Molecular clustering in osteoarthritis primary tissues identifies shared inflammatory and tissue-specific pathway

Odysseas Sotirios Stergiou1, Norbert Bittner2, Georgia Katsoula3

  • 1Graduate School of Experimental Medicine, Technical University of Munich, München, Germany; Institute of Translational Genomics, Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany; Technical University of Munich (TUM), TUM University Hospital, TUM School of Medicine and Health, Munich, Germany.

Abstract

Insights

This study classified knee osteoarthritis (OA) molecular subtypes in cartilage and other joint tissues using gene expression. Findings reveal shared and tissue-specific pathways for better patient stratification in OA.

Area of Science:

  • Genomics
  • Molecular Biology
  • Biomedical Engineering

Background:

  • Knee osteoarthritis (OA) exhibits significant molecular heterogeneity.
  • Understanding this heterogeneity is crucial for developing targeted therapies and improving patient stratification.
  • Current classifications often lack molecular granularity across different joint tissues.

Purpose of the Study:

  • To classify and characterize transcriptomic clusters in multiple knee joint tissues from osteoarthritis patients.
  • To identify distinct biological pathways driving OA heterogeneity.
  • To establish a foundation for gene expression-based patient stratification in OA.

Main Methods:

  • RNA sequencing data from 330 knee OA patients across cartilage, synovium, and infrapatellar fat pad tissues were analyzed.
  • Unsupervised machine learning identified transcriptomic clusters, followed by differential expression and pathway enrichment analyses.
  • A gene expression-based classifier was developed and validated for subtype prediction.

Main Results:

  • Robust transcriptomic clusters were identified in all analyzed joint tissues.
  • Low-grade cartilage showed two patient groups distinguished by inflammation and transcriptional regulation (94.5% classifier accuracy).
  • High-grade cartilage revealed three clusters (inflammatory, neuroactive, housekeeping); synovium and fat pad showed two clusters each, with shared immune activation pathways.

Conclusions:

  • Gene expression-based patient clusters were identified across different primary joint tissues in knee osteoarthritis.
  • Shared and tissue-specific molecular programs underlying OA pathogenesis were uncovered.
  • These findings provide a basis for developing transcription signature-based patient stratification strategies for OA.