This study in rabbits indicates that the application of low O2 during incubation periods of chondrocyte expansion is sufficient to produce engineered cartilage of increased GAG content. The data demonstrate that, when cultured as aggregates at 21% O2, chondrocytes expanded at 5% O2 produce cartilage aggregates that contain more total GAG, more GAG per wet weight, more GAG per DNA, and more total collagen than chondrocytes expanded at 21% O2. The application of low O2 during incubation periods of chondrocyte expansion was found to have less effect on GAG and collagen content when aggregate culture was performed at 5% O2.
Previous work by Egli
et al. established that low O
2 is an expansion condition capable of enhancing postexpansion of bovine chondrocyes,
7 and the results shown here are in general agreement for rabbit chondrocytes. In contrast to this study, Egli
et al.
7 made use of a hypoxic workstation to control ambient O
2 tension during all stages of expansion and aggregate culture. Although hypoxic workstations provide rigorous control of ambient O
2 tension, their potential to find widespread use in chondrocyte-based cartilage tissue engineering strategies may be hampered by their cost, restrictive interface, and size. To address this issue, the present study used O
2 control incubation to examine whether application of low O
2 during incubation periods of chondrocyte expansion is sufficient to produce engineered cartilage of increased GAG content. As with the work by Egli
et al. and other previous studies in which O
2 tension was controlled in the gas phase rather than the liquid phase, in this study it is likely that O
2 tension at the level of the cells was lower than the level being regulated in the gas phase, as the amount of detectable O
2 at the cell surface during monolayer culture is a function of cell density, the O
2 tension in the incubator, and cellular activity.
21Several of the findings of the present work parallel those of the work by Egli
et al. First, the present data show that chondrocytes expanded at 5% O
2 produced aggregates that contained significantly more total GAG than those produced by chondrocytes expanded at 21% O
2. The 5% O
2 expansion group had more total GAG in samples from five of six rabbits, with differences ranging from 0.49% (no difference) to 200%. Egli
et al. reported similar finding using bovine cells, with aggregates from a 1.5% O
2 expansion group having more total GAG than a 21% O
2 expansion group in three of three experiments, with differences ranging from 17% to 107%. Second, in this study, the expansion condition was only found to affect GAG content when aggregate culture was performed at 21% O
2. For aggregate culture at 5% O
2, there was no significant difference in total GAG in aggregates produced by chondrocytes expanded at 5% or 21% O
2. Similarly, Egli
et al. reported that aggregate culture at 1.5% or 5% O
2 did not, or to a lesser extent, support the formation of a cartilage-like matrix, although total GAG content for these samples was not quantified. Last, as with the data reported by Egli
et al., in this study we found no substantial difference in the level of the transcripts encoding aggrecan core protein, despite the increase in the content of total GAG. More generally, on the level of transcripts, Egli
et al. reported that no consistent differences could be observed between aggregates cultured after expansion at 1.5% O
2 or 21% O
2. In this study we observed that, when compared with chondrocytes expanded at 21% O
2, chondrocytes expanded at 5% O
2 expressed significantly higher levels of
COL2A1 type IIA and
COL2A1 type IIB during specific periods of expansion and aggregate culture and produced aggregates of more total collagen protein, yet the expression levels of
SOX9 were not affected by expansion condition. It remains to be determined whether this apparent discrepancy would be resolved by a more detailed analysis of gene expression—gene expression during aggregate culture was assessed at a single time point (7 days of aggregate culture)—or if our findings and the findings of Egli
et al. are indicative of more complex factors, such as phosphorylation of Sox9
22 or a chondrogenic pathway that is not dependent on Sox9 upregulation.
23Although this study achieved the objective of determining whether application of low O2 during incubation periods of chondrocyte expansion is sufficient to produce engineered cartilage of increased GAG content, the study was not designed to test whether application of low O2 during incubation periods of chondrocyte expansion produced the same effect as would be produced in a hypoxic workstation. The parallels described above between our findings and those of the work by Egli et al. certainly suggest that the benefits of low O2 expansion achieved through the use of an O2 control incubator may be similar to those produced through the use of a hypoxic workstation, but determination of the functional and biochemical extent of this similarity requires further investigation.
In addition to the above results that were consistent with the previous findings of Egli
et al.,
7 this study also assessed whether low O
2 during expansion affects the matrix density of the cartilage formed, or simply the quantity, as the previous study reported total GAG content, rather than GAG content normalized to wet or dry weight. We found that for aggregate culture performed at 21% O
2, low O
2 during expansion does affect the matrix density of the cartilage formed, as chondrocytes expanded at 5% O
2 produced aggregates that contained not only more total GAG but also more GAG per wet weight, more GAG per DNA, and more total collagen than those produced by chondrocytes expanded at 21% O
2, whereas there was no significant difference in collagen per wet weight. In contrast, we found that expansion conditions had no effect on cartilage matrix density for aggregate culture at 5% O
2, as chondrocytes expanded at 5% O
2 produced aggregates that contained more total collagen but no significant difference in total GAG, GAG per wet weight, GAG per DNA, or collagen per wet weight. It was also found that chondrocytes expanded at 5% O
2 produced aggregates significantly larger than those produced by chondrocytes expanded at 21% O
2. In fact, chondrocytes expanded at 5% O
2 generated, in a period of 1 week, cartilage tissue of wet weight comparable to that generated in a period of 3 weeks by chondrocytes expanded at 21% O
2 (). These new observations collectively indicate that application of low O
2 during incubation periods of chondrocyte expansion alone is sufficient to produce engineered cartilage of enhanced matrix density and quantity. However, it is important to note that the biomechanical properties of the neo-cartilage generated during postexpansion chondrogenesis were not assessed in either this study or the previous study by Egli
et al.,
7 and it is not known whether chondrocytes expanded at 5% O
2 produced neo-cartilage with biomechanical properties similar to or different than that produced by chondrocytes expanded at 21% O
2.
As noted, aggregates collected at day 3 of aggregate culture did not yield sufficient RNA for real-time PCR and were excluded from gene expression analysis. This observation raises the possibility of cell death during aggregate culture, particularly during the early phases of aggregate culture. To assess the potential effects of O2 tension on cell viability, we performed an additional single rabbit experiment using the same experimental groups described above and assaying cell viability (DAPI staining of nuclei and a Hoechst staining of dead cells) and total DNA (as described above) in quadruplicate samples from each experimental group at 1, 3, 5, and 7 days of aggregate culture. The results suggest that cell death is not an overriding factor in the outcome of these experiments. Cell viability was greater than 94% for all experimental groups at 1 day of aggregate culture and increased to greater than 98% viability at days 3, 5, and 7 (data not shown). Total DNA was fairly constant within each experimental group during aggregate culture (data not shown). These results suggest that it is unlikely that cell death was responsible for the low RNA yield in the day 3 aggregates. The same aggregate homogenization and RNA extraction protocol was used for day 3 and day 7 aggregates, and it is possible that optimization of the protocol to each set of aggregates would increase RNA yield for the day 3 aggregates.
In conclusion, this work in rabbits shows that application of low O2 during incubation periods of chondrocyte expansion is sufficient to produce engineered cartilage of increased GAG content, as has previously been produced using a hypoxic workstation to produce low O2 during all stages of expansion. In addition, the present results show that low O2 during expansion enhances the matrix density of the cartilage formed, not simply the quantity. Based on these findings, we suggest that application of low O2 during incubation periods of chondrocyte expansion may be a useful tool for enhancing chondrocyte-based cartilage tissue engineering strategies, such as autologous chondrocyte transplantation or matrix-assisted chondrocyte implantation. The fact that the benefits of low O2 expansion can be achieved through the use of an O2 control incubator provides the potential for expansion-phase low O2 to find widespread use in chondrocyte-based cartilage tissue engineering strategies.