Skip to content
2000
image of Diverse Programmed Cell Death Patterns and Diagnostic Value in Osteoarthritis Analyzed by Integrative Multiomics Data

Abstract

Introduction

Chronic pain and high disability rates caused by osteoarthritis (OA) significantly impact quality of life. Programmed cell death (PCD) plays a crucial role in OA pathogenesis; however, a comprehensive analysis of PCD patterns in OA is lacking, limiting understanding of their potential role.

Methods

Batch transcriptomic data related to OA were obtained from the GEO database. Differential expression analysis based on 13 PCD patterns was performed to identify differentially expressed genes (DEGs). Unsupervised clustering algorithms were applied to define molecular subtypes associated with OA. The CIBERSORT algorithm was used to analyze the immune microenvironment and evaluate the immunological relevance of each cluster. Hub PCD-related DEGs were identified using a combination of machine learning algorithms, and an OA diagnostic model was constructed based on these hub genes. Single-cell RNA sequencing (scRNA-seq) dataset GSE169454 was used to classify OA chondrocytes into distinct cell clusters. The AddModuleScore function calculated PCD scores, allowing evaluation of hub-gene expression and PCD variation across clusters. Expression levels of ten hub PCD-related DEGs were further validated in OA cells and rat models.

Results and Discussion

Differential expression analysis identified 61 PCD-related DEGs. Unsupervised clustering revealed two molecular subtypes of OA (cluster 1 and cluster 2), with immune-related pathways significantly enriched in cluster 1, including potential NK cell activation. Ten hub PCD-related DEGs were identified using three machine learning algorithms, leading to a highly effective diagnostic model (AUC = 0.993). Five distinct cell types were identified in OA chondrocytes, with higher PCD scores observed in OA samples and the HomC subgroup. Functional analysis indicated significant enrichment of the PI3K-AKT signaling pathway in high BINP3-expressing preHTCs, associated with extracellular matrix composition. mRNA and protein levels of the ten hub DEGs were confirmed in animal models. These findings suggested that the identified hub PCD-related genes may contribute to disease progression through coordinated regulation of inflammatory responses and chondrocyte fate, supporting their potential as diagnostic biomarkers and therapeutic targets.

Conclusion

This multi-omics analysis of 13 PCD patterns provides a preliminary evaluation of the diagnostic and classification value of PCD-related genes in OA, highlighting potential biomarkers for clinical application.

Loading

Article metrics loading...

/content/journals/cscr/10.2174/011574888X398652251128074957
2026-01-14
2026-02-27
Loading full text...

Full text loading...

References

  1. Zhang Y. Jordan J.M. Epidemiology of Osteoarthritis. Clin. Geriatr. Med. 2010 26 3 355 369 10.1016/j.cger.2010.03.001 20699159
    [Google Scholar]
  2. Felson D.T. Lawrence R.C. Dieppe P.A. Osteoarthritis: New insights. Part 1: The disease and its risk factors. Ann. Intern. Med. 2000 133 8 635 646 10.7326/0003‑4819‑133‑8‑200010170‑00016 11033593
    [Google Scholar]
  3. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2010-2012. MMWR Morb. Mortal. Wkly. Rep. 2013 62 44 869 873 24196662
    [Google Scholar]
  4. Ogden C.L. Carroll M.D. Lawman H.G. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA 2016 315 21 2292 2299 10.1001/jama.2016.6361 27272581
    [Google Scholar]
  5. Lohmander L.S. Englund P.M. Dahl L.L. Roos E.M. The long-term consequence of anterior cruciate ligament and meniscus injuries: Osteoarthritis. Am. J. Sports Med. 2007 35 10 1756 1769 10.1177/0363546507307396 17761605
    [Google Scholar]
  6. Flegal K.M. Kruszon-Moran D. Carroll M.D. Fryar C.D. Ogden C.L. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016 315 21 2284 2291 10.1001/jama.2016.6458 27272580
    [Google Scholar]
  7. Barnett R. Osteoarthritis Lancet 2018 391 10134 1985 10.1016/S0140‑6736(18)31064‑X 29864015
    [Google Scholar]
  8. Sharma L. Hochberg M. Nevitt M. Knee tissue lesions and prediction of incident knee osteoarthritis over 7 years in a cohort of persons at higher risk. Osteoarthritis Cartil 2017 25 7 1068 1075 10.1016/j.joca.2017.02.788 28232012
    [Google Scholar]
  9. Lankhorst N.E. Damen J. Oei E.H. Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: The Cohort Hip and Cohort Knee study. Osteoarthritis Cartil 2017 25 5 647 653 10.1016/j.joca.2016.12.006 27940216
    [Google Scholar]
  10. Hannan M.T. Felson D.T. Pincus T. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J. Rheumatol. 2000 27 6 1513 1517 10852280
    [Google Scholar]
  11. Bedoui S. Herold M.J. Strasser A. Emerging connectivity of programmed cell death pathways and its physiological implications. Nat. Rev. Mol. Cell Biol. 2020 21 11 678 695 10.1038/s41580‑020‑0270‑8 32873928
    [Google Scholar]
  12. Tower J. Programmed cell death in aging. Ageing Res Rev 2015 23 Pt A 90 100 10.1016/j.arr.2015.04.002 25862945
    [Google Scholar]
  13. Kulkarni M. Hardwick J.M. Programmed cell death in unicellular versus multicellular organisms. Annu. Rev. Genet. 2023 57 1 435 459 10.1146/annurev‑genet‑033123‑095833 37722687
    [Google Scholar]
  14. Green D.R. The coming decade of cell death research: Five riddles. Cell 2019 177 5 1094 1107 10.1016/j.cell.2019.04.024 31100266
    [Google Scholar]
  15. Wang Y. Kanneganti T.D. From pyroptosis, apoptosis and necroptosis to PANoptosis: A mechanistic compendium of programmed cell death pathways. Comput. Struct. Biotechnol. J. 2021 19 4641 4657 10.1016/j.csbj.2021.07.038 34504660
    [Google Scholar]
  16. Van Opdenbosch N. Lamkanfi M. Caspases in cell death, inflammation, and disease. Immunity 2019 50 6 1352 1364 10.1016/j.immuni.2019.05.020 31216460
    [Google Scholar]
  17. Liu S. Pan Y. Li T. The role of regulated programmed cell death in osteoarthritis: From pathogenesis to therapy. Int. J. Mol. Sci. 2023 24 6 5364 10.3390/ijms24065364 36982438
    [Google Scholar]
  18. Sharif M. Whitehouse A. Sharman P. Perry M. Adams M. Increased apoptosis in human osteoarthritic cartilage corresponds to reduced cell density and expression of caspase‐3. Arthritis Rheum. 2004 50 2 507 515 10.1002/art.20020 14872493
    [Google Scholar]
  19. Wang S. Li W. Zhang P. Mechanical overloading induces GPX4-regulated chondrocyte ferroptosis in osteoarthritis via Piezo1 channel facilitated calcium influx. J. Adv. Res. 2022 41 63 75 10.1016/j.jare.2022.01.004 36328754
    [Google Scholar]
  20. Yao X. Sun K. Yu S. Chondrocyte ferroptosis contribute to the progression of osteoarthritis. J. Orthop. Translat. 2021 27 33 43 10.1016/j.jot.2020.09.006 33376672
    [Google Scholar]
  21. Morris J.A. Gayther S.A. Jacobs I.J. Jones C. A suite of Perl modules for handling microarray data. Bioinformatics 2008 24 8 1102 1103 10.1093/bioinformatics/btn085 18353790
    [Google Scholar]
  22. Leek J.T. Johnson W.E. Parker H.S. Jaffe A.E. Storey J.D. The sva package for removing batch effects and other unwanted variation in high-throughput experiments. Bioinformatics 2012 28 6 882 883 10.1093/bioinformatics/bts034 22257669
    [Google Scholar]
  23. Zheng T. Liu Q. Xing F. Zeng C. Wang W. Disulfidptosis: A new form of programmed cell death. J. Exp. Clin. Cancer Res. 2023 42 1 137 10.1186/s13046‑023‑02712‑2 37259067
    [Google Scholar]
  24. Park W. Wei S. Kim B.S. Diversity and complexity of cell death: A historical review. Exp. Mol. Med. 2023 55 8 1573 1594 10.1038/s12276‑023‑01078‑x 37612413
    [Google Scholar]
  25. Ritchie M.E. Phipson B. Wu D. limma powers differential expression analyses for RNA-sequencing and microarray studies. Nucleic Acids Res. 2015 43 7 47 10.1093/nar/gkv007 25605792
    [Google Scholar]
  26. Ito K. Murphy D. Application of ggplot2 to pharmacometric graphics. CPT Pharmacometrics Syst. Pharmacol. 2013 2 10 1 16 10.1038/psp.2013.56 24132163
    [Google Scholar]
  27. Yu G. Wang L.G. Han Y. He Q.Y. clusterProfiler: An R package for comparing biological themes among gene clusters. OMICS 2012 16 5 284 287 10.1089/omi.2011.0118 22455463
    [Google Scholar]
  28. Shannon P. Markiel A. Ozier O. Cytoscape: A software environment for integrated models of biomolecular interaction networks. Genome Res. 2003 13 11 2498 2504 10.1101/gr.1239303 14597658
    [Google Scholar]
  29. Wilkerson M.D. Hayes D.N. ConsensusClusterPlus: A class discovery tool with confidence assessments and item tracking. Bioinformatics 2010 26 12 1572 1573 10.1093/bioinformatics/btq170 20427518
    [Google Scholar]
  30. Chen B. Khodadoust M.S. Liu C.L. Newman A.M. Alizadeh A.A. Profiling tumor infiltrating immune cells with CIBERSORT. Methods Mol. Biol. 2018 1711 243 259 10.1007/978‑1‑4939‑7493‑1_12 29344893
    [Google Scholar]
  31. Yip S.H. Sham P.C. Wang J. Evaluation of tools for highly variable gene discovery from single-cell RNA-seq data. Brief. Bioinform. 2019 20 4 1583 1589 10.1093/bib/bby011 29481632
    [Google Scholar]
  32. Liu J. Shi Y. Zhang Y. Multi-omics identification of an immunogenic cell death-related signature for clear cell renal cell carcinoma in the context of 3P medicine and based on a 101-combination machine learning computational framework. EPMA J. 2023 14 2 275 305 10.1007/s13167‑023‑00327‑3 37275552
    [Google Scholar]
  33. Robin X. Turck N. Hainard A. pROC: An open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 2011 12 1 77 10.1186/1471‑2105‑12‑77 21414208
    [Google Scholar]
  34. Wei M. Shi X. Tang W. Lv Q. Wu Y. Xu Y. Identification of a novel disulfidptosis-related gene signature in osteoarthritis using bioinformatics analysis and experimental validation. Sci. Rep. 2025 15 1 1339 10.1038/s41598‑025‑85569‑z 39779817
    [Google Scholar]
  35. Nedunchezhiyan U. Varughese I. Sun A.R. Wu X. Crawford R. Prasadam I. Obesity, inflammation, and immune system in osteoarthritis. Front. Immunol. 2022 13 907750 10.3389/fimmu.2022.907750 35860250
    [Google Scholar]
  36. Lopes E.B.P. Filiberti A. Husain S.A. Humphrey M.B. Immune contributions to osteoarthritis. Curr. Osteoporos. Rep. 2017 15 6 593 600 10.1007/s11914‑017‑0411‑y 29098574
    [Google Scholar]
  37. Weber A.E. Bolia I.K. Trasolini N.A. Biological strategies for osteoarthritis: From early diagnosis to treatment. Int. Orthop. 2021 45 2 335 344 10.1007/s00264‑020‑04838‑w 33078204
    [Google Scholar]
  38. Glyn-Jones S. Palmer A.J.R. Agricola R. Osteoarthritis. Lancet 2015 386 9991 376 387 10.1016/S0140‑6736(14)60802‑3 25748615
    [Google Scholar]
  39. Bijlsma J.W.J. Berenbaum F. Lafeber F.P.J.G. Osteoarthritis: An update with relevance for clinical practice. Lancet 2011 377 9783 2115 2126 10.1016/S0140‑6736(11)60243‑2 21684382
    [Google Scholar]
  40. Braun H.J. Gold G.E. Diagnosis of osteoarthritis: Imaging. Bone 2012 51 2 278 288 10.1016/j.bone.2011.11.019 22155587
    [Google Scholar]
  41. Kopeina G.S. Zhivotovsky B. Programmed cell death: Past, present and future. Biochem. Biophys. Res. Commun. 2022 633 55 58 10.1016/j.bbrc.2022.09.022 36344162
    [Google Scholar]
  42. Moujalled D. Strasser A. Liddell J.R. Molecular mechanisms of cell death in neurological diseases. Cell Death Differ. 2021 28 7 2029 2044 10.1038/s41418‑021‑00814‑y 34099897
    [Google Scholar]
  43. An S. Hu H. Li Y. Hu Y. Pyroptosis plays a role in osteoarthritis. Aging Dis. 2020 11 5 1146 1157 10.14336/AD.2019.1127 33014529
    [Google Scholar]
  44. Blanco F.J. López-Armada M.J. Maneiro E. Mitochondrial dysfunction in osteoarthritis. Mitochondrion 2004 4 5-6 715 728 10.1016/j.mito.2004.07.022 16120427
    [Google Scholar]
  45. De Carvalho D.D. Binato R. Pereira W.O. BCR–ABL-mediated upregulation of PRAME is responsible for knocking down TRAIL in CML patients. Oncogene 2011 30 2 223 233 10.1038/onc.2010.409 20838376
    [Google Scholar]
  46. Huang B. Yu H. Li Y. Zhang W. Liu X. Upregulation of long noncoding TNFSF10 contributes to osteoarthritis progression through the miR‐376‐3p/FGFR1 axis. J. Cell. Biochem. 2019 120 12 19610 19620 10.1002/jcb.29267 31297857
    [Google Scholar]
  47. Ma C. Wu L. Song L. The pro‐inflammatory effect of NR4A3 in osteoarthritis. J. Cell. Mol. Med. 2020 24 1 930 940 10.1111/jcmm.14804 31701670
    [Google Scholar]
  48. Lv Z. Sun D. Li X. Wu G. GSK3B overexpression alleviates posttraumatic osteoarthritis in mice by promoting DNMT1-mediated hypermethylation of NR4A3 promoter. Dis. Markers 2022 2022 1 20 10.1155/2022/4185489 35747513
    [Google Scholar]
  49. Novak I. Kirkin V. McEwan D.G. Nix is a selective autophagy receptor for mitochondrial clearance. EMBO Rep. 2010 11 1 45 51 10.1038/embor.2009.256 20010802
    [Google Scholar]
  50. Lomonosova E. Chinnadurai G. Bh3-only proteins in apoptosis and beyond: An overview. Oncogene 2008 27 Suppl. 1 S2 S19 10.1038/onc.2009.39 19641503
    [Google Scholar]
  51. Kim D. Song J. Jin E.J. BNIP3-dependent mitophagy via PGC1α promotes cartilage degradation. Cells 2021 10 7 1839 10.3390/cells10071839
    [Google Scholar]
  52. Wang W.F. Liu S.Y. Qi Z.F. Lv Z.H. Ding H.R. Zhou W.J. MiR-145 targeting BNIP3 reduces apoptosis of chondrocytes in osteoarthritis through Notch signaling pathway. Eur. Rev. Med. Pharmacol. Sci. 2020 24 16 8263 8272 10.26355/eurrev_202008_22622 32894532
    [Google Scholar]
  53. Feng X. Pan J. Li J. Metformin attenuates cartilage degeneration in an experimental osteoarthritis model by regulating AMPK/mTOR. Aging 2020 12 2 1087 1103 10.18632/aging.102635 31945013
    [Google Scholar]
  54. Pal B. Endisha H. Zhang Y. Kapoor M. mTOR: A potential therapeutic target in osteoarthritis? Drugs R D. 2015 15 1 27 36 10.1007/s40268‑015‑0082‑z 25688060
    [Google Scholar]
  55. Zhang Y. Yang Y. Wang C. Identification of diagnostic biomarkers of osteoarthritis based on multi-chip integrated analysis and Machine Learning. DNA Cell Biol. 2020 39 12 2245 2256 10.1089/dna.2020.5552 33064574
    [Google Scholar]
  56. Yu Y. Lu S. Li Y. Xu J. Overview of distinct N6-Methyladenosine profiles of messenger RNA in osteoarthritis. Front. Genet. 2023 14 1168365 10.3389/fgene.2023.1168365 37229206
    [Google Scholar]
/content/journals/cscr/10.2174/011574888X398652251128074957
Loading
/content/journals/cscr/10.2174/011574888X398652251128074957
Loading

Data & Media loading...

Supplements

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test