Therapeutic restoration of mitochondria–endoplasmic reticulum cross talk for osteoarthritis

M Mingzhuang Hou (Department of Orthopaedics, First Affiliated Hospital of Soochow University) Y Yifan Ma Y Yaoge Deng (Department of Orthopaedics, First Affiliated Hospital of Soochow University) Y Yubin Wu (Department of Orthopaedics, First Affiliated Hospital of Soochow University) Y Yanrun Zhu (Department of Orthopaedics, First Affiliated Hospital of Soochow University) Y Yang Liu X Xiaoping Li (Department of Orthopaedics, First Affiliated Hospital of Soochow University) L Lili Yu Z Zirui He (Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology) Y Yifan Wang S Shiyan Dong (Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center) X Xiaowei Xia (Department of Orthopaedics, First Affiliated Hospital of Soochow University) J Jianfeng Yu (Department of Orthopaedics, First Affiliated Hospital of Soochow University) C Chenqi Yu (Department of Orthopaedics, First Affiliated Hospital of Soochow University) K Kang Kang (Department of Orthopaedics, First Affiliated Hospital of Soochow University) Y Yingjie Lu (Department of Orthopaedics, First Affiliated Hospital of Soochow University) L Lili Sun (Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology) B Betty Y. S. Kim Y Yuan Yuan Y Yijian Zhang (Department of Orthopaedics, First Affiliated Hospital of Soochow University) W Wen Jiang X Xuesong Zhu (Department of Orthopaedics, First Affiliated Hospital of Soochow University)

Abstract

Osteoarthritis is a prevalent joint disease in the aging population. The hallmark of osteoarthritis is the degeneration of the joint cartilage, characterized by changes in chondrocytes including mitochondrial dysfunction. However, the precise mechanisms of how this affects chondrocyte homeostasis and whether such processes can be explored as therapeutic targets for osteoarthritis remain unclear. Here, we show that impaired mitochondrial function and disrupted cartilage matrix metabolism due to loss of mitofusin-2 (MFN2) expression in chondrocytes leads to the development of osteoarthritis. Sirtuin-3 (SIRT3), a key regulator of mitochondrial function, plays a critical role in modulating MFN2 to restore mitochondrial dynamics, reduce fragmentation, and preserve mitochondrial function in chondrocytes. Specifically, SIRT3 directly deacetylates and indirectly deubiquitinates MFN2, preventing its degradation. MFN2-mediated mitochondrial–endoplasmic reticulum (ER) junctions support cellular homeostasis, alleviate ER stress, and maintain mitochondrial calcium ion balance, which collectively mitigate chondrocyte senescence. Extracellular vesicles engineered with MFN2 mRNA effectively prevented cartilage degeneration and restored mobility in osteoarthritic mice. These findings suggest that targeting MFN2 is a promising strategy to prevent cartilage degeneration and alleviate progression of osteoarthritis.

Article Details

Volume / Issue Vol. 122, Issue 36
Published September 09, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (22)

M

Mingzhuang Hou

Department of Orthopaedics, First Affiliated Hospital of Soochow University

Y

Yifan Ma

Y

Yaoge Deng

Department of Orthopaedics, First Affiliated Hospital of Soochow University

Y

Yubin Wu

Department of Orthopaedics, First Affiliated Hospital of Soochow University

Y

Yanrun Zhu

Department of Orthopaedics, First Affiliated Hospital of Soochow University

Y

Yang Liu

X

Xiaoping Li

Department of Orthopaedics, First Affiliated Hospital of Soochow University

L

Lili Yu

Z

Zirui He

Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology

Y

Yifan Wang

S

Shiyan Dong

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center

X

Xiaowei Xia

Department of Orthopaedics, First Affiliated Hospital of Soochow University

J

Jianfeng Yu

Department of Orthopaedics, First Affiliated Hospital of Soochow University

C

Chenqi Yu

Department of Orthopaedics, First Affiliated Hospital of Soochow University

K

Kang Kang

Department of Orthopaedics, First Affiliated Hospital of Soochow University

Y

Yingjie Lu

Department of Orthopaedics, First Affiliated Hospital of Soochow University

L

Lili Sun

Key Laboratory for Ultrafine Materials of Ministry of Education, School of Materials Science and Engineering, East China University of Science and Technology

B

Betty Y. S. Kim

Y

Yuan Yuan

Y

Yijian Zhang

Department of Orthopaedics, First Affiliated Hospital of Soochow University

W

Wen Jiang

X

Xuesong Zhu

Department of Orthopaedics, First Affiliated Hospital of Soochow University