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Cartilage-protective effects of C-type natriuretic peptide over expression in K/BxN TCR arthritis model


The c-type natriuretic peptide (CNP) signaling pathway is known as a major contributor to skeletal growth in children. CNP is produced and secreted by both growth plate and joint chondrocytes, and has a paracrine regulatory effect on cartilage tissue. CNP increases matrix production by chondrocytes and promotes their proliferation. In this study, we investigated whether over-expression of CNP in chondrocytes would be protective of joint cartilage degradation during chronic inflammatory arthritis in vivo.


We first developed transgenic mice that over-express CNP (CNPcol2a1TG) in chondrocytes under the control of the collagen 2a1 promoter and enhancer. Then, we obtained K/BxN TCR transgenic mice from a collaborator and analyzed both transgenic mice for their joint cartilage clinical and histologic findings over time. We crossed CNPcol2a1TG mouse with K/BxN TCR transgenic mouse to produce mice with both K/BxN TCR and CNPcol2a1TG backgrounds. The degree of arthritis and cartilage damage in the offspring was analyzed using a clinical scoring system and two histological scoring systems. Differences between the scores were analyzed using the Student’s t-test.


Mice that carried the transgene for both CNPcol2a1TG and K/BxN TCR showed less severe clinical and histologic arthritis findings in the joint cartilage compared to wild type littermates. Between the ages of 6-14 weeks, the average arthritis score of K/BxN TCR transgenic mice that over-expressed CNP was 4.37 ±1.38 (n=8), while the average arthritis score of K/BxN TCR arthritic mice of the same age was 8.66 ±3.26 (n=14), (p<0.05). Histological staining and morphometry did not show any evidence of cartilage degradation in the joint cartilage of CNPcol2a1TG mice. The knee and ankle cartilage of CNPcol2a1TG mice was thick and showed increased proteoglycan content by Safranin-O staining. However, the double-transgenic offspring mice (K/BxN/CNPcol2a1TG) developed less cartilage damage and less chondrocyte disorganization while still developing inflammatory changes (pannus) in the synovium, similar to the K/BxN TCR mice. We adapted the ICRS histological scoring system and gave scores to the knee joint cartilage of the 8-week-old male mice. K/BxN mice (n=7) scored significantly lower for both chondrocytic cell distribution (III) and chondrocyte matrix content (II) (p<0.001 and p<0.05, respectively) than the (K/BxN/ CNPcol2a1TG mice (n=12).


K/BxN TCR arthritic mice over-expressing CNP did not have joint cartilage damage due to chronic inflammation. We conclude that excess paracrine production of CNP in the joint cartilage of double-transgenic K/BxN/CNPcol2a1TG arthritic mice was able to overcome the effects of pro-inflammatory cytokines on joint cartilage in vivo. CNP and the effector molecules of CNP signaling pathway may have therapeutic potential in protecting cartilage homeostasis during chronic inflammatory arthritis.


Hulya Bukulmez: None; Cynthia F. Bartels: None; Kabita Nanda: None; Tariq M. Haqqi: None; Jean F. Welter: None.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Bukulmez, H., Bartels, C.F., Nanda, K. et al. Cartilage-protective effects of C-type natriuretic peptide over expression in K/BxN TCR arthritis model. Pediatr Rheumatol 10 (Suppl 1), A109 (2012).

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