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Human C-reactive protein aggravates osteoarthritis development in mice on a high-fat diet

Kozijn, A.E.; Tartjiono, M.T.; Ravipati, S.; van der Ham, F.; Barrett, D.A.; Mastbergen, S.C.; Korthagen, N.M.; Lafeber, F.P.J.G.; Zuurmond, A.M.; Bobeldijk, I.; Weinans, H.; Stoop, R.

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A.E. Kozijn

M.T. Tartjiono

S. Ravipati

F. van der Ham

D.A. Barrett

S.C. Mastbergen

N.M. Korthagen

F.P.J.G. Lafeber

A.M. Zuurmond

I. Bobeldijk

H. Weinans

R. Stoop


Objective: C-reactive protein (CRP) levels can be elevated in osteoarthritis (OA) patients. In addition to indicating systemic inflammation, it is suggested that CRP itself can play a role in OA development. Obesity and metabolic syndrome are important risk factors for OA and also induce elevated CRP levels. Here we evaluated in a human CRP (hCRP)-transgenic mouse model whether CRP itself contributes to the development of ‘metabolic’ OA.
Design: Metabolic OA was induced by feeding 12-week-old hCRP-transgenic males (hCRP-tg, n = 30) and wild-type littermates (n = 15) a 45 kcal% high-fat diet (HFD) for 38 weeks. Cartilage degradation, osteophytes and synovitis were graded on Safranin O-stained histological knee joint sections. Inflammatory status was assessed by plasma lipid profiling, flow cytometric analyses of blood immune cell populations and immunohistochemical staining of synovial macrophage subsets.
Results: Male hCRP-tg mice showed aggravated OA severity and increased osteophytosis compared with their wild-type littermates. Both classical and non-classical monocytes showed increased expression of CCR2 and CD86 in hCRP-tg males. HFD-induced effects were evident for nearly all lipids measured and indicated a similar low-grade systemic inflammation for both genotypes. Synovitis scores and synovial macrophage subsets were similar in the two groups.
Conclusions: Human CRP expression in a background of HFD-induced metabolic dysfunction resulted in the aggravation of OA through increased cartilage degeneration and osteophytosis. Increased recruitment of classical and non-classical monocytes might be a mechanism of action through which CRP is involved in aggravating this process. These findings suggest interventions selectively directed against CRP activity could ameliorate metabolic OA development.


Kozijn, A., Tartjiono, M., Ravipati, S., van der Ham, F., Barrett, D., Mastbergen, S., …Stoop, R. (2019). Human C-reactive protein aggravates osteoarthritis development in mice on a high-fat diet. Osteoarthritis and Cartilage, 27(1), 118-128.

Journal Article Type Article
Acceptance Date Sep 13, 2018
Online Publication Date Sep 22, 2018
Publication Date Jan 1, 2019
Deposit Date Dec 18, 2018
Publicly Available Date Dec 19, 2018
Journal Osteoarthritis and Cartilage
Print ISSN 1063-4584
Electronic ISSN 1522-9653
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 27
Issue 1
Pages 118-128
Keywords Rheumatology; Orthopedics and Sports Medicine; Biomedical Engineering
Public URL
Publisher URL
Contract Date Dec 19, 2018


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