Mechanical Stress Protects Against Chondrocyte Pyroptosis through Lipoxin A4 via Synovial Macrophage M2 Subtype Polarization in an Osteoarthritis Model

Our previous study found that lipoxin A4 (LXA4) exerted therapeutic effects on osteoarthritis (OA). In this study, we evaluated the effects of LXA4 via synovial macrophage M1/M2 subtype polarization on chondrocyte pyroptosis and mechanisms during mechanical stimulation. Synovial macrophages were subjected to various LXA4 concentrations and cyclic tensile strain (CTS) conditions to determine optimal co-culture conditions. The effects of LXA4 on chondrocyte pyroptosis, as represented by macrophage M1/M2 subtype polarization, were detected by western blot, immunofluorescence, and flow cytometry analyses. Forty male Sprague-Dawley rats were randomly divided into four groups (n = 10): control group (CG), OA group (OAG), OA with moderate-intensity treadmill exercise (OAE), and OAE + BOC-2 (an LXA4 antagonist). All rats were evaluated using histology, enzyme-linked immunosorbent assay (ELISA), quantitative PCR, and western blot analyses. We found that LXA4 was downregulated in articular fluid and that CD 86/Arg 1 was up-regulated in the synovium of patients with increasing Kellgren-Lawrence grade. In vitro, CTS and LXA4 both promoted M2 subtype polarization of synovial macrophages, inhibiting the nuclear translocation of NF-κB p65 and the NLRP3 formation in chondrocytes. In vivo, the OAE treatment exerted protective effects on articular cartilage and facilitated M2 polarization of synovial macrophages. These effects were suppressed by BOC-2 treatment. We concluded that moderate CTS enhances the therapeutic effects of LXA4 by inhibiting the nuclear translocation of NF-κB p65 and NLRP3. Furthermore, the therapeutic effects of LXA4 during treadmill exercise in monoiodoacetate-induced OA were driven by promotion of synovial macrophage M2 subtype polarization.