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Bone remodelling and increased subchondral densification are important in osteoarthritis (OA). Modifications of bone vascularization parameters, which lead to ischemic episodes associated with hypoxic conditions, have been suspected in OA. Among several factors potentially involved, leptin and dickkopf-related protein 2 (DKK2) are good candidates because they are upregulated in OA osteoblasts (Obs). Therefore, in the present study, we investigated the hypothesis that hypoxia may drive the expression of leptin and DKK2 in OA Obs.    Methods  Obs from the sclerotic portion of OA tibial plateaus were cultured under either 20% or 2% oxygen tension in the presence or not of 50 nM 1,25-dihydroxyvitamin D 3  (VitD 3 ). The expression of leptin, osteocalcin, DKK2, hypoxia-inducible factor 1α (Hif-1α) and Hif-2α was measured by real-time polymerase chain reaction and leptin production was measured by enzyme-linked immunosorbent assay (ELISA). The expression of Hif-1α, Hif-2α, leptin and DKK2 was reduced using silencing RNAs (siRNAs). The signalling pathway of hypoxia-induced leptin was investigated by Western blot analysis and with mitogen-activated protein kinase (MAPK) inhibitors.    Results  The expression of leptin and DKK2 in Obs was stimulated 7-fold and 1.8-fold, respectively ( P  <0.05) under hypoxia. Interestingly, whereas VitD 3  stimulated leptin and DKK2 expression 2- and 4.2-fold, respectively, under normoxia, it stimulated their expression by 28- and 6.2-fold, respectively, under hypoxia ( P  <0.05). The hypoxia-induced leptin production was confirmed by ELISA, particularly in the presence of VitD 3  ( P  <0.02). Compared to Obs incubated in the presence of scramble siRNAs, siHif-2α inhibited VitD 3 -stimulated leptin mRNA and protein levels by 70% ( P  =0.004) and 60% ( P  <0.02), respectively, whereas it failed to significantly alter the expression of DKK2. siHif-1α has no effect on these genes. Immunoblot analysis showed that VitD 3  greatly stabilized Hif-2α under hypoxic conditions. The increase in leptin expression under hypoxia was also regulated, by p38 MAPK ( P  <0.03) and phosphoinositide 3-kinase ( P  <0.05). We found that the expression of leptin and DKK2 were not related to each other under hypoxia.    Conclusions  Hypoxic conditions via Hif-2 regulation trigger Obs to produce leptin, particularly under VitD 3  stimulation, whereas DKK2 is regulated mainly by VitD 3  rather than hypoxia.

Hypoxia and vitamin D differently contribute to leptin and dickkopf-related protein 2 production in human osteoarthritic subchondral bone osteoblasts