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Recent developments in crystal-induced inflammation pathogenesis and management

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Abstract

Crystal-induced inflammation pathogenesis is under-going a transition with respect to monosodium urate, calcium pyrophosphate dihydrate, and even basic calcium phosphate crystals. It is now recognized that innate immunity could be involved in the earlier pathogenic events and that the inflammasome, along with other signaling pathways, is activated and results in interleukin-1 processing and secretion, ultimately activating cells as a paracrine or autocrine cytokine. Management of acute and chronic monosodium urate crystal-induced inflammation, namely gout, has been critically reviewed by a dedicated European working group, and on the behalf of the European League against Rheumatism, 12 evidence-based recommendations have been reported. Calcium pyrophosphate dihydrate chronic inflammation could benefit from colchicine and from methotrexate as an anti-inflammatory agent.

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References and Recommended Reading

  1. Lioté F, Ea HK: Pathogenesis of crystal-induced inflammation. Rev Rhum 2007, 74:131–137.

    Article  Google Scholar 

  2. Liu-Bryan R, Lioté F: Monosodium urate and calcium pyrophosphate dihydrate (CPPD) crystals, inflammation, and cellular signaling. Joint Bone Spine 2005, 72:295–302.

    Article  PubMed  Google Scholar 

  3. Ea HK, Uzan B, Rey C, Lioté F: Octacalcium phosphate crystals directly stimulate expression of inducible nitric oxide synthase through p38 and JNK mitogen-activated protein kinases in articular chondrocytes. Arthritis Res Ther 2005, 7:R915–926.

    Article  PubMed  CAS  Google Scholar 

  4. Fujiwara K, Ohkawara S, Takagi K, et al.: Involvement of CXC chemokine growth-related oncogene-alpha in monosodium urate crystal-induced arthritis in rabbits. Lab Invest 2002, 82:1297–1304.

    PubMed  CAS  Google Scholar 

  5. Choi HK, Mount DB, Reginato AM: Pathogenesis of gout. Ann Intern Med 2005, 143:499–516.

    PubMed  CAS  Google Scholar 

  6. Tramontini N, Huber C, Liu-Bryan R, et al.: Central role of complement membrane attack complex in monosodium urate crystal-induced neutrophilic rabbit knee synovitis. Arthritis Rheum 2004, 50:2633–2639.

    Article  PubMed  Google Scholar 

  7. Shi Y, Evans JE, Rock KL: Molecular identification of a danger signal that alerts the immune system to dying cells. Nature 2003, 425:516–521.

    Article  PubMed  CAS  Google Scholar 

  8. Rock KL, Hearn A, Chen CJ, et al.: Natural endogenous adjuvants. Spinger Semin Immunopathol 2005, 26:231–246.

    Article  Google Scholar 

  9. Liu-Bryan R, Scott P, Sydlaske A, et al.: Innate immunity conferred by Toll-like receptors 2 and 4 and myeloid differentiation factor 88 expression is pivotal to monosodium urate monohydrate crystal-induced inflammation. Arthritis Rheum 2005, 52:2936–2946.

    Article  PubMed  CAS  Google Scholar 

  10. Grandjean-Laquerriere A, Tabary O, Jacquot J, et al.: Involvement of toll-like receptor 4 in the inflammatory reaction induced by hydroxyapatite particles. Biomaterials 2007, 28:400–404.

    Article  PubMed  CAS  Google Scholar 

  11. Liu-Bryan R, Pritzker K, Firestein GS, Terkeltaub R: TLR2 signaling in chondrocytes drives calcium pyrophosphate dihydrate and monodium urate crystal-induced nitric oxide generation. J Immunol 2005, 174:5016–5023.

    PubMed  CAS  Google Scholar 

  12. Scott P, Ma H, Viriyakosol S, et al.: Engagement of CD14 mediates the inflammatory potential of monosodium urate crystals. J Immunol 2006, 177:6370–6378.

    PubMed  CAS  Google Scholar 

  13. Chen CJ, Shi Y, Hearn A, et al.: MyD88-dependent IL-1 receptor signaling is essential for gouty inflammation stimulated by monosodium urate crystals. J Clin Invest 2006, 116:2262–2271.

    Article  PubMed  CAS  Google Scholar 

  14. Martinon F, Petrilli V, Mayor A, et al.: Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature 2006, 440:237–241.

    Article  PubMed  CAS  Google Scholar 

  15. Murakami Y, Akohoshi T, Hayashi T, et al.: Induction of triggering receptor expressed on myeloid cells 1 in murine resident peritoneal macrophages by monosodium urate monohydrate crystals. Arthritis Rheum 2006, 54:455–464.

    Article  PubMed  CAS  Google Scholar 

  16. Liu-Bryan R, Terkeltaub R: Evil humors take their Toll as innate immunity makes gouty joints TREM-ble. Arthritis Rheum 2006, 54:383–386.

    Article  PubMed  CAS  Google Scholar 

  17. Tschopp J, Martinon F, Burns K: NALPS: a novel protein family involved in inflammation. Nat Rev Mol Cell Biol 2003, 4:95–104.

    Article  PubMed  CAS  Google Scholar 

  18. Martinon F, Tschopp J: NLRs join TLRs as innate sensors of pathogens. Trends Immunol 2005, 26:447–454.

    Article  PubMed  CAS  Google Scholar 

  19. Rose DM, Liu-Bryan R: Innate immunity in triggering and resolution of acute gouty inflammation. Curr Rheumatol Rep 2006, 8:209–214.

    Article  PubMed  CAS  Google Scholar 

  20. Landis RC, Yagnik DR, Florey O, et al.: Safe disposal of inflammatory monosodium urate monohydrate crystals by differenciated macrophages. Arthritis Rheum 2002, 46:3026–3033.

    Article  PubMed  CAS  Google Scholar 

  21. Lioté F, Ea HK: Gout: update on some pathogenic and clinical aspects. Rheum Dis Clin North Am 2006, 32:295–311, vi.

    Article  PubMed  Google Scholar 

  22. Rose DM, Sydlaske AD, Agha-Babakhani A, et al.: Transglutaminase 2 limits murine peritoneal acute gout-like inflammation by regulating macrophage clearance of apoptotic neutrophils. Arthritis Rheum 2006, 54:3363–3371.

    Article  PubMed  CAS  Google Scholar 

  23. Zhang W, Doherty M, Bardin T, et al.: EULAR Standing Committee for International Clinical Studies Including Therapeutics. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006, 65:1312–1324.

    Article  PubMed  CAS  Google Scholar 

  24. Schlesinger N, Detry MA, Holland BK, et al.: Local ice therapy during bouts of acute gouty arthritis. J Rheumatol 2002, 29:331–334.

    PubMed  Google Scholar 

  25. Schlesinger N: Response to application of ice may help differentiate between gouty arthritis and other inflammatory arthritides. J Clin Rheumatol 2006, 12:275–276.

    Article  PubMed  Google Scholar 

  26. Niel E, Scherrmann JM: Colchicine today. Joint Bone Spine 2006, 73:672–678.

    Article  PubMed  CAS  Google Scholar 

  27. Rubin BR, Burton R, Navarra S, et al.: Efficacy and safety profile of treatment with etoricoxib 120 mg once daily compared with indomethacin 50 mg three times daily in acute gout. Arthritis Rheum 2004, 50:598–606.

    Article  PubMed  CAS  Google Scholar 

  28. Juhlin T, Bjorkman S, Gunnarsson B, et al.: Acute administration of diclofenac, but possibly not long term low dose aspirin, causes detrimental renal effects in heart failure patients treated with ACE-inhibitors. Eur J Heart Fail 2004, 6:909–916.

    PubMed  CAS  Google Scholar 

  29. Rull M, Clayburne G, Sieck M, Schumacher HR: Intra-articular corticosteroid preparations: different characteristics and their effect during inflammation induced by monosodium urate crystals in the rat subcutaneous air pouch. Rheumatology (Oxford) 2003, 42:1093–1100.

    Article  CAS  Google Scholar 

  30. Getting SJ, Christian HC, Flower RJ, Perretti M: Activation of melanocortin type 3 receptor as a molecular mechanism for adrenocorticotropic hormone efficacy in gouty arthritis. Arthritis Rheum 2002, 46:2765–2775.

    Article  PubMed  CAS  Google Scholar 

  31. Neogy T, Hunter DJ, Chasson CE, et al.: Frequency of innapropriate management of gout attacks. Arthritis Rheum 2004, 50:S339.

    Article  Google Scholar 

  32. Fang W, Zeng X, Li M, et al.: The management of gout at an academic healthcare center in Beijing: a physician survey. J Rheumatol 2006, 33:2041–2049.

    PubMed  Google Scholar 

  33. Perez-Ruiz F, Lioté F: Lowering sUA levels: what is the optimal target for improving clinical outcomes in gout? Arthritis Care Res 2007, in press.

  34. Richy F, Bruyere O, Ethgen O, et al.: Time dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: a consensus statement using a meta-analytic approach. Ann Rheum Dis 2004, 63:759–766.

    Article  PubMed  CAS  Google Scholar 

  35. Alejandro A, Spilberg I: Colchicine prophylaxis in pseudogout. J Rheumatol 1986, 13:804–805.

    Google Scholar 

  36. Chollet-Janin A, Finckh A, Dudler J, Guerne PA: Methotrexate as an alternative therapy for chronic calcium pyrophosphate deposition disease: analysis. Arthritis Rheum 2007, 56:688–692.

    Article  PubMed  Google Scholar 

  37. Getting SJ: Targeting melanocortin receptors as potential novel therapeutics. Pharmacol Ther 2006, 111:1–15.

    Article  PubMed  CAS  Google Scholar 

  38. Schlesinger N, Schumacher R, Catton M, Maxwell L: Colchicine for acute gout. Cochrane Database Syst Rev 2006, (4): CD006190.

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Correspondence to Frédéric Lioté MD, PhD.

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Lioté, F., Ea, HK. Recent developments in crystal-induced inflammation pathogenesis and management. Curr Rheumatol Rep 9, 243–250 (2007). https://doi.org/10.1007/s11926-007-0039-5

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