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Bschorer F, Höller S, Baumhoer D, Bschorer R. Pseudogout growing from the temporomandibular joint into the middle cranial fossa. Oral Maxillofac Surg 2024; 28:441-445. [PMID: 36194300 DOI: 10.1007/s10006-022-01117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022]
Abstract
Calcium pyrophosphate dihydrate deposition disease (CPDD or pseudogout) is a degenerative joint disease. It is defined by the presence of calcium pyrophosphate dihydrate crystals. It usually manifests in the knee and wrist. Manifestation in the temporomandibular joint (TMJ) is only reported in case reports. We present a patient with CPDD mimicking a malignant tumor of the TMJ. A 53-year-old woman presented with progressive pain and a slow-growing swelling of the left TMJ. Imaging showed an extensive mass in the infratemporal fossa extending into the middle cranial fossa and compressing the temporal lobe. Assuming a potential malignancy, we excised the growth, which extended into the dura. We covered the resulting tissue defect within the primary surgery using a microsurgically anastomosed scapular flap and performed further reconstructive surgeries. Calcium pyrophosphate dihydrate crystals were found in the histopathologic examination of the excised tissue, resulting in the diagnosis of CPDD. That is a benign diagnosis, but we treated it like a malignancy. This leads us to the question, was there overtreatment? Tumoral CPDD in the TMJ can be a difficult diagnosis to obtain. The treatment remains controversial, but complete excision of the mass was performed in most reported cases.
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Affiliation(s)
- Frizzi Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany.
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany.
| | - Sylvia Höller
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, CH, Switzerland
- Institute of Pathology, University Hospital Zürich, Schmelzbergstrasse 12, 8091, Zurich, CH, Switzerland
| | - Daniel Baumhoer
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, CH, Switzerland
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany
- MKG-Praxis Am Stadthafen, Schliemannstr. 18, 19055, Schwerin, Germany
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2
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Villa-Bellosta R. Role of the extracellular ATP/pyrophosphate metabolism cycle in vascular calcification. Purinergic Signal 2022:10.1007/s11302-022-09867-1. [PMID: 35511317 DOI: 10.1007/s11302-022-09867-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/19/2022] [Indexed: 10/18/2022] Open
Abstract
Conventionally, ATP is considered to be the principal energy source in cells. However, over the last few years, a novel role for ATP as a potent extracellular signaling molecule and the principal source of extracellular pyrophosphate, the main endogenous inhibitor of vascular calcification, has emerged. A large body of evidence suggests that two principal mechanisms are involved in the initiation and progression of ectopic calcification: high phosphate concentration and pyrophosphate deficiency. Pathologic calcification of cardiovascular structures, or vascular calcification, is a feature of several genetic diseases and a common complication of chronic kidney disease, diabetes, and aging. Previous studies have shown that the loss of function of several enzymes and transporters involved in extracellular ATP/pyrophosphate metabolism is associated with vascular calcification. Therefore, pyrophosphate homeostasis should be further studied to facilitate the design of novel therapeutic approaches for ectopic calcification of cardiovascular structures, including strategies to increase pyrophosphate concentrations by targeting the ATP/pyrophosphate metabolism cycle.
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Affiliation(s)
- Ricardo Villa-Bellosta
- Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Av Barcelona, Campus Vida, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain. .,Department of Biochemistry and Molecular Biology, Universidade de Santiago de Compostela, Plaza do Obradoiro s/n, Santiago de Compostela, Spain.
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Duan J, Zhang J, Yang H, Liu Q, Xie M, Zhang M, Chu Y, Zhou P, Yu S, Chen C, Wang M. Mineral deposition intervention through reduction of phosphorus intake suppresses osteoarthritic lesions in temporomandibular joint. Osteoarthritis Cartilage 2021; 29:1370-1381. [PMID: 34126199 DOI: 10.1016/j.joca.2021.05.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore the suppressing impact of low phosphorus intake on osteoarthritic temporomandibular joint and the possible mechanisms of nuclear acid injury in the insulted chondrocytes. DESIGN Chondrocytes were loaded with fluid flow shear stress (FFSS) with or without low phosphorus medium. Seventy-two mice (sampled at 3-, 7- and 11-wk, n = 6) and forty-eight rats (sampled at 12-wks for different testing purpose, n = 6) were applied with unilateral anterior crossbite (UAC) with or without low phosphorus diet. In the FFSS model, the Ca and P content, molecules related to nucleic acid degradation and the mineral-producing responses in chondrocytes were detected. The effect of culture dish stiffness on chondrocytes osteogenic differentiation was measured. In the UAC model, the content of Ca and P in serum were tested. The condylar cartilage ossification and stiffness were detected using micro-CT, scanning electron microscope and atomic force microscope. RESULTS FFSS induced nucleic acid degradation, Pi accumulation and mineral-producing responses in the cultured chondrocytes, all were alleviated by low P medium. Stiffer dish bottoms promoted the osteogenic differentiation of the cultured chondrocytes. UAC stimulated cartilage degeneration and chondrocytes nucleic acid damage, increased PARP 1 and serum P content, and enhanced ossification and stiffening of the cartilage, all were suppressed by low phosphorus diet (all, P < 0.05). CONCLUSION Nucleic acid damage takes a role in phosphorus production in osteoarthritic cartilage, contributing to the enhanced mineralization and stiffness of the cartilage that in turn promotes cartilage degradation, which can be alleviated by low phosphorus intake.
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Affiliation(s)
- J Duan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - J Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - H Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Q Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - M Xie
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - M Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Y Chu
- Key Laboratory for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - P Zhou
- Xiangya Stomatological Hospital, Central South University, No. 72, Xiang Ya Road, Changsha, Hunan, 410000, China
| | - S Yu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - C Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - M Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
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Mitton-Fitzgerald E, Gohr CM, Bettendorf B, Rosenthal AK. The Role of ANK in Calcium Pyrophosphate Deposition Disease. Curr Rheumatol Rep 2016; 18:25. [PMID: 27032788 DOI: 10.1007/s11926-016-0574-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The protein product of the progressive ankylosis gene, known as ANK, is a 492-amino acid multi-pass transmembrane protein. This protein is critical for the regulation of pyrophosphate, and gain of function ANK mutations is associated with calcium pyrophosphate deposition disease. Much about the structure, function, and regulation of ANK remain unstudied. This review of the current literature examines recent contributions to our understanding of ANK. We focus on new work on the function, binding partners, and regulators of ANK. A more complete understanding of this important protein may help to identify future therapeutic targets for the treatment of calcium pyrophosphate deposition disease.
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Affiliation(s)
- Elizabeth Mitton-Fitzgerald
- The Division of Rheumatology, Department of Medicine, Medical College of Wisconsin and the Zablocki VA Medical Center, Milwaukee, WI, 53295-1000, USA
| | - Claudia M Gohr
- The Division of Rheumatology, Department of Medicine, Medical College of Wisconsin and the Zablocki VA Medical Center, Milwaukee, WI, 53295-1000, USA.
| | - Brittany Bettendorf
- The Division of Rheumatology, Department of Medicine, Medical College of Wisconsin and the Zablocki VA Medical Center, Milwaukee, WI, 53295-1000, USA
| | - Ann K Rosenthal
- The Division of Rheumatology, Department of Medicine, Medical College of Wisconsin and the Zablocki VA Medical Center, Milwaukee, WI, 53295-1000, USA
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Villa-Bellosta R. Vascular Calcification Revisited: A New Perspective for Phosphate Transport. Curr Cardiol Rev 2015; 11:341-351. [PMID: 26242187 PMCID: PMC4774640 DOI: 10.2174/1573403x11666150805120505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 12/30/2022] Open
Abstract
Elevated serum phosphorus has emerged as a key risk factor for pathologic calcification of
cardiovascular structures, or vascular calcification (VC). To prevent the formation of calciumphosphate
deposits (CPD), the body uses adenosine-5’-triphosphate (ATP) to synthesize inhibitors of
calcification, including proteins and inhibitors of low molecular weight. Extracellular pyrophosphate
(PPi) is a potent inhibitor of VC, which is produced during extracellular hydrolysis of ATP. Loss of
function in the enzymes and transporters that are involved in the cycle of extracellular ATP, including
Pi transporters, leads to excessive deposition of calcium-phosphate salts. Treatment of hyperphosphatemia
with Pi-binders and Injection of exogenous PPi are the effective treatments to prevent CPD
in the aortic wall. The role of sodium phosphate cotransporters in ectopic calcification is contradictory and not well defined,
but their important role in the control of intracellular Pi levels and the synthesis of ATP make them an important
target to study.
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