| Osteoarthritis (OA) is one of the most common age-related chronic disorders. The multiplicity of loci identified in OA linkage studies and the large number of associated SNPs suggests that many molecular pathways are involved in OA pathogenesis. Most of these pathways share common features with the process of endochondral ossification, normally occuring during embryogenesis. Cartilage degradation and the presence of osteophytes, hallmarks of OA, could be attributable to the reinitiation of this process. One gene that has surfaced both in OA and in musculoskeletal development is PITX1. Contrary to its original moniker, PITX1 is expressed in many tissues beyond the pituitary gland, including bone, cartilage, muscle and fibroblast cells. Pitx1 is considered as a master regulator of hindlimb identity and its complete inactivation in mice leads to a forelimb-like phenotype. Less severe, its partial inactivation results in early OA symptoms in aging mice. In humans, loss of PITX1 expression is observed in OA cartilage concomitantly with the upregulation of EXTL3, REG1 and PARP1. The association between these proteins and tissue regeneration is consistent with the biosynthesis phase initially taking place in OA cartilage. The dose-dependent relationship between PITX1 and cell proliferation supports the view that low PITX1 expression levels are necessary for chondrocytes to proliferate. Conversely, high levels of PITX1 would prevent proliferation and be required to maintain a differentiated state in normal articular chondrocytes. The regulation of PITX1 gene is of particular interest since it could help to better understand its role in osteoarthritis pathogenesis and in the process of endochondral ossification. Search for mechanisms responsible for the downregulation of PITX1 in OA led to the identification of prohibitin (PHB1) bound to its distal promoter region. PHB1 is a mitochondrial marker but its presence in chondrocytes nuclei seems to correlate with the initiation stage of OA. This discovery could impact diagnosis as well as possible treatments for osteoarthritis. |
