SEQ ID NO: 83) Reverse CGCTACACAAGTCGTAGTCTGG (SEQ ID NO: 84) DICER Forward AAAATTGTCCATCATGTCCTCGC (SEQ ID NO: 85) Reverse CCACCAGGTCAGTTGCAGTT (SEQ ID NO: 86) PRKDC Forward CTGTGCAACTTCACTAAGTCCA (SEQ ID NO: 87) Reverse CAATCTGAGGACGAATTGCCT (SEQ ID NO: 88) AICDA Forward GAGGCGTGACAGTGCTACATC (SEQ ID NO: 89) Reverse CAGGGTCTAGGTCCCAGTCC (SEQ ID NO: 90) IL-6 Forward TGTCTGAGGCTCATTCTGC (SEQ ID NO: 91) Reverse TGGGGCAGGGAAGGCA (SEQ ID NO: 92) *For mouse and human

TABLE 2 siRNA Sequences A TABLE OF SILINE-1S SEQUENCES. SEQUENCES ARE DESIGNED AND ARE ARBITRARILY NAMED A THROUGH F. NAME SEQUENCES (5′ TO 3′) SILINE-1A AAC CTG GAC GAA ATG GAC AAA (SEQ ID NO: 93) SILINE-1B AAG TAG ACC AAT GGA ATA GAA (SEQ ID NO: 94) SILINE-1C AAG CCA CTA TTA CTC TGA TAC (SEQ ID NO: 95) SILINE-1D AAG GTC AAA TCT AAG TGG ATC (SEQ ID NO: 96) SILINE-1E AAG TTT CTG CAA GGC AAA AGA (SEQ ID NO: 97) SILINE-1F AAT GGC TAA GAT CAA AAA TTC (SEQ ID NO: 98)

Mouse Model of Destabilization of Medial Meniscus (DMM)

129S6/SvEv male mice were chosen for experimental subjects at their age of 8-week-old. To create mouse injury/trauma induced OA model, medial meniscus ligament was transected using a previously described method (Lohmander, L. S., et al. Am J Sports Med 35, 1756-1769 (2007)). Briefly, 8-week-old male mice were anesthetized using either intraperitoneal (IP) injection of Ketamine/Dexmedetomidine or isoflurane to carry out medial parapatellar arthrotomy. Transection was made with a stab knife (Sharpoint™, Cat. 72-1551). At Weeks 12, mice were euthanized and dissected for histological examination as well as cartilage RNA extraction. 12 mice were used for each group/time point.

Human Specimens

Cartilages were prospectively gathered from consenting individuals who had been diagnosed with OA and underwent total knee replacement. All the procedures were prior approved by IRB. For the sake of patients' identity protection, all the information was confidential except for those relevant to experiments, such as information of gender and age. Samples were harvested immediately after surgeries. Pictures of specimens were taken for recording purpose (FIG. 7). OA lesion and non-lesion areas were empirically identified by orthopedic surgeons based on direct observation. For each site of interest, a 1×1 mm2 tissue with a depth ranging from 4-8 mm was harvested using sterile, RNase free Rib-Back® scalpels (Bard-Parker®, Cat. 371115) manually. Care must be taken to avoid any subchondral bone. To obtain maximal digestion efficacy, resected specimens were further minced by scalpels before submerging into 350 mL QIAzol Lysis Reagent (Qiagen, Cat No./ID: 79306). Specimens can either be stored at −80° C. or be accessed using diverse methods.

Femur Explant Organ Culture

Femurs were obtained from 21-day-old WT C57BL/6 mice. Femurs with intact articular surface and periosteum was sterilely dissected under microscope. Upon harvesting, femurs were rinsed with HBSS (Gibco®, Grand Island, N.Y. 14072 USA) and then submerged into DMEM (Gibco, Grand Island, N.Y. 14072 USA) medium supplemented with 10% fetal bovine serum (FBS, Gibco®, Grand Island, N.Y. 14072 USA) in 12-well culture dishes. The first-generation cytidine analogue/NRTI-3TC or newest-generation cytidine analogue/NRTI-FTC was added into the medium with desired concentrations. After a total of 48 hrs incubation at 37° C. in an atmosphere of 5% CO2, femurs were rinsed with HBSS and articular cartilage was peeled off using surgical scalpels under dissecting microscope for RNA extraction.

Histology, Immunohistochemistry (IHC), and Immunofluorescence

Human cartilage tissues were fixed in 4% Paraformaldehyde (PFA) for 24 hrs at 4° C., followed by 30% Diethyl pyrocarbonate (DEPC)-sucrose (Sigma, Cat. 50289-500G, St. Louis, Mo. 63103 USA) at 4° C. until the specimens were sunken to the bottom of the containers. Tissues were embedded in optimal cutting temperature compound (O.C.T., SAKURA FINETEK USA INC, Tissue-Tek® O.C.T. Compound, Cat. 4583). A cryo-section microtome (Model: CM3050, Leica, Germany) was used to cut 6-μm-thick sections. The sections were stained by H&E staining to assess morphology. Mouse tissues were fixed in 10% formalin for 24-48 hrs depending on tissue size, followed by de-calcification process using DEPC de-calcification reagents (Ethylenediaminetetraacetic acid, Sigma, Cat. EDS-1KG, St. Louis, Mo. 63103 USA) at room temperature for 10-14 days. After de-calcification, tissues were dehydrated in ethanol before embedded in paraffin with routine procedures. A microtome (Model: FINESSE ME, Thermo Shandon, UK) was used to cut 6-μm-thick sections. For every 80 μm interval, 5 sister sections were harvested to make a total of 13-16 slices from one knee of a fully-grown mouse. Number of slides form one knee may vary due to varying sizes of the specimens. Slides were then de-paraffinized and stained GAG with Alcian blue (Sigma, Cat. A3157-10G) or Safranin O (Sigma, Cat. 58884-25G, St. Louis, Mo. 63103 USA). Morphology is assessed by H&E staining. For IHC, paraffin sections were processed with routine procedures instructed by Histostain® Plus 3rd Gen IHC Detection Kit (Life Technologies, Cat. 859673, Frederick, Md. 21704 USA). Rabbit or mouse antibodies specifically against antigens of interest were used, followed by incubation of HRP-conjugated secondary antibodies against rabbit or mouse IgG (provided by the kit). Primary and secondary antibodies are listed in Table 3 below. Signals are then visualized by a DAB-Plus Substrate Kit (Life Technologies, Cat. 002020, Frederick, Md. 21704 USA).

TABLE 3 Antibody List PROTEINS VENDOR CATALOG# ORIGIN MW (KD) B-ACTIN Cell Signaling cs-4970S Rabbit 45 LINE-1 ORF1 Cell Signaling cs-88701S Rabbit 42 SQSTM1 Santa Cruz sc-28359 Rabbit 65 DICER Abcam ab14601 Mouse 240 IHH Abcam ab52919 Rabbit 45 PRKDC Abcam ab32566 Rabbit 469

Safranin O Staining

Paraffin sections were de-paraffinized in 2 changes of xylene, 10 mins each, followed by re-hydration in 2 changes of 100% alcohol, 5 mins each; 2 changes of 95% alcohol, 5 mins each; 70% alcohol for 5 mins. Sections were then rinsed in running tap water for 2 mins before stained with 0.4% fast green solution (Sigma, Cat. F-7258, St. Louis, Mo. 63103 USA) for 2 mins however the latter timing must be empirically controlled to assure desired coloration. Stained sections were then quickly rinsed with 1% acetic acid solution (Sigma, Cat. 695092-500ML-GL, St. Louis, Mo. 63103 USA) for no more than 10-15 sec. 0.1% Safranin O Solution was used for staining proteoglycan however the actual timing must be carefully determined based on actual coloring condition, for maximally 10 mins. After Safranin O staining, sections were submerged in 2 changes of 95% alcohol, 2 mins each, 2 changes of 100% alcohol, 2 mins each for de-hydration. Lastly, sections were cleared in 2 changes of xylene, 2 mins each, and mounted using resinous mounting medium (ACRYMOUNT™, Cat. SL80-4, McKinney, Tex. 75069 USA).

OARSI Scoring

To histologically evaluate OA severity, we quantified Safranin O stained knee sections according to OARSI semi-quantitative system as previously described3. Detailed scoring standards are summarized in Table 4 below:

TABLE 4 OASRI Scoring Guideline: GRADE OSTEOARTHRITIC DAMAGE 0 Normal 0.5 Loss of Safranin-O without structural changes 1 Small fibrillations without loss of cartilage 2 Vertical clefts down to the layer immediately below the superficial layer and some loss of surface lamina 3 Vertical clefts/erosion to the calcified cartilage extending to <25% of the articular surface 4 Vertical clefts/erosion to the calcified cartilage extending to 25-50% of the articular surface 5 Vertical clefts/erosion to the calcified cartilage extending to 50-75% of the articular surface 6 Vertical clefts/erosion to the calcified cartilage extending >75% of the articular surface

Hematoxylin and Eosin (H&E) Staining

Paraffin sections were de-paraffinized in 2 changes of xylene, 10 mins each, followed by re-hydration in 2 changes of 100% alcohol, 5 mins each; 2 changes of 95% alcohol, 5 mins each; 70% alcohol for 5 mins. Sections were then rinsed in running tap water for 2 mins before stained in Mayer's Hematoxylin solution (NovaUltra™ H&E Stain Kit, IHCWORLD, Cat. IW-3100) for 2 mins however the latter timing must be empirically controlled to assure desired coloration. Stained sections were then rinsed in running tap water for 5 mins before dipped into 95% alcohol for 10 times or 30″ based on performer's preference. Eosin Solution (NovaUltra™ H&E Stain Kit, IHCWORLD, Cat. IW-3100) was used for counterstaining however the actual timing must be carefully determined based on actual coloring condition. After counterstaining, sections were dipped in 95% alcohol for 2 times before transferred through 2 changes of 100% alcohol, 5 mins each for de-hydration. Lastly, sections are cleared in 2 changes of xylene, 5 mins each, and mounted with resinous mounting medium.

For frozen sections, procedures were similar with the exception between Eosin counterstaining and 95% alcohol dipping steps. Instead, during these two steps, frozen sections must be air dried for 30 mins at room temperature and fixed in 10% formalin for 10 mins. Then the sections were taken out for another 30 mins air dry at room temperature before rinsed in water.

Homogenization

A PowerGen 125 (Fisher Scientific, Cat. 03.349248) was used to homogenize samples for RNA extraction. A cycle of 45″ homogenization at speed of 5, followed by a cool down step of 15″ was repeated for 5 cycles before switching to a finer drill for the same cycles. Drills/PowerGen Generator (Fisher Scientific, Cat. 14-261-15) were rinsed in DEPC-water followed by 100% ethanol rinse between different specimens to avoid cross contamination. All procedures took place on ice to avoid RNA degradation due to heat.

Primary Growth Plate/Articular Chondrocytes (PCs) Culture

Rib cages were sterilely isolated from neonatal mice (within 7-day-old) of desired genotypes and rinsed with HBSS for five times. To remove unspecific tissues, rib cages were digested in Collagenase D (3 μg/mL, Roche, Cat. 11088882001, Mannheim, Germany) for 2-4 hrs at 37° C. and rinsed with HBSS (Gibco®, Grand Island, N.Y. 14072 USA) for five times to remove detached unspecific tissues. To detach chondrocytes from rib cages, the samples underwent secondary digestion in Collagenase D (3 μg/mL) for at least 4 hrs at 37° C. with constant agitation (200 rpm). Detached chondrocytes were pelleted to remove excessive Collagenase D and resuspended in complete medium of DMEM (Gibco®, Grand Island, N.Y. 14072 USA) which contains 10% FBS, 100 U/mL penicillin and 100 μg/mL streptomycin (Gibco®, Grand Island, N.Y. 14072 USA). Growth plate PCs were grown at 37° C. in an atmosphere of 5% CO2. The media was changed on the following day to remove remaining Collagenase D and every 3 days thereafter.

Similarly, articular cartilages were sterilely isolated under dissection microscope from neonatal mice (within 7-day-old) of desired genotypes and rinsed with HBSS for five times. In brief, the skins of hindlimbs were removed and transections on Ilia and muscles around hip joints were made to detach hindlimbs from torsi, then transferred to a petri dish. Under a dissection microscope placed in a cell culture hood, soft tissues were cleared while knee and hip joints were exposed. Femur heads could be easily peeled off whilst a fine cut of epiphyses based on vascularization were made to isolate articular cartilage from secondary ossification center. Beyond that, isolated tissues were minced into finer fragments and then put together before undergoing HBSS rinse and subsequent Collagenase D digestion. To remove unspecific tissues, articular cartilages were minced and digested in Collagenase D (3 μg/mL) for 2 hrs at 37° C. and rinsed with HBSS for five times to remove detached unspecific tissues. To detach chondrocytes from cartilage matrix, the samples underwent secondary digestion in Collagenase D (3 μg/mL) for at least 4 hrs at 37° C. with constant agitation (200 rpm). Detached chondrocytes were pelleted to remove excessive Collagenase D and resuspended in complete medium of DMEM which contains 10% FBS, 100 U/mL penicillin and 100 μg/mL streptomycin. Articular PCs were grown at 37° C. in an atmosphere of 5% CO2. The media was changed on the following day to remove remaining Collagenase D and every 3 days thereafter.

Transient Transfection

Cells were seeded onto desired size plates to reach 70-90% confluence and transfected with miR-365 mimic or miRNA mimic negative control or miR-365 inhibitor or inhibitor negative control (Dharmacon®, Lafayette, Colo., USA). Lipofectamine 3000 (Invitrogen®, Waltham, Mass., USA) was used as transfection reagents. Medium is changed 24 hrs after transfection. 48 hrs post transfection, cells were lysated in either QIAzol for RNA purification and real-time PCR analysis or ice-cold lysis buffer containing protease inhibitor and phosphatase inhibitor for western blot analysis. MiR-365 mimic, miRNA mimic negative control, miR-365 inhibitor and inhibitor negative control were typically used at a final concentration of 25 nM unless otherwise stated.

Quantitative Real-Time PCR (qPCR)

Both miRNA and mRNA were extracted using miRNeasy Mini Kit (Qiagen®, Germantown, Md., USA) and reversely transcribed using miScriptIIRT Kit (Qiagen®, Germantown, Md., USA) according to manufacturer's instruction. qPCR was performed using SYBR Green PCR master mix (Qiagen®, Germantown, Md., USA) on a Bio-Rad CFX96 real-time PCR detection system (Bio-Rad®, Hercules, Calif., USA). Amplification conditions are as follows: 95° C. for 10 min, 40 cycles of 95° C. for 10″, 55° C. for 30″, and 72° C. for 30″. Sense and antisense primers are listed in Table 2. 18S ribosomal or GAPDH RNA was used as an internal control gene to normalize the mRNAs level. The ubiquitously expressed snRNA U6 was used as an endogenous control for miRNAs level. Primers were synthesized by Integrated DNA Technologies (http://www.idtdna.com). The primers for miR-365 were purchased from Qiagen. Fold changes of mRNA and miRNAs were calculated by the 2{circumflex over ( )}(ΔΔCt) method and normalized to 18S/GAPDH or U6 snRNA, respectively.

Prediction of miR-365 Target Genes

Potential targets of miR-365-5p and miR-365-3p were identified using the TargetScan (http://www.targetscan.org/) and miRanda/mirSVR (http://34.236.212.39/microrna/home.do) target prediction algorithms.

Plasmid Construction

WT Aicda, Dicer1, Prkdc, Sqstm1 and Zc3hav1 3′UTRs bearing potential response elements (REs) serving as miR-365 seeding sites predicted by microrna.org were cloned from mouse genomic DNA (50 ng-250 ng) using primers designed to introduce ideal restriction enzyme cleavage sites according to the backbone plasmid pmirGLO construct (Promega, Madison, Wis., USA). Detailed thermal cycles are: 98° C. for 30 sec, 25-35 cycles of 98° C. for 10 sec, 55-60° C. for 30 sec, and 72° C. for 15 sec and final extension at 72° C. for 10 min before holding at 4° C. Designed primers are summarized in Table 1, above. PmeI and XhoI were enzymes used to cleave for sticky ends. After restriction enzymes cleavage, approximately 500 bp 3′UTR sequences were annealed into pmirGLO construct (1 pg-10 ng). REs were mutated according to QuikChange Lightning Multi Site-Directed Mutagenesis Kit's instruction (Agilent, Cat. 210513/210515, Santa Clare, Calif. 95051 USA).

Luciferase Assays

ATDC5 cells were cultured at 2.5×104 cells/well in 24-well plates. The cells were co-transfected with miR-365 mimic (25 nM) or miRNA mimic negative control (25 nM) and 500 ng of pmirGLO-Dicer1/Zap/Sqstm1/Prkdc/Aicda 3′-UTR WT or Mut plasmids. Transfection was performed using Lipofectamine 3000 (Invitrogen, Cat. L3000-008, Carlsbad, Calif. 92008 USA) reagent. The assays were performed in triplicate unless otherwise stated. 24 hrs after transfection, cells were collected, and luciferase activity was determined using the Dual-Luciferase reporter assay system (Promega, Madison, Wis., USA) with the GLOMAX 20/20 luminometer (Model: 2031_000, Turner BioSystems, Sunnyvale, Calif. USA). Briefly, cells were rinsed with PBS and incubated with Passive Lysis Buffer (provided by the kit) for 15 mins with constant agitation at room temperature. Lysates were scraped into 1.5 mL Eppendorf tubes. 20 μl of lysates were fixed with 50 μl Luciferase Assay Buffer II to measure Firefly luciferase luminescence. 50 μl Stop & Glo buffer was then added to measure Renilla luminescence. The luciferase activity was represented by the ratio of Firefly/Renilla measurements.

Western Blot (WB)

All pre-treated samples were washed with ice-cold PBS and lysated in RIPA buffer (M-PER, Pierce, Ill.) plus protease inhibitor phenylmethylsulfonyl fluoride [Halt™, Thermo Scientific, Protease Inhibitor Single-Use Cocktail (100×), Cat. 78430] for 30 min on ice with constant agitation. The lysates are centrifuged at 12,000 g for 15 min at 4° C. The supernatants were collected, and the protein concentrations were determined using Pierce™ BCA assay (Thermo Scientific, Cat. 23225). Samples were mixed with equal volume 2×Laemmli sample buffer (Bio-Rad, Cat. 161-0737) which contains 2-Mercaptoethanol (Bio-Rad, Cat. 161-0710) and heated for 5 min at 100° C. to denature. Equal amount of proteins for each sample were separated by 8-12% SDS polyacrylamide gel depending on protein size of interest and then transferred to nitro-cellulous membrane (Bio-Rad, Cat. 162-0112) for 70 min at 100 V. The membrane was blocked with 5% bovine serum albumin (BSA, Sigma, Cat. A7906-50G) in 0.1% Tris-Buffered Saline-Tween 20 (TBS-T, BBP, Cat. IBB-581X) for 1 hr at room temperature, followed by incubation with primary antibodies against proteins of interest (antibodies are listed in Table 3, provided above) at 4° C. overnight. On the following day, the membrane was rinsed with TBS-T for 10 min for a total of 5 times and incubated with anti-rabbit-Alexa Fluor 680 (Molecular Probes, Eugene, Oreg., USA) for 1 hr at room temperature followed by TBS-T rinse for 10 min for a total of 5 times. The blots were then scanned using an Odyssey fluorescence scanner (LI-COR Biosciences, Lincoln, Nebr., USA) and quantitatively analyzed by ImageJ (https://imagej.nih.gov/ij/index.html).

Statistical Analysis

Data represents mean values±SD (error bars). Statistical significance was calculated using student's t-test (unpaired) or one-way ANOVA test. A p-value≤0.05 was considered statistically significant. There is a minimum of n≥3 for all groups unless otherwise stated.

Other Embodiments

While the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims.

The patent and scientific literature referred to herein establishes the knowledge that is available to those with skill in the art. All United States patents and published or unpublished United States patent applications cited herein are incorporated by reference. All published foreign patents and patent applications cited herein are hereby incorporated by reference. Genbank and NCBI submissions indicated by accession number cited herein are hereby incorporated by reference. All other published references, documents, manuscripts and scientific literature cited herein are hereby incorporated by reference.

While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims.

US Patent for Composition and methods for treating articulating joint disorders with nucleoside reverse transcriptase inhibitors Patent (Patent #  12,121,530 issued October 22, 2024) (2024)
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