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Osteogenesis imperfecta (OI) is characterized by short stature, skeletal deformities, low bone mass, and motor deficits. A subset of OI patients also present with joint hypermobility; however, the role of tendon dysfunction in OI pathogenesis is largely unknown. Using the  Crtap -/-   mouse model of severe, recessive OI, we found that mutant Achilles and patellar tendons were thinner and weaker with increased collagen cross-links and reduced collagen fibril size at 1- and 4-months compared to wildtype. Patellar tendons from  Crtap -/-   mice also had altered numbers of CD146 + CD200 +  and CD146 - CD200 +  progenitor-like cells at skeletal maturity. RNA-seq analysis of Achilles and patellar tendons from 1-month  Crtap -/-   mice revealed dysregulation in matrix and tendon marker gene expression concomitant with predicted alterations in TGF-β, inflammatory, and metabolic signaling. At 4-months,  Crtap -/-   mice showed increased αSMA, MMP2, and phospho-NFκB staining in the patellar tendon consistent with excess matrix remodeling and tissue inflammation. Finally, a series of behavioral tests showed severe motor impairments and reduced grip strength in 4-month  Crtap -/-   mice – a phenotype that correlates with the tendon pathology.

Tendon and motor phenotypes in the Crtap -/- mouse model of recessive osteogenesis imperfecta