To investigate whether short‐term, systemic depletion of macrophages can mitigate osteoarthritis (OA) following injury in the setting of obesity.

CSF‐1R–GFP+ macrophage Fas‐induced apoptosis (MaFIA)–transgenic mice that allow conditional depletion of macrophages were placed on a high‐fat diet and underwent surgery to induce knee OA. A small molecule (AP20187) was administrated to deplete macrophages in MaFIA mice. The effects of macrophage depletion on acute joint inflammation, OA severity, and arthritic bone changes were evaluated using histology and micro–computed tomography. Immunohistochemical analysis was performed to identify various immune cells. The levels of serum and synovial fluid cytokines were also measured.

Macrophage‐depleted mice had significantly fewer M1 and M2 macrophages in the surgically operated joints relative to controls and exhibited decreased osteophyte formation immediately following depletion. Surprisingly, macrophage depletion did not attenuate the severity of OA in obese mice; instead, it induced systemic inflammation and led to a massive infiltration of CD3+ T cells and particularly neutrophils, but not B cells, into the injured joints. Macrophage‐depleted mice also demonstrated a markedly increased number of proinflammatory cytokines including granulocyte colony‐stimulating factor, interleukin‐1β (IL‐1β), IL‐6, IL‐8, and tumor necrosis factor in both serum and joint synovial fluid, although the mice showed a trend toward decreased levels of insulin and leptin in serum after macrophage depletion.

Our findings indicate that macrophages are vital for modulating homeostasis of immune cells in the setting of obesity and suggest that more targeted approaches of depleting specific macrophage subtypes may be necessary to mitigate inflammation and OA in the setting of obesity.