OA, a widespread chronic joint disease, affects many individuals worldwide[36]. OA has gradually increased healthcare and social expenditures as the primary cause of impairment in older persons [37]. Although multiple diagnostic and therapeutic approaches are available for OA, the clinical outcomes are still unsatisfactory. IDD is a degenerative spine disease that causes chronic lower back pain and motor disturbance[38]. In more severe stages, loss of joint space, subchondral sclerosis, and osteophytes, similar to OA in the articular joint, accompany intervertebral disc degeneration[39]. Thus, IDD may accelerate the progression of OA. Nevertheless, there are few reports illustrating the interactions between the two diseases. Here, we employed various bioinformatics analysis methods to reveal the potential molecular mechanism of IDD in the pathogenesis of OA and provide a possible basis for future targeted and preventive treatment.
Here, 184 common DEGs were identified between OA and IDD. After constructing the PPI network of shared DEGs, 114 common hub genes were identified based on the degree and MCC algorithm of the cytoHubba plugin in Cytoscape. Subsequently, 114 identified shared hub genes were evaluated by functional enrichment and pathway analysis. The enrichment analysis results showed that these common hub genes were significantly associated with the MAPK signaling pathway, T cell receptor signaling pathway, Rap1 signaling pathway, immune response, neutrophil-mediated immunity, and negative regulation of inflammatory response. Existing research indicates an inherent connection between the MAPK signaling pathway and osteoarthritis (OA) advancement. An imbalance in the MAPK pathway expedites inflammatory reactions, releasing a multitude of cartilage matrix-degrading enzymes and intensifying cartilage degeneration[40]. The Rap1 signaling pathway is an essential component of pathological osteoclast resorption, contributing to the progression of arthritis[41]. Furthermore, research has reported that T-cell signaling mediates the onset of various inflammatory diseases, such as inflammatory bowel disease and autoimmune arthritis[42]. Therefore, these data indicated that these common DEG-related pathways are closely associated with the inflammatory response.
Previous research has shown that OA, as an inflammatory disease, can be exacerbated by a dysregulated inflammatory storm[43], and large amounts of pro-inflammatory cytokines can be detected in patients with IDD[44]. To investigate the distribution of these DEGs across various immune cell types, we delved deeper into the characteristics of single-cell atlases derived from OA tissue samples. Our data proved that 30 of these hub genes were broadly enriched in macrophages compared to other cell types, and subgroup analysis of macrophages also revealed that the IL1B+ macrophage subtype was a prominent source of expression for these 30 genes. Meanwhile, we further observed that these genes were highly expressed in IDD and OA patients compared to control samples. Subsequently, based on the expression of these 30 genes, the score derived from ssGSEA calculations for these gene sets is to be constructed to explore further the characteristic changes of these genes in OA immune cell infiltration. The ssGSEA score of these gene sets was significantly higher in the OA disease group than in the control group. These scores also positively correlated with M1 macrophages, eosinophils, and neutrophils. Meanwhile, we further assessed the associations between several pro-inflammatory cytokines in OA and these scores. The results showed a significant positive correlation between these pro-inflammatory cytokines and these scores. Polarization of synovial macrophages towards M1 exacerbates the development of OA[45].
Additionally, research has indicated that neutrophil elastase (NE) contributes to tissue degeneration, osteophyte formation, and the release of inflammatory cytokines and chemokines, thereby participating in the progression of OA[46]. Therefore, based on these findings, it can be inferred that the highly expressed IRGs in IL1B+ macrophages could be the primary drivers of the cytokine storm in OA. IDD might also contribute to OA progression through cytokine storms.
Subsequently, we conducted feature selection utilizing two distinct algorithms to delve deeper into potential biomarkers for osteoarthritis (OA). The results showed that two hub genes (CSF1 and S100A12) were identified as feature genes using LASSO regression analysis and the SVM-RFE method. CSF1, the protein encoded by this gene, is a cytokine that controls macrophage production, differentiation, and function. CSF regulates the development, proliferation, differentiation and activation of myeloid cells in health and disease[47]. In addition, it has been reported that CSF-1 can promote the survival, proliferation and differentiation of bone marrow cells (including monocytes, macrophages and osteoclast) by binding to the tyrosine kinase receptor CSF1R[48]. Exogenous administration of CSF-1 exacerbates the incidence and severity of OA[49]. The protein encoded by is a member of the S100 protein family containing two EF-hand calcium-binding motifs. S100 protein has also been proven to have important extracellular pro-inflammatory effects and cytokine-like activity[51]. Clinical research shows serum S100A12 expression is elevated in patients with OA [52]. The change in S100A12 expression level in synovial fluid can reflect the clinical severity of patients with primary knee osteoarthritis[53]. Here, our findings revealed significant overexpression of CSF1 and S100A12 in both the test and validation sets among IDD and OA patients and the OA patients with high CSF1 and S100A12 levels had positively correlated with M1 macrophages.
Meanwhile, the results of the correlation analysis indicate a significant positive correlation between these two genes and pro-inflammatory cytokines in the progression of OA. Experimental studies also demonstrated that blocking the CSF1R can reduce inflammation in human and mouse models of rheumatoid arthritis[50]. Furthermore, clinical case study results indicate that S100A12 in the serum and synovial fluid (SF) of patients with OA may be an independent factor for predicting the risk of this condition[53]. Therefore, these two genes may serve as potential diagnostic biomarkers for OA patients and could be involved in the pathogenesis of OA through inflammatory responses.
Transcription factors (TFs) govern the proportion of transcriptional processes, while miRNAs play a crucial role in gene regulation at the post-transcriptional level and in RNA silencing. Both TFs and miRNAs are of significant importance in understanding disease progression. Then, a study of the interactions between TFs-genes and miRNAs-genes was done to determine which regulators control the transcription and expression of common hub genes. 36 TFs and 29 miRNAs were found to have substantial interactions with common hub genes. For example, YY1[54] and NFKB1[55] are associated with the regulation and progression of OA diseases. Furthermore, some miRNAs, such as miR-335-5p[56] and miR-218-5p[57], participated in the progression of OA.
In recent years, several chemical agents and drugs have been utilized as potential therapeutic approaches to OA. Local nonsteroidal anti-inflammatory drugs (NSAIDs) such as lurbiprofen cataplasms and loxoprofen sodium cataplasm have effectively treated OA[58]. However, the incidence rate of OA disease has increased significantly, so it is urgent to develop new drugs to treat OA. Based on shared hub genes, some potential drugs and compounds targeting OA and IDD have been identified using database, such as valproic acid (VPA), estradiol, and trichostatin A. VPA is a flavonoid compound extracted from herbaceous plants and is a first-line drug for treating epilepsy and mania[59]. VPA has been proven to have multiple therapeutic effects, including anticancer, neuroprotective, differentiation, and neurodegenerative activity[60]. Besides, studies found that VPA was identified as a putative agent associated with OA progression and protected chondrocytes from damage caused by OA stimulation[61]. Estradiol is a well-known homeostatic regulator of the bone and immune system and can also control exercise ability and pain sensitivity[62]. In addition, experimental studies have confirmed that the physiological level of estradiol limits the progression of OA in mice[63]. Trichostatin A (TSA) is a non-selective histone deacetylase inhibitor that inhibits OA and rheumatoid arthritis progression by inhibiting the expression of MMP[64]. So, these chemical compounds might be good choices for drugs to treat OA. However, there are still some limitations to this study. First, the sample size of this study is small, which may affect the reliability of the conclusions. In addition, the results of this study are all based on the analysis of database data. The necessary support of experimental evidence is lacking. CSF1 and S100A12 need further validation through cell experiments, animal models and clinical samples. Additionally, these drugs need to undergo chemical experiments for further confirmation. Despite these limitations, the results of the current study may provide potential directions for future research.
Our study elucidates the potential molecular connections between IDD and OA at the cellular and molecular levels through comprehensive transcriptome and single-cell sequencing data analysis. Our research has identified that IDDD exacerbates the severity of OA through an excessive cytokine storm. Additionally, we identified two potential diagnostic biomarkers for these diseases. By expanding our understanding of these conditions, our research provides potential directions for further investigating the molecular mechanisms of OA. It may lead to more effective therapeutic strategies and improved clinical outcomes for OA patients.