Systemic administration of cytotoxic T lymphocyte‐associated antigen 4 (CTLA‐4)‐Ig abrogates alveolar bone resorption in induced periodontitis through inhibition of osteoclast differentiation and activation: An experimental investigation

Abstract Background/objectives Cytotoxic T lymphocyte‐associated antigen 4 (CTLA‐4) is a critical immunoregulatory molecule expressed on T cells. CTLA‐4 also binds to the surfaces of monocytes and macrophages, precursors of osteoclasts. Research on rheumatoid arthritis demonstrated that CTLA‐4 suppresses inflammation and bone resorption. However, its effects on alveolar bone have yet to be understood. The purpose of this study was to investigate the role and potential mechanism of CTLA‐4 in bone resorption in periodontitis. Materials and methods In vivo, the effects of systemic administration of CTLA‐4 immunoglobulin fusion protein (CTLA‐4‐Ig) on alveolar bone resorption were investigated using a periodontitis mouse model. A total of 20 C57BL/6J mice were randomly assigned to two groups according to the administration modes. Periodontitis was induced by placing a ligature around the left maxillary second molar. The contralateral tooth was left un‐ligated. In the CTLA‐4‐Ig (+) group, CTLA‐4‐Ig was administered by intraperitoneal injection at 1 and 3 days after ligature placement. Animals in the CTLA‐4‐Ig (−) group were given only phosphate‐buffered saline each time. At 5 days after ligature placement, bone resorption was assessed by micro‐computed tomography and histological examination, and the prevalence of osteoclast‐like cells was assessed by tartrate‐resistant acid phosphatase (TRAP) staining. In vitro, the effects of CTLA‐4‐Ig on osteoclasts were evaluated. Viability of RAW 264.7 cells treated with receptor activator of nuclear factor‐κB ligand (RANKL) and CTLA‐4‐Ig was tested by WST‐1 assay. Osteoclast‐like cells were enumerated by TRAP staining, and osteoclast activity was evaluated by resorption pit assay. Gene expression levels of osteoclast differentiation markers (macrophage‐colony stimulating factor receptor, carbonic anhydrase II, cathepsin K, and Trap) and protein phosphatase 2A (PP2A), a major serine‐threonine phosphatase, were assessed by quantitative real‐time polymerase chain reaction. The effect of CTLA‐4‐Ig on the nuclear factor‐κB (NF‐κB) activation was assessed by enzyme‐linked immunosorbent assay. Results In vivo, ligature‐induced bone resorption and the numbers of osteoclast‐like cells were significantly decreased by the administration of CTLA‐4‐Ig. In vitro, treatment with RANKL and CTLA‐4‐Ig had no significant effect on cell viability. CTLA‐4‐Ig significantly reduced the prevalence and activation of osteoclast‐like cells and decreased the expressions of osteoclast differentiation markers, compared with the RANKL‐treated control. CTLA‐4‐Ig significantly suppressed RANKL‐induced phosphorylation of NF‐κB p65 but increased PP2A expression. Conclusion These results suggest that CTLA‐4‐Ig abrogates bone resorption in induced periodontitis, possibly via inhibition of osteoclast differentiation and activation. The regulation of the NF‐κB pathway and PP2A expression may be one mechanism by which CTLA‐4‐Ig suppresses osteoclast behavior.