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Niessink T, Stassen RHMJ, Kischkel B, Vuscan P, Emans PJ, van den Akker GGH, Janssen M, Joosten LAB, Otto C, Welting TJM, Jansen TL. Discovery of calcite as a new pro-inflammatory calcium-containing crystal in human osteoarthritic synovial fluid. Osteoarthritis Cartilage 2024:S1063-4584(24)01203-2. [PMID: 38806070 DOI: 10.1016/j.joca.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE We aimed to characterize calcium-containing crystals present in synovial fluid from patients with knee osteoarthritis (OA) using Raman spectroscopy, and specifically investigate the biological effects of calcite crystals. DESIGN Thirty-two synovial fluid samples were collected pre-operatively from knee OA patients undergoing total joint arthroplasty. An integrated Raman polarized light microscope was used for identification of crystals in synovial fluid. Human peripheral blood mononuclear cells (PBMC's), human OA articular chondrocytes (HACs) and fibroblast-like synoviocytes (FLSs) were exposed to calcite crystals. Expression of relevant cytokines and inflammatory genes were measured using ELISA and real-time PCR. RESULTS Various calcium-containing crystals were identified, including calcium pyrophosphate (37.5 %) and basic calcium phosphate (21.8 %), but they were never found simultaneously in the same OA synovial fluid sample. For the first time, we discovered the presence of calcite crystals in 93.8 % of the samples, while dolomite was detected in 25 % of the cases. Characterization of the cellular response to calcite crystal exposure revealed increased production of innate immune-derived cytokines by PBMC's, when co-stimulated with lipopolysaccharide (LPS). Additionally, calcite crystal stimulation of HACs and FLSs resulted in enhanced secretion of pro-inflammatory molecules and alterations in the expression of extracellular matrix remodeling enzymes. CONCLUSIONS This study highlights the unique role of Raman spectroscopy in OA crystal research and identified calcite as a novel pro-inflammatory crystal type in OA synovial fluid. Understanding the role of specific crystal species in the OA joint may open new avenues for pharmacological interventions and personalized approaches to treating OA.
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Affiliation(s)
- Tom Niessink
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, the Netherlands; Personalized Therapeutics and Diagnostics, Department of Bioengineering Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands.
| | - Roderick H M J Stassen
- Department of Experimental Orthopaedics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Brenda Kischkel
- Department of Internal Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, the Netherlands
| | - Patricia Vuscan
- Department of Internal Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, the Netherlands
| | - Peter J Emans
- Department of Experimental Orthopaedics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Guus G H van den Akker
- Department of Experimental Orthopaedics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, the Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, the Netherlands; Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Pasteur, Nr. 6, 400012 Cluj-Napoca, Romania
| | - Cees Otto
- Personalized Therapeutics and Diagnostics, Department of Bioengineering Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
| | - Tim J M Welting
- Department of Experimental Orthopaedics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, the Netherlands
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Stevanovic Sancar B, Günen Yılmaz S. A retrospective study of the prevalence of calcium deposits around the dens axis via cone beam computed tomography. Cranio 2024:1-5. [PMID: 38785099 DOI: 10.1080/08869634.2024.2355856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between the presence of calcium deposits (CDs) around the dens axis and patients' age, gender, and systemic diseases. METHODS This retrospective study was carried out by examining CBCT. Basic descriptive statistical analyses and normality tests were performed on all variables. The assumption of normality was checked using the Shapiro-Wilk method. The statistical significance level was accepted as a p-value less than 0.05. RESULTS CDs were observed in a total of 99 (21.9%) individuals. The incidence of CDs statistically significantly increased with age (p < .01),while it didn't statistically significantly differ between genders (p = .47). 13% were systemically healthy, while 55% had hypertension. The incidence of CDs was statistically significantly higher in individuals with hypertension. CONCLUSIONS In the presence of CDs, the patient should be referred to a medical doctor to confirm the diagnosis of CDS and prevent possible complications.
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Affiliation(s)
- Bilay Stevanovic Sancar
- Faculty of Dentistry; Department of Oral and Maxillofacial Radiology, Akdeniz University, Antalya, Turkey
| | - Sevcihan Günen Yılmaz
- Faculty of Dentistry; Department of Oral and Maxillofacial Radiology, Akdeniz University, Antalya, Turkey
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Stücker S, Koßlowski F, Buchholz A, Lohmann CH, Bertrand J. High frequency of BCP, but less CPP crystal-mediated calcification in cartilage and synovial membrane of osteoarthritis patients. Osteoarthritis Cartilage 2024:S1063-4584(24)01176-2. [PMID: 38735362 DOI: 10.1016/j.joca.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Ectopic articular calcification is a common phenomenon of osteoarthritic joints, and closely related to disease progression. Identification of the involved calcium crystal types represents an important topic in research and clinical practice. Difficulties in accurate detection and crystal type identification have led to inconsistent data on the prevalence and spatial distribution of Basic calcium phosphate (BCP) and calcium pyrophosphate (CPP) deposition. METHOD Combining multiple imaging methods including conventional radiography, histology and Raman spectroscopy, this study provides a comprehensive analysis of BCP and CPP-based calcification, its frequency and distribution in cartilage and synovial membrane samples of 92 osteoarthritis patients undergoing knee replacement surgery. RESULTS Conventional radiography showed calcifications in 35% of patients. Von Kossa staining detected calcified deposits in 88% and 57% of cartilage and synovial samples, respectively. BCP crystals presented as brittle deposits on top of the cartilage surface or embedded in synovial tissue. CPP deposits appeared as larger granular needle-shaped clusters or dense circular pockets below the cartilage surface or within synovial tissue. Spectroscopic analysis detected BCP crystals in 75% of cartilage and 43% of synovial samples. CPP deposition was only detected in 18% of cartilage and 15% of synovial samples, often coinciding with BCP deposits. CONCLUSION BCP is the predominant crystal type in calcified cartilage and synovium while CPP deposition is rare, often coinciding with BCP. Distinct and qualitative information on BCP and CPP deposits in joint tissues gives rise to the speculation that different disease entities are involved that might need different treatment strategies.
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Affiliation(s)
- Sina Stücker
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Franziska Koßlowski
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Adrian Buchholz
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany.
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Feng C, Lu BQ, Fan Y, Ni H, Zhao Y, Tan S, Zhou Z, Liu L, Hachtel JA, Kepaptsoglou D, Wu B, Gebauer D, He S, Chen F. Amorphous 1-D nanowires of calcium phosphate/pyrophosphate: A demonstration of oriented self-growth of amorphous minerals. J Colloid Interface Sci 2024; 657:960-970. [PMID: 38096779 DOI: 10.1016/j.jcis.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/02/2024]
Abstract
Amorphous inorganic solids are traditionally isotropic, thus, it is believed that they only grow in a non-preferential way without the assistance of regulators, leading to the morphologies of nanospheres or irregular aggregates of nanoparticles. However, in the presence of (ortho)phosphate (Pi) and pyrophosphate ions (PPi) which have synergistic roles in biomineralization, the highly elongated amorphous nanowires (denoted ACPPNs) form in a regulator-free aqueous solution (without templates, additives, organics, etc). Based on thorough characterization and tracking of the formation process (e.g., Cryo-TEM, spherical aberration correction high resolution TEM, solid state NMR, high energy resolution monochromated STEM-EELS), the microstructure and its preferential growth behavior are elucidated. In ACPPNs, amorphous calcium orthophosphate and amorphous calcium pyrophosphate are distributed at separated but close sites. The ACPPNs grow via either the preferential attachment of ∼2 nm nanoclusters in a 1-dimension way, or the transformation of bigger nanoparticles, indicating an inherent driving force-governed process. We propose that the anisotropy of ACPPNs microstructure, which is corroborated experimentally, causes their oriented growth. This study proves that, unlike the conventional view, amorphous minerals can form via oriented growth without external regulation, demonstrating a novel insight into the structures and growth behaviors of amorphous minerals.
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Affiliation(s)
- Chaobo Feng
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Bing-Qiang Lu
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China.
| | - Yunshan Fan
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Haijian Ni
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Yunfei Zhao
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Shuo Tan
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Zhi Zhou
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Lijia Liu
- Department of Chemistry, University of Western Ontario, London, ON N6A5B7, Canada
| | - Jordan A Hachtel
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, United States
| | - Demie Kepaptsoglou
- SuperSTEM Laboratory, SciTech Daresbury Campus, Daresbury WA4 4AD, UK; Department of Physics, University of York, York YO10 5DD, UK
| | - Baohu Wu
- Forschungszentrum Jülich GmbH, JCNS-4, JCNS at MLZ, Lichtenbergstr. 1, 85748 Garching, Germany
| | - Denis Gebauer
- Institute of Inorganic Chemistry, Leibniz University Hannover, Callinstr. 9, D-30167 Hanover, Germany
| | - Shisheng He
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China.
| | - Feng Chen
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, 200001 PR China.
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Bernabei I, Faure E, Romani M, Wegrzyn J, Brinckmann J, Chobaz V, So A, Hugle T, Busso N, Nasi S. Inhibiting Lysyl Oxidases prevents pathologic cartilage calcification. Biomed Pharmacother 2024; 171:116075. [PMID: 38183742 DOI: 10.1016/j.biopha.2023.116075] [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: 10/13/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024] Open
Abstract
Lysyl oxidases (LOX(L)) are enzymes that catalyze the formation of cross-links in collagen and elastin fibers during physiologic calcification of bone. However, it remains unknown whether they may promote pathologic calcification of articular cartilage, an important hallmark of debilitating arthropathies. Here, we have studied the possible roles of LOX(L) in cartilage calcification, related and not related to their cross-linking activity. We first demonstrated that inhibition of LOX(L) by β-aminoproprionitrile (BAPN) significantly reduced calcification in murine and human chondrocytes, and in joint of meniscectomized mice. These BAPN's effects on calcification were accounted for by different LOX(L) roles. Firstly, reduced LOX(L)-mediated extracellular matrix cross-links downregulated Anx5, Pit1 and Pit2 calcification genes. Secondly, BAPN reduced collagen fibrotic markers Col1 and Col3. Additionally, LOX(L) inhibition blocked chondrocytes hypertrophic differentiation (Runx2 and COL10), pro-inflammatory IL-6 release and reactive oxygen species (ROS) production, all triggers of chondrocyte calcification. Through unbiased transcriptomic analysis we confirmed a positive correlation between LOX(L) genes and genes for calcification, hypertrophy and extracellular matrix catabolism. This association was conserved throughout species (mouse, human) and tissues that can undergo pathologic calcification (kidney, arteries, skin). Overall, LOX(L) play a critical role in the process of chondrocyte calcification and may be therapeutic targets to treat cartilage calcification in arthropathies.
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Affiliation(s)
- Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Elodie Faure
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Mario Romani
- Aging and Bone Metabolism Laboratory, Service of Geriatric Medicine & Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Julien Wegrzyn
- Department of Orthopedic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jürgen Brinckmann
- Department of Dermatology and Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Véronique Chobaz
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Thomas Hugle
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland.
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Venegas FC, Sánchez-Rodríguez R, Luisetto R, Angioni R, Viola A, Canton M. Oxidative Stress by the Mitochondrial Monoamine Oxidase B Mediates Calcium Pyrophosphate Crystal-Induced Arthritis. Arthritis Rheumatol 2024; 76:279-284. [PMID: 37695218 DOI: 10.1002/art.42697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/22/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Calcium pyrophosphate (CPP) crystal deposition in the joints is associated with a heterogeneous set of debilitating syndromes characterized by inflammation and pain, for which no effective therapies are currently available. Because we found that the mitochondrial enzyme monoamine oxidase B (MAO-B) plays a fundamental role in promoting inflammatory pathways, this study aims at assessing the efficacy of two clinical-grade inhibitors (iMAO-Bs) in preclinical models of this disease to pave the way for a novel treatment. METHODS We tested our hypothesis in two murine models of CPP-induced arthritis, by measuring cytokine and chemokine levels, along with immune cell recruitment. iMAO-Bs (rasagiline and safinamide) were administered either before or after crystal injection. To elucidate the molecular mechanism, we challenged in vitro primed macrophages with CPP crystals and assessed the impact of iMAO-Bs in dampening proinflammatory cytokines and in preserving mitochondrial function. RESULTS Both in preventive and therapeutic in vivo protocols, iMAO-Bs blunted the release of proinflammatory cytokines (interleukin [IL]-6 and IL1-β) and chemokines (CXCL10, CXCL1, CCL2 and CCL5) (n > 6 mice/group). Importantly, they also significantly reduced ankle swelling (50.3% vs 17.1%; P < 0.001 and 23.1%; P = 0.005 for rasagiline and safinamide, respectively). Mechanistically, iMAO-Bs dampened the burst of reactive oxygen species and the mitochondrial dysfunction triggered by CPP crystals in isolated macrophages. Moreover, iMAO-Bs blunted cytokine secretion and NLRP3 inflammasome activation through inhibition of the NF-κB and STAT3 pathways. CONCLUSION iMAO-Bs dampen inflammation in murine models of crystal-induced arthropathy, thereby uncovering MAO-B as a promising target to treat these diseases.
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Affiliation(s)
- Francisca C Venegas
- University of Padua and Fondazione Istituto di Ricerca Pediatrica Città della Speranza (IRP), Padua, Italy
| | - Ricardo Sánchez-Rodríguez
- University of Padua and Fondazione Istituto di Ricerca Pediatrica Città della Speranza (IRP), Padua, Italy
| | | | - Roberta Angioni
- University of Padua and Fondazione Istituto di Ricerca Pediatrica Città della Speranza (IRP), Padua, Italy
| | | | - Marcella Canton
- University of Padua and Fondazione Istituto di Ricerca Pediatrica Città della Speranza (IRP), Padua, Italy
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7
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Damart J, Filippou G, Andrès M, Cipolletta E, Sirotti S, Carboni D, Filippucci E, Diez P, Abhishek A, Latourte A, Ea HK, Ottaviani S, Letarouilly JG, Desbarbieux R, Graf S, Norberciak L, Richette P, Pascart T. Retention, safety and efficacy of off-label conventional treatments and biologics for chronic calcium pyrophosphate crystal inflammatory arthritis. Rheumatology (Oxford) 2024; 63:446-455. [PMID: 37216917 DOI: 10.1093/rheumatology/kead228] [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: 02/15/2023] [Revised: 03/16/2023] [Accepted: 03/29/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVES Very little is known on the efficacy and safety of drugs for the management of chronic calcium pyrophosphate (CPP) crystal inflammatory arthritis. The objectives of this work were to describe the drugs used in the management of chronic CPP crystal inflammatory arthritis in expert European centres, and to examine treatment retention. METHODS This was a retrospective cohort study. Charts from patients with a diagnosis of persistent inflammatory and/or recurrent acute CPP crystal arthritis were reviewed in seven European centres. Baseline characteristics were collected, and visits at months 3, 6, 12 and 24 included an assessment of treatment response and safety. RESULTS One hundred and ninety-four treatments were initiated in 129 patients. Colchicine (used first-line in n = 73/86), methotrexate (used first-line in n = 14/36), anakinra (n = 27) and tocilizumab (n = 25) were the most prescribed treatments, while long-term corticosteroids, hydroxychloroquine, canakinumab and sarilumab were used occasionally. The 24-month on-drug retention was higher for tocilizumab (40%) than anakinra (18.5%) (P < 0.05), while the difference between colchicine (29.1%) and methotrexate (44.4%) was not statistically significant (P = 0.10). Adverse events led to 14.1% of colchicine discontinuations (100% of diarrhoea), 4.3% for methotrexate, 31.8% for anakinra and 20% for tocilizumab; all other discontinuations were related to insufficient response or losses to follow-up. Efficacy outcomes did not differ significantly between treatments throughout follow-up. CONCLUSION Daily colchicine is the first-line therapy used in chronic CPP crystal inflammatory arthritis, which is considered efficient in a third to half of cases. Second-line treatments include methotrexate and tocilizumab, which have higher retention than anakinra.
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Affiliation(s)
- Julien Damart
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lille, France
| | - Georgios Filippou
- Department of Rheumatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Mariano Andrès
- Department of Rheumatology, Dr Balmis General University Hospital-ISABIAL, Miguel Hernandez University, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Silvia Sirotti
- Department of Rheumatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Davide Carboni
- Department of Rheumatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Pilar Diez
- Department of Rheumatology, Dr Balmis General University Hospital-ISABIAL, Miguel Hernandez University, Alicante, Spain
| | | | - Augustin Latourte
- Hôpital Lariboisière, APHP-Nord, Service de Rhumatologie, 2 rue Ambroise Paré, Paris, France; Bioscar UMR Inserm 1132 and Université de Paris Cité, Paris, France
| | - Hang-Korng Ea
- Hôpital Lariboisière, APHP-Nord, Service de Rhumatologie, 2 rue Ambroise Paré, Paris, France; Bioscar UMR Inserm 1132 and Université de Paris Cité, Paris, France
| | - Sébastien Ottaviani
- Department of Rheumatology, Hôpital Bichat APHP Paris Nord and Université de Paris, Paris, France
| | - Jean-Guillaume Letarouilly
- Université de Lille, Centre Hospitalier Universitaire Lille, MABLab ULR 4490, Service de Rhumatologie, Lille, France
| | - Renaud Desbarbieux
- Department of Rheumatology, Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France
| | - Sahara Graf
- Department of Biostatistics and Methodology, Saint-Philibert Hospital, Lille Catholic University, Lille, France
| | - Laurène Norberciak
- Department of Biostatistics and Methodology, Saint-Philibert Hospital, Lille Catholic University, Lille, France
| | - Pascal Richette
- Hôpital Lariboisière, APHP-Nord, Service de Rhumatologie, 2 rue Ambroise Paré, Paris, France; Bioscar UMR Inserm 1132 and Université de Paris Cité, Paris, France
| | - Tristan Pascart
- Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, Lille, France
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Tamborrini G, Hügle T, Ricci V, Filippou G. Ultrasound imaging in crystal arthropathies: a pictorial review. Reumatismo 2023; 75. [PMID: 38115778 DOI: 10.4081/reumatismo.2023.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/08/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE The prevalence of crystal arthropathies in the general population is rising. The purpose of this pictorial study is to describe the sonographic elements of the most prevalent crystal arthropathies by emphasizing particular sonographic findings using illustrative images and cases while considering technical details and common pitfalls. METHODS Using established recommendations, specialists in the fields of sonography and crystal arthropathies agreed by consensus on the unique ultrasound signs associated with each of the conditions. RESULTS Gout, calcium pyrophosphate deposition arthropathy, and hydroxyapatite arthropathy are the three most prevalent crystal arthropathies. Today's high-resolution sonography enables reliable evaluation of the underlying crystal deposits, post-inflammatory changes, and a precise description of joint inflammation. CONCLUSIONS High-prevalence crystal arthropathies are reliably detectable by ultrasound with current ultrasound equipment. It is necessary to have extensive ultrasound training, know specific sonographic findings, and understand all possible differential diagnoses for disorders affecting the musculoskeletal system.
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Affiliation(s)
- G Tamborrini
- Swiss Ultrasound Center, Institute of Rheumatology, Basel; Clinic for Rheumatology, University Hospital of Basel.
| | - T Hügle
- Rheumatology, Vaud University Hospital, Lausanne.
| | - V Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan.
| | - G Filippou
- Department of Rheumatology, Galeazzi - Sant'Ambrogio IRCCS Hospital, Milan.
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Miyashima Y, Uemura T, Hama S, Konishi S, Nakamura H. Bilateral locking or triggering fingers due to intratendinous calcium pyrophosphate dihydrate crystal deposition: A case report. J Orthop Sci 2023; 28:1456-1460. [PMID: 34175179 DOI: 10.1016/j.jos.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/26/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Yusuke Miyashima
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan; Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Uemura
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan; Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Shunpei Hama
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Sadahiko Konishi
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Jarraya M, Roemer F, Kwoh CK, Guermazi A. Crystal arthropathies and osteoarthritis-where is the link? Skeletal Radiol 2023; 52:2037-2043. [PMID: 36538066 DOI: 10.1007/s00256-022-04246-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
Osteoarthritis (OA) is one of the leading causes of disability worldwide. As our understanding of OA progressively has moved from a purely mechanical "wear and tear" concept toward a complex multi-tissue condition in which inflammation plays a central role, the possible role of crystal-induced inflammation in OA incidence and progression may be relevant. In addition to gout, which affects 4% of the US population, basic calcium phosphate and calcium pyrophosphate deposition both may induce joint inflammation and may play a role in pain in OA. This narrative review article discusses the possible mechanisms underlying the associations between crystal-induced arthropathies and OA, and the important implications of these for clinical practice and future research.
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Affiliation(s)
- Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, YAW 6044, Boston, MA, 02114, USA.
| | - Frank Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - C Kent Kwoh
- Division of Rheumatology, The University of Arizona, Tucson, AZ, USA
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, VA Boston Healthcare System, West Roxbury, MA, USA
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11
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Pascart T, Robinet P, Ottaviani S, Leroy R, Segaud N, Pacaud A, Grandjean A, Luraschi H, Rabin T, Deplanque X, Maciejasz P, Visade F, Mackowiak A, Baclet N, Maréchaux S, Lefebvre A, Budzik JF, Bardin T, Richette P, Norberciak L, Ducoulombier V, Houvenagel E. Evaluating the safety and short-term equivalence of colchicine versus prednisone in older patients with acute calcium pyrophosphate crystal arthritis (COLCHICORT): an open-label, multicentre, randomised trial. THE LANCET. RHEUMATOLOGY 2023; 5:e523-e531. [PMID: 38251496 DOI: 10.1016/s2665-9913(23)00165-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Acute calcium pyrophosphate crystal arthritis causes intense joint pain mainly affecting older people. Because guidance and evidence remain scarce, management of this disease relies on expert opinion. We therefore aimed to compare the safety and short-term equivalence of low-dose colchicine with oral prednisone in older patients with acute calcium pyrophosphate crystal arthritis. METHODS We did an open-label, multicentre, randomised, trial (COLCHICORT) at six hospitals in Paris and northern France. We enrolled patients who were admitted to hospital who were 65 years or older and who presented with acute calcium pyrophosphate crystal arthritis with a symptom duration of less than 36 h. Diagnosis of calcium pyrophosphate crystal arthritis was made by the identification of calcium pyrophosphate crystals on synovial fluid analysis or typical clinical presentation (onset of joint pain and swelling). Key exclusion criteria included absence of calcium pyrophosphate crystals on synovial fluid analysis or a history of gout. Participants were randomly allocated (1:1), using a centralised electronic treatment group allocation module, to receive either colchicine 1·5 mg on day 1 and 1 mg on day 2 (ie, the colchicine group) or oral prednisone 30 mg on days 1 and 2 (ie, the prednisone group). The primary outcome was change in joint pain (measured by visual analogue scale [VAS] from 0 mm to 100 mm) at 24 h. Equivalence was determined whether the 95% CI of the between-group difference at 24 h was within the -13 mm to +13 mm margin in the per-protocol analysis. Adverse events were recorded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). This trial is completed and is registered with ClinicalTrials.gov, NCT03128905. FINDINGS Between Feb 5, 2018, and May 7, 2022, 111 patients who were admitted to hospital were randomly assigned (57 [51%] to the colchicine group and 54 [49%] to the prednisone group). 95 (86%) of 111 patients were included in the per-protocol analysis (49 [52%] in the colchicine group and 46 [48%] in the prednisone group). The median age was 88·0 years (IQR 82·0-91·0) and 69 (73%) of 95 participants were women and 26 (27%) were men. Acute calcium pyrophosphate crystal arthritis affected mainly the knee in 46 (48%) of 95 participants, the wrist in 19 (20%), and the ankle in 12 (13%). Pain VAS at baseline was 68 mm (SD 17). At 24 h, change in pain VAS was -36 mm (SD 32) in the colchicine group and -38 mm (SD 23) in the prednisone group. The between-group difference in change in pain VAS at 24 h was -1 mm (95% CI -12 to 10), showing equivalence between the two drugs. In the colchicine group, 12 (22%) of 55 patients had diarrhoea, one (2%) had hypertension, and none had hyperglycaemia. In the prednisone group, three (6%) of 54 had diarrhoea, six (11%) had hypertension, and three (6%) had hyperglycaemia. No deaths occurred in the colchicine group; two deaths occurred in the prednisone group, which were deemed unrelated to prednisone (one due to infectious valvular endocarditis leading to heart failure, and one due to a stroke). INTERPRETATION Colchicine and prednisone exhibit equivalent short-term efficacy for the treatment of acute calcium pyrophosphate crystal arthritis, with different safety profiles in the older population. FUNDING French Inter-regional Hospital Program of Clinical Research.
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Affiliation(s)
- Tristan Pascart
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France.
| | - Pierre Robinet
- Department of Geriatrics, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | | | - Rémi Leroy
- Department of Rheumatology, Centre Hospitalier de Dunkerque, Dunkirk, France
| | - Nicolas Segaud
- Department of Internal Medicine, Centre Hospitalier d'Armentières, Armentières, France
| | - Aurore Pacaud
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Agathe Grandjean
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Hélène Luraschi
- Department of Rheumatology, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Thibault Rabin
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Xavier Deplanque
- Department of Geriatrics, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Pierre Maciejasz
- Department of Geriatrics, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Fabien Visade
- Department of Geriatrics, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Alexandre Mackowiak
- Department of Neurology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Nicolas Baclet
- Department of Internal Medicine, Hôpital Saint-Vincent-de-Paul, Université Catholique de Lille, Lille, France
| | - Sylvestre Maréchaux
- Department of Cardiology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Antoine Lefebvre
- Department of Pharmacy, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Jean-François Budzik
- Department of Radiology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord, INSERM, UMR 1132, Bioscar, Paris, France
| | - Pascal Richette
- Department of Rheumatology, Hôpital Lariboisière APHP Paris Nord, INSERM, UMR 1132, Bioscar, Paris, France
| | - Laurène Norberciak
- Research Department-Biostatistics and Methodology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Vincent Ducoulombier
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
| | - Eric Houvenagel
- Department of Rheumatology, Hôpital Saint-Philibert, Université Catholique de Lille, Lomme, France
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Døssing A, Conaghan PG, K Stamp L, M McCarthy G, Henriksen M, Christensen R, Terslev L, Ellegaard K, Henrik Søe N, Juul L, Hansen P, Radev DI, Nybing JD, Boesen M, Bliddal H. Pain in hand osteoarthritis is associated with crystals in the synovial fluid: a cross-sectional study of people with hand osteoarthritis undergoing surgery. RMD Open 2023; 9:e003319. [PMID: 37620112 PMCID: PMC10450056 DOI: 10.1136/rmdopen-2023-003319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/26/2023] Open
Affiliation(s)
- Anna Døssing
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Lisa K Stamp
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ellegaard
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Søe
- Department of Orthopedic Surgery, Division of Hand Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lars Juul
- Department of Rheumatology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Philip Hansen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Dimitar Ivanov Radev
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Boesen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bliddal
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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13
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Cowley S, McCarthy G. Diagnosis and Treatment of Calcium Pyrophosphate Deposition (CPPD) Disease: A Review. Open Access Rheumatol 2023; 15:33-41. [PMID: 36987530 PMCID: PMC10040153 DOI: 10.2147/oarrr.s389664] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Calcium Pyrophosphate Dihydrate (CPPD) crystal-related arthropathies are a common cause of acute and chronic arthritis caused by the deposition of calcium pyrophosphate crystals in joints and soft tissues, resulting in inflammation and joint damage. They present with a wide spectrum of clinical manifestations and often present challenges to diagnosis and management as they commonly affect older co-morbid patients. The challenges are compounded by a lack of a well-defined description of CPPD. However, an international expert-driven process is underway to develop CPPD classification criteria. Treatment is also problematic as unlike gout, there are no agents available that decrease the crystal burden. Treatment options have often been extrapolated from gout treatment pathways without having extensive trials or a solid evidence base. It is hoped the new CPPD classification guidelines will contribute to large multicentre studies, with well-defined patient cohorts, which will facilitate the production of high-quality evidence to guide the management of this condition. Here, we discuss the barriers and facilitators in diagnosing and treating CPPD-related arthropathy.
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Affiliation(s)
- Sharon Cowley
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Geraldine McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland
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14
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Wang X, Wu Q, Zhang R, Fan Z, Li W, Mao R, Du Z, Yao X, Ma Y, Yan Y, Sun W, Wu H, Wei W, Hu Y, Hong Y, Hu H, Koh YW, Duan W, Chen X, Ouyang H. Stage-specific and location-specific cartilage calcification in osteoarthritis development. Ann Rheum Dis 2023; 82:393-402. [PMID: 36261249 DOI: 10.1136/ard-2022-222944] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/30/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study investigated the stage-specific and location-specific deposition and characteristics of minerals in human osteoarthritis (OA) cartilages via multiple nano-analytical technologies. METHODS Normal and OA cartilages were serially sectioned for micro-CT, scanning electron microscopy with energy dispersive X-ray spectroscopy, micro-Raman spectroscopy, focused ion beam scanning electron microscopy, high-resolution electron energy loss spectrometry with transmission electron microscopy, nanoindentation and atomic force microscopy to analyse the structural, compositional and mechanical properties of cartilage in OA progression. RESULTS We found that OA progressed by both top-down calcification at the joint surface and bottom-up calcification at the osteochondral interface. The top-down calcification process started with spherical mineral particle formation in the joint surface during early-stage OA (OA-E), followed by fibre formation and densely packed material transformation deep into the cartilage during advanced-stage OA (OA-A). The bottom-up calcification in OA-E started when an excessive layer of calcified tissue formed above the original calcified cartilage, exhibiting a calcified sandwich structure. Over time, the original and upper layers of calcified cartilage fused, which thickened the calcified cartilage region and disrupted the cartilage structure. During OA-E, the calcified cartilage was hypermineralised, containing stiffer carbonated hydroxyapatite (HAp). During OA-A, it was hypomineralised and contained softer HAp. This discrepancy may be attributed to matrix vesicle nucleation during OA-E and carbonate cores during OA-A. CONCLUSIONS This work refines our current understanding of the mechanism underlying OA progression and provides the foothold for potential therapeutic targeting strategies once the location-specific cartilage calcification features in OA are established.
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Affiliation(s)
- Xiaozhao Wang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Qin Wu
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ru Zhang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Zhang Fan
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenyue Li
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Renwei Mao
- ZJU-UIUC Institute, International Campus, Zhejiang University, Haining, Zhejiang, China
| | - Zihao Du
- ZJU-UIUC Institute, International Campus, Zhejiang University, Haining, Zhejiang, China
| | - Xudong Yao
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Yuanzhu Ma
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Yiyang Yan
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Wei Sun
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Hongwei Wu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Wei Wei
- International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Yejun Hu
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Yi Hong
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Huan Hu
- ZJU-UIUC Institute, International Campus, Zhejiang University, Haining, Zhejiang, China
| | - Yi Wen Koh
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wangping Duan
- Department of Orthopedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiao Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
| | - Hongwei Ouyang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, and Department of Orthopedic Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China .,Department of Sports Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, and Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,China Orthopedic Regenerative Medicine Group, CORMed, Hangzhou, Zhejiang, China
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15
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Bernabei I, So A, Busso N, Nasi S. Cartilage calcification in osteoarthritis: mechanisms and clinical relevance. Nat Rev Rheumatol 2023; 19:10-27. [PMID: 36509917 DOI: 10.1038/s41584-022-00875-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
Pathological calcification of cartilage is a hallmark of osteoarthritis (OA). Calcification can be observed both at the cartilage surface and in its deeper layers. The formation of calcium-containing crystals, typically basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPP) crystals, is an active, highly regulated and complex biological process that is initiated by chondrocytes and modified by genetic factors, dysregulated mitophagy or apoptosis, inflammation and the activation of specific cellular-signalling pathways. The links between OA and BCP deposition are stronger than those observed between OA and CPP deposition. Here, we review the molecular processes involved in cartilage calcification in OA and summarize the effects of calcium crystals on chondrocytes, synovial fibroblasts, macrophages and bone cells. Finally, we highlight therapeutic pathways leading to decreased joint calcification and potential new drugs that could treat not only OA but also other diseases associated with pathological calcification.
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Affiliation(s)
- Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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16
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Eliseev MS, Cheremushkina EV, Nasonov EL. The use of Anakinra in treatment of calcium pyrophosphate crystal deposition disease: Analysis of own experience and a literature review. RHEUMATOLOGY SCIENCE AND PRACTICE 2022. [DOI: 10.47360/1995-4484-2022-570-577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Calcium pyrophosphate crystal deposition disease (CPPD) is a disease caused by the deposition of calcium pyrophosphate crystals, mainly in the articular cartilage, and often manifests as severe acute or chronic arthritis. Therapy given in such cases with non-steroidal anti-inflammatory drugs, colchicine, methotrexate and glucocorticoids is often effective. In these cases, the possibility of prescribing biological drugs, primarily interleukin 1 (IL-1) inhibitors, is being considered. The article analyzes the experience of using Anakinra, an IL-1 receptor antagonist, registered in the Russian Federation in 2021, in 5 patients with persistent arthritis in CPPD. The article also presents an analysis of data from key studies on the use of the drug in patients with CPPD.
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Affiliation(s)
| | | | - E. L. Nasonov
- V.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)
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17
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Development of a cyclic-inverso AHSG/Fetuin A-based peptide for inhibition of calcification in osteoarthritis. Osteoarthritis Cartilage 2022; 31:727-740. [PMID: 36414226 DOI: 10.1016/j.joca.2022.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Ectopic calcification is an important contributor to chronic diseases, such as osteoarthritis. Currently, no effective therapies exist to counteract calcification. We developed peptides derived from the calcium binding domain of human Alpha-2-HS-Glycoprotein (AHSG/Fetuin A) to counteract calcification. METHODS A library of seven 30 amino acid (AA) long peptides, spanning the 118 AA Cystatin 1 domain of AHSG, were synthesized and evaluated in an in vitro calcium phosphate precipitation assay. The best performing peptide was modified (cyclic, retro-inverso and combinations thereof) and evaluated in cellular calcification models and the rat Medial Collateral Ligament Transection + Medial Meniscal Tear (MCLT + MMT) osteoarthritis model. RESULTS A cyclic peptide spanning AA 1-30 of mature AHSG showed clear inhibition of calcium phosphate precipitation in the nM-pM range that far exceeded the biological activity of the linear peptide variant or bovine Fetuin. Biochemical and electron microscopy analyses of calcium phosphate particles revealed a similar, but distinct, mode of action in comparison with bFetuin. A cyclic-inverso variant of the AHSG 1-30 peptide inhibited calcification of human articular chondrocytes, vascular smooth muscle cells and during osteogenic differentiation of bone marrow derived stromal cells. Lastly, we evaluated the effect of intra-articular injection of the cyclic-inverso AHSG 1-30 peptide in a rat osteoarthritis model. A significant improvement was found in histopathological osteoarthritis score and animal mobility. Serum levels of IFNγ were found to be lower in AHSG 1-30 peptide treated animals. CONCLUSIONS The cyclic-inverso AHSG 1-30 peptide directly inhibits the calcification process and holds the potential for future application in osteoarthritis.
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18
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Scanu A, Luisetto R, Oliviero F, Galuppini F, Lazzarin V, Pennelli G, Masiero S, Punzi L. Bactericidal/Permeability-Increasing Protein Downregulates the Inflammatory Response in In Vivo Models of Arthritis. Int J Mol Sci 2022; 23:ijms232113066. [PMID: 36361854 PMCID: PMC9656099 DOI: 10.3390/ijms232113066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
We investigated the effects of bactericidal/permeability-increasing protein (BPI) alone or in combination with hyaluronic acid (HA) in two animal models: collagen-induced arthritis (CIA) and crystal-induced inflammation. In CIA, mice were intraperitoneally injected with PBS, HA, or BPI plus or minus HA, twice a week for 2 months, and then euthanized to collect paw and blood. Arthritis was assessed in ankle joints by clinical and histological evaluation. Pathogenic crystals were intraperitoneally injected in mice plus or minus BPI, or with a composition of BPI and HA. After sacrifice, total and differential leukocyte counts were determined. Cytokine levels were measured in serum and peritoneal fluids. In CIA mice, BPI improved clinical and histological outcomes (histological scores ≥2-fold), and downregulated inflammatory mediators (47–93%). In crystal-induced inflammation, BPI reduced leukocyte infiltration (total count: ≥60%; polymorphonuclear cells: ≥36%) and inhibited cytokine production (35–74%). In both models, when mice were co-treated with BPI and HA, the improvement of all parameters was greater than that observed after administration of the two substances alone. Results show that BPI attenuates CIA and inflammation in mice, and this effect is enhanced by HA co-administration. Combined use of BPI and HA represents an interesting perspective for new potential treatments in arthritis.
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Affiliation(s)
- Anna Scanu
- Rehabilitation Unit, Department of Neuroscience—DNS, University of Padova, 35128 Padova, Italy
- Correspondence:
| | - Roberto Luisetto
- Department of Surgery, Oncology and Gastroenterology—DISCOG, University of Padova, 35128 Padova, Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Francesca Galuppini
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Vanni Lazzarin
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Gianmaria Pennelli
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy
| | - Stefano Masiero
- Rehabilitation Unit, Department of Neuroscience—DNS, University of Padova, 35128 Padova, Italy
| | - Leonardo Punzi
- Centre for Gout and Metabolic Bone and Joint Diseases, Rheumatology, SS Giovanni and Paolo Hospital, 30122 Venice, Italy
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Abstract
Osteoarthritis (OA) affects more than 240 million people worldwide. In 2016, the Osteoarthritis Research Society International submitted a report to the United States Food and Drug Administration highlighting OA as a 'serious' disease, and appealed for the urgent development and review of new therapies to address a significant unmet need. Despite this, international guidelines for the treatment of OA have been largely unchanged for over a decade. There is now an updated understanding that OA is more than simply a non-inflammatory 'wear-and-tear' process involving articular cartilage. Based on this, potential emerging therapies are being developed that target novel inflammatory, pain, and regeneration pathways. Drugs targeting the latter are being lauded as 'Disease-Modifying Osteoarthritis Drugs' - a concept which has so far proved elusive in OA research. While this review does not recommend a change in current practice, it should prompt readers to rethink the OA treatment paradigm. The global pandemic has added another layer of consideration when managing patients with OA. At a time when there is more strain on hospital systems, there is a need to expand our pharmacological armamentarium in order to manage OA without elective surgery and hospital admission.
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Affiliation(s)
- Julia Sewell
- Rheumatology Department, Monash Health, Melbourne, Australia
| | - Andrew Östör
- Melbourne Rheumatology Group, Cabrini Health, Melbourne, Australia
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20
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Nogueira Gomes T, Camelo Pereira M, Pinheiro Alves A, Madeiro M. Crowned Dens Syndrome: A Rare Complication of Calcium Pyrophosphate Crystal Deposition Disease. Cureus 2022; 14:e25593. [PMID: 35785005 PMCID: PMC9249022 DOI: 10.7759/cureus.25593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 11/15/2022] Open
Abstract
Crowned dens syndrome (CDS) is a clinical entity characterized by neck pain associated with fever, headaches, and neck stiffness, along with radiologic evidence of peri-odontoid process calcification in a characteristic “crown” or “halo” distribution. It is likely an underdiagnosed condition and patients can initially be misdiagnosed, leading to costly evaluation and unnecessary treatment interventions. We present the case of a 76-year-old man who presented to the emergency department (ED) with a 3-day history of progressively worsening neck pain that was associated with headaches, malaise, decreased oral intake, chills, and fever. Initial evaluation was significant for the presence of fever, tachycardia, and elevated inflammatory markers. We report a case of CDS attributed to calcium pyrophosphate deposition and review the pertinent literature about the presentation, diagnostic evaluation, and treatment of this rare clinical entity.
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21
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Adamiak P, Inkpen P, Bardi M. Ultrasound guided anterior approach to intra-articular injection of the knee. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:435-440. [PMID: 34939689 DOI: 10.1002/jcu.23110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
In this clinical practice article, we describe a novel, anterior, approach for therapeutic intra-articular injection of the knee under ultrasound guidance. The benefits of this approach are improved accuracy in knees that do not have an effusion, simplified sonoanatomy for learners, and easy localization in patients with enlarged body habitus or altered anatomy. This article describes the positioning, sonographic anatomy, risks, and technical considerations for this anterior approach.
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Affiliation(s)
- Paul Adamiak
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
| | - Peter Inkpen
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
| | - Mohammad Bardi
- Division of Rheumatology, University of British Columbia, Vancouver, Canada
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22
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Chang CC, Lee KL, Chan TS, Chung CC, Liang YC. Histone Deacetylase Inhibitors Downregulate Calcium Pyrophosphate Crystal Formation in Human Articular Chondrocytes. Int J Mol Sci 2022; 23:ijms23052604. [PMID: 35269745 PMCID: PMC8910507 DOI: 10.3390/ijms23052604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
Calcium pyrophosphate (CPP) deposition disease (CPPD) is a form of CPP crystal-induced arthritis. A high concentration of extracellular pyrophosphate (ePPi) in synovial fluid is positively correlated with the formation of CPP crystals, and ePPi can be upregulated by ankylosis human (ANKH) and ectonucleotide pyrophosphatase 1 (ENPP1) and downregulated by tissue non-specific alkaline phosphatase (TNAP). However, there is currently no drug that eliminates CPP crystals. We explored the effects of the histone deacetylase (HDAC) inhibitors (HDACis) trichostatin A (TSA) and vorinostat (SAHA) on CPP formation. Transforming growth factor (TGF)-β1-treated human primary cultured articular chondrocytes (HC-a cells) were used to increase ePPi and CPP formation, which were determined by pyrophosphate assay and CPP crystal staining assay, respectively. Artificial substrates thymidine 5′-monophosphate p-nitrophenyl ester (p-NpTMP) and p-nitrophenyl phosphate (p-NPP) were used to estimate ENPP1 and TNAP activities, respectively. The HDACis TSA and SAHA significantly reduced mRNA and protein expressions of ANKH and ENPP1 but increased TNAP expression in a dose-dependent manner in HC-a cells. Further results demonstrated that TSA and SAHA decreased ENPP1 activity, increased TNAP activity, and limited levels of ePPi and CPP. As expected, both TSA and SAHA significantly increased the acetylation of histones 3 and 4 but failed to block Smad-2 phosphorylation induced by TGF-β1. These results suggest that HDACis prevented the formation of CPP by regulating ANKH, ENPP1, and TNAP expressions and can possibly be developed as a potential drug to treat or prevent CPPD.
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Affiliation(s)
- Chi-Ching Chang
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Kun-Lin Lee
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; (K.-L.L.); (C.-C.C.)
- Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Tze-Sian Chan
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei 11696, Taiwan
| | - Chia-Chen Chung
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; (K.-L.L.); (C.-C.C.)
- Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Chih Liang
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; (K.-L.L.); (C.-C.C.)
- Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
- Ph.D. Program in Drug Discovery and Development Industry, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Correspondence:
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23
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The Evaluation of the Efficacy and Safety of Oral Colchicine in the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trails. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2381828. [PMID: 35132374 PMCID: PMC8817842 DOI: 10.1155/2022/2381828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/20/2021] [Accepted: 01/08/2022] [Indexed: 12/15/2022]
Abstract
Objective. To evaluate the efficacy and safety of oral colchicine in the treatment for knee OA. Design. Meta-analysis. Data Sources. Embase, PubMed (MEDLINE), the Cochrane Library, and Web of Science from inception to December 12, 2021. Study Selection. RCTs comparing colchicine with placebo for knee OA were included. No language or date restrictions were applied. Two authors abstracted data and determined quality. Outcomes of interest included VAS-pain, WOMAC total index, and patient-reported adverse events. Results. A total of five RCTs including 400 adult patients with OA met the inclusion criteria. The mean age of patients included was 56.05 years (range 21 to 79), and 80.87% were female. There was no difference in VAS-pain (MD -1.49; 95% CI -3.15, 0.17;
) when compared colchicine group with placebo group. And there was no statistically difference in WOMAC total index (std. MD -0.13; 95% CI -0.64, 0.38;
) and patient report adverse events (RR 1.23; 95% CI 0.72, 2.11;
). Conclusion. Colchicine is not currently recommended as a treatment for knee OA but might have insignificant effect. The conclusion is limited due to the variation in assessment indicator among available data. Further RCTs with larger sample size and longer follow-up are needed to confirm the findings.
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Svensson S, Palmer M, Svensson J, Johansson A, Engqvist H, Omar O, Thomsen P. Monocytes and pyrophosphate promote mesenchymal stem cell viability and early osteogenic differentiation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:11. [PMID: 35032239 PMCID: PMC8761140 DOI: 10.1007/s10856-021-06639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Pyrophosphate-containing calcium phosphate implants promote osteoinduction and bone regeneration. The role of pyrophosphate for inflammatory cell-mesenchymal stem cell (MSC) cross-talk during osteogenesis is not known. In the present work, the effects of lipopolysaccharide (LPS) and pyrophosphate (PPi) on primary human monocytes and on osteogenic gene expression in human adipose-derived MSCs were evaluated in vitro, using conditioned media transfer as well as direct effect systems. Direct exposure to pyrophosphate increased nonadherent monocyte survival (by 120% without LPS and 235% with LPS) and MSC viability (LDH) (by 16-19% with and without LPS). Conditioned media from LPS-primed monocytes significantly upregulated osteogenic genes (ALP and RUNX2) and downregulated adipogenic (PPAR-γ) and chondrogenic (SOX9) genes in recipient MSCs. Moreover, the inclusion of PPi (250 μM) resulted in a 1.2- to 2-fold significant downregulation of SOX9 in the recipient MSCs, irrespective of LPS stimulation or culture media type. These results indicate that conditioned media from LPS-stimulated inflammatory monocytes potentiates the early MSCs commitment towards the osteogenic lineage and that direct pyrophosphate exposure to MSCs can promote their viability and reduce their chondrogenic gene expression. These results are the first to show that pyrophosphate can act as a survival factor for both human MSCs and primary monocytes and can influence the early MSC gene expression. Graphical abstract.
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Affiliation(s)
- Sara Svensson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Palmer
- Department of Engineering Sciences, Applied Materials Science Section, Uppsala University, Uppsala, Sweden
| | - Johan Svensson
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
| | - Anna Johansson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Håkan Engqvist
- Department of Engineering Sciences, Applied Materials Science Section, Uppsala University, Uppsala, Sweden
| | - Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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25
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Cui S, Su Y, Cai T. Amorphous-mediated crystallization of calcium pyrophosphate tetrahydrate: the role of alkaline earth metal ions. CrystEngComm 2022. [DOI: 10.1039/d2ce00390b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although calcium pyrophosphates are commonly involved in crystal arthropathies, their formation mechanisms remain largely underexplored. Here, we investigated the crystallization pathway of calcium pyrophosphate tetrahydrate in the absence and presence...
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26
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Ghouri A, Quicke JG, Conaghan PG. New developments in osteoarthritis pharmacological therapies. Rheumatology (Oxford) 2021; 60:vi1-vi11. [PMID: 34951922 PMCID: PMC8709565 DOI: 10.1093/rheumatology/keab679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/31/2021] [Indexed: 12/14/2022] Open
Abstract
OA is an increasingly common, painful condition with complex aetiology and limited therapies. Approaches to expanding our therapeutic armamentarium have included repurposing existing therapies used for other rheumatological conditions, modifying existing OA preparations to enhance their benefits, and identifying new therapeutics. HCQ and low-dose MTX have been unsuccessful in improving hand OA pain or reducing structural progression. Anti-IL-6 and anti-GM-CSF also did not improve symptoms in hand OA trials, but IL-1 remains an intriguing target for large-joint OA, based on reduced joint replacements in a post hoc analysis from a large cardiovascular disease trial. The peripheral nociceptive pathway appears an attractive target, with mAbs to nerve growth factor and IA capsaicin demonstrating efficacy; tropomyosin receptor kinase A inhibitors are at an earlier stage of development. Limited evidence suggests pharmacological therapies can modify cartilage and bone structural progression, though evidence of synchronous symptom benefits are lacking.
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Affiliation(s)
- Asim Ghouri
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds and
| | - Jonathan G Quicke
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds and
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27
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Stack J, McCarthy G. Calcium pyrophosphate deposition (CPPD) disease - Treatment options. Best Pract Res Clin Rheumatol 2021; 35:101720. [PMID: 34756508 DOI: 10.1016/j.berh.2021.101720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In contrast to gout, no disease-modifying therapies currently exist that reduce articular crystal deposition of calcium pyrophosphate crystals (CPPs). Treatment is aimed at ameliorating the inflammatory response and reducing the frequency and severity of clinical symptoms due to CPP deposition (CPPD). Despite being one of the most common forms of inflammatory arthritis, CPPD remains under-studied and evidence-based treatment guidelines remain lacking. Commonly used treatments for clinical manifestations of CPPD (non-steroidal anti-inflammatory drugs [NSAIDs], colchicine and corticosteroids [CSs]) are extrapolated from use in gout. Anakinra and tocilizumab can be used in refractory cases. Though no current crystal-targeted treatments exist, studies suggest that nucleoside analogues and phosphocitrate can attenuate calcification of human cartilage ex-vivo. Hindering research, is the lack of a well-defined description of CPPD. However, international working groups have convened to establish classification criteria and validated outcome domains for CPPD. This should help facilitate the setting up of large multicentre studies, with well-defined cohorts, which can evaluate suitable therapies, providing high levels of evidence to guide clinicians. Here, we summarise and discuss the currently available anti-inflammatory treatment options for CPPD and discuss potential future crystal-targeted approaches.
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Affiliation(s)
- John Stack
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland; University College Dublin, Ireland.
| | - Geraldine McCarthy
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland; University College Dublin, Ireland.
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28
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Qin X, Hu X, Wang Q, Zeng J, Chen J. A rare acute neck pain cause that can have misdiagnosis or missed diagnosis-crowned dens syndrome: description of two cases and a literature analysis. Quant Imaging Med Surg 2021; 11:4491-4496. [PMID: 34604002 DOI: 10.21037/qims-20-1347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Xin Qin
- Department of Radiology, Xingyi People's Hospital, Qian Xi'Nan, Gui Zhou, China
| | - Xiaofei Hu
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qingzhen Wang
- Department of Radiology, Xingyi People's Hospital, Qian Xi'Nan, Gui Zhou, China
| | - Jigang Zeng
- Department of Radiology, Xingyi People's Hospital, Qian Xi'Nan, Gui Zhou, China
| | - Jie Chen
- Department of Radiology, Xingyi People's Hospital, Qian Xi'Nan, Gui Zhou, China
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29
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Finkelstein D, Foremny G, Singer A, Clifford P, Pretell-Mazzini J, Kerr DA, Subhawong TK. Differential diagnosis of T2 hypointense masses in musculoskeletal MRI. Skeletal Radiol 2021; 50:1981-1994. [PMID: 33651128 DOI: 10.1007/s00256-021-03711-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 02/02/2023]
Abstract
Many soft tissue masses have an indeterminate appearance on MRI, often displaying varying degrees and extent of T2 hyperintensity. However, a subset of neoplasms and tumor-like lesions may exhibit prominent areas of T2 hypointensity relative to skeletal muscle. The hypointensity observed on T2-weighted MRI can be caused by a variety of substances, including evolving blood products, calcifications or other inorganic crystals, or fibrous tissue. Carefully evaluating the presence and pattern of T2 hypointensity in soft tissue masses and considering potential causes in their associated clinical contexts can help to narrow the differential diagnosis among neoplastic and non-neoplastic possibilities. These include endometriosis, aneurysmal bone cysts, tenosynovial giant cell tumor, arteriovenous malformation and pseudoaneurysm, calcium pyrophosphate and hydroxyapatite deposition diseases, tumoral calcinosis, gout, amyloidosis, hemangiomas with phleboliths, low-grade fibromyxoid sarcoma, ossifying fibromyxoid tumor, collagenous fibroma, desmoid-type fibromatosis, myxofibrosarcoma, peripheral nerve sheath tumors, dedifferentiated liposarcoma, and treated sarcoma.
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Affiliation(s)
- Dara Finkelstein
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave, JMH WW 279, Miami, FL, 33136, USA
| | - Gregory Foremny
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave, JMH WW 279, Miami, FL, 33136, USA
| | - Adam Singer
- Department of Radiology, Emory University Hospital, Atlanta, GA, 30322, USA
| | - Paul Clifford
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave, JMH WW 279, Miami, FL, 33136, USA
| | - Juan Pretell-Mazzini
- Department of Orthopaedics, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, 33136, USA
| | - Darcy A Kerr
- Department of Pathology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Ty K Subhawong
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave, JMH WW 279, Miami, FL, 33136, USA.
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30
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Early JO, Fagan LE, Curtis AM, Kennedy OD. Mitochondria in Injury, Inflammation and Disease of Articular Skeletal Joints. Front Immunol 2021; 12:695257. [PMID: 34539627 PMCID: PMC8448207 DOI: 10.3389/fimmu.2021.695257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Inflammation is an important biological response to tissue damage caused by injury, with a crucial role in initiating and controlling the healing process. However, dysregulation of the process can also be a major contributor to tissue damage. Related to this, although mitochondria are typically thought of in terms of energy production, it has recently become clear that these important organelles also orchestrate the inflammatory response via multiple mechanisms. Dysregulated inflammation is a well-recognised problem in skeletal joint diseases, such as rheumatoid arthritis. Interestingly osteoarthritis (OA), despite traditionally being known as a ‘non-inflammatory arthritis’, now appears to involve an element of chronic inflammation. OA is considered an umbrella term for a family of diseases stemming from a range of aetiologies (age, obesity etc.), but all with a common presentation. One particular OA sub-set called Post-Traumatic OA (PTOA) results from acute mechanical injury to the joint. Whether the initial mechanical tissue damage, or the subsequent inflammatory response drives disease, is currently unclear. In the former case; mechanobiological properties of cells/tissues in the joint are a crucial consideration. Many such cell-types have been shown to be exquisitely sensitive to their mechanical environment, which can alter their mitochondrial and cellular function. For example, in bone and cartilage cells fluid-flow induced shear stresses can modulate cytoskeletal dynamics and gene expression profiles. More recently, immune cells were shown to be highly sensitive to hydrostatic pressure. In each of these cases mitochondria were central to these responses. In terms of acute inflammation, mitochondria may have a pivotal role in linking joint tissue injury with chronic disease. These processes could involve the immune cells recruited to the joint, native/resident joint cells that have been damaged, or both. Taken together, these observations suggest that mitochondria are likely to play an important role in linking acute joint tissue injury, inflammation, and long-term chronic joint degeneration - and that the process involves mechanobiological factors. In this review, we will explore the links between mechanobiology, mitochondrial function, inflammation/tissue-damage in joint injury and disease. We will also explore some emerging mitochondrial therapeutics and their potential for application in PTOA.
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Affiliation(s)
- James Orman Early
- Department of Anatomy and Regenerative Medicine and Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lauren E Fagan
- Department of Anatomy and Regenerative Medicine and Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences and Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Annie M Curtis
- School of Pharmacy and Biomolecular Sciences and Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Oran D Kennedy
- Department of Anatomy and Regenerative Medicine and Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Mechanical and Manufacturing Engineering, Trinity College Dublin, Dublin, Ireland
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31
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The Gasotransmitter Hydrogen Sulfide (H 2S) Prevents Pathologic Calcification (PC) in Cartilage. Antioxidants (Basel) 2021; 10:antiox10091433. [PMID: 34573065 PMCID: PMC8471338 DOI: 10.3390/antiox10091433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/09/2023] Open
Abstract
Pathologic calcification (PC) is a painful and disabling condition whereby calcium-containing crystals deposit in tissues that do not physiologically calcify: cartilage, tendons, muscle, vessels and skin. In cartilage, compression and inflammation triggered by PC leads to cartilage degradation typical of osteoarthritis (OA). The PC process is poorly understood and treatments able to target the underlying mechanisms of the disease are lacking. Here we show a crucial role of the gasotransmitter hydrogen sulfide (H2S) and, in particular, of the H2S-producing enzyme cystathionine γ-lyase (CSE), in regulating PC in cartilage. Cse deficiency (Cse KO mice) exacerbated calcification in both surgically-induced (menisectomy) and spontaneous (aging) murine models of cartilage PC, and augmented PC was closely associated with cartilage degradation (OA). On the contrary, Cse overexpression (Cse tg mice) protected from these features. In vitro, Cse KO chondrocytes showed increased calcification, potentially via enhanced alkaline phosphatase (Alpl) expression and activity and increased IL-6 production. The opposite results were obtained in Cse tg chondrocytes. In cartilage samples from patients with OA, CSE expression inversely correlated with the degree of tissue calcification and disease severity. Increased cartilage degradation in murine and human tissues lacking or expressing low CSE levels may be accounted for by dysregulated catabolism. We found higher levels of matrix-degrading metalloproteases Mmp-3 and -13 in Cse KO chondrocytes, whereas the opposite results were obtained in Cse tg cells. Finally, by high-throughput screening, we identified a novel small molecule CSE positive allosteric modulator (PAM), and demonstrated that it was able to increase cellular H2S production, and decrease murine and human chondrocyte calcification and IL-6 secretion. Together, these data implicate impaired CSE-dependent H2S production by chondrocytes in the etiology of cartilage PC and worsening of secondary outcomes (OA). In this context, enhancing CSE expression and/or activity in chondrocytes could represent a potential strategy to inhibit PC.
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Fontes T, Silvério-António M, Macieira C, Fonseca JE, Polido-Pereira J. An unusual cause of shoulder pain in a young woman with systemic sclerosis: isolated intra-articular calcinosis. Rheumatology (Oxford) 2021; 61:e165-e166. [PMID: 34387302 DOI: 10.1093/rheumatology/keab645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tomás Fontes
- Hospital do Divino Espírito Santo de Ponta Delgada EPE, Rheumatology, Ponta Delgada, Azores, PT.,Centro Hospitalar Universitário Lisboa Norte EPE, Rheumatology, Lisboa, Lisboa, PT
| | - Manuel Silvério-António
- Centro Hospitalar Universitário Lisboa Norte EPE, Rheumatology, Lisboa, Lisboa, PT.,Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Rheumatology Research Unit, Lisboa, Lisboa, PT
| | - Carla Macieira
- Centro Hospitalar Universitário Lisboa Norte EPE, Rheumatology, Lisboa, Lisboa, PT.,Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Rheumatology Research Unit, Lisboa, Lisboa, PT
| | - João Eurico Fonseca
- Centro Hospitalar Universitário Lisboa Norte EPE, Rheumatology, Lisboa, Lisboa, PT.,Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Rheumatology Research Unit, Lisboa, Lisboa, PT
| | - Joaquim Polido-Pereira
- Centro Hospitalar Universitário Lisboa Norte EPE, Rheumatology, Lisboa, Lisboa, PT.,Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Rheumatology Research Unit, Lisboa, Lisboa, PT
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Døssing A, Müller FC, Becce F, Stamp L, Bliddal H, Boesen M. Dual-Energy Computed Tomography for Detection and Characterization of Monosodium Urate, Calcium Pyrophosphate, and Hydroxyapatite: A Phantom Study on Diagnostic Performance. Invest Radiol 2021; 56:417-424. [PMID: 33559986 DOI: 10.1097/rli.0000000000000756] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to determine the diagnostic performance of dual-energy computed tomography (DECT) to detect and distinguish crystal deposits in a phantom. The primary objective was to determine the cutoff DECT ratio and the cross-sectional area (CSA) of a crystal deposit necessary to differentiate monosodium urate (MSU), calcium pyrophosphate (CPP), and calcium hydroxyapatite (HA) using DECT. Our secondary objective was to determine the concentration for limit of detection for MSU, CPP, and HA crystal deposits. Exploratory objectives included the comparison between 2 generations of DECT scanners from the same manufacturer as well as different scanner settings. MATERIALS AND METHODS We used a cylindrical soft tissue phantom with synthetic MSU, CPP, and HA crystals suspended in resin. Crystal suspension concentration increased with similar attenuation between MSU, CPP, and HA in conventional CT. The phantom was scanned on 2 dual-source DECT scanners, at 2 dose levels and all available tube voltage combinations. Both scanners had a tin (Sn) filter at the high-energy spectra. Dual-energy CT ratios were calculated for a given tube voltage combination by dividing linear regression lines of CT numbers against concentration. Dual-energy CT ratios were compared using an analysis of covariance. Receiver operating characteristic curves and corresponding areas under the curve (AUCs) were calculated for individual crystal suspension comparisons (HA vs CPP, MSU vs CPP, and MSU vs HA). RESULTS At standard clinical scan settings with 8 mGy and 80/Sn150 kV, the DECT ratios were as follows: CPP, 2.02 (95% confidence interval [CI], 1.98-2.07); HA, 2.00 (95% CI, 1.96-2.05); and MSU, 1.09 (95% CI, 1.06-1.11). Ratios varied numerically depending on the scanner and tube voltage combination. Monosodium urate crystal DECT ratios were significantly different from HA and CPP (P < 0.001), whereas DECT ratios for HA and CPP crystals did not differ significantly (P = 0.99). The differentiation of MSU crystals from both calcium crystals (HA and CPP) was excellent with an AUC of 1.00 (95% CI, 1.00-1.00) and an optimal cutoff DECT ratio of 1.43:1.40 depending on the scanner. In addition, differentiation of MSU and calcium-containing crystals (HA and CPP) required a CSA of minimum 4 pixels of crystal at standard clinical scan conditions. In contrast, differentiation between CPP and HA crystals was moderate with AUCs ranging from 0.66 (95% CI, 0.52-0.80) to 0.80 (95% CI, 0.69-0.91) and an optimal cutoff DECT ratio of 2.02:2.06 depending on the scanner. Furthermore, differentiation between CPP and HA crystals required a CSA of minimum 87 pixels of crystal at standard clinical scan conditions, corresponding to a region of interest of 3.7 mm diameter. When scanning at highest possible spectral separation and maximum dose of 50 mGy, the limit of detection for crystals within a region of interest of 50 pixels was 14 mg/cm3 for MSU and 2 mg/cm3 for both CPP and HA. CONCLUSIONS This phantom study shows that DECT can be used to detect MSU, CPP, and HA crystal deposits. Differentiation of CPP and HA was not possible in crystals deposits less than 3.7 mm in diameter, but MSU could accurately be differentiated from CPP and HA crystal deposits at standard clinical scan conditions.
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Affiliation(s)
- Anna Døssing
- From the The Parker Institute, Bispebjerg and Frederiksberg Hospital
| | - Felix Christoph Müller
- Department of Radiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lisa Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Henning Bliddal
- From the The Parker Institute, Bispebjerg and Frederiksberg Hospital
| | - Mikael Boesen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Galozzi P, Bindoli S, Luisetto R, Sfriso P, Ramonda R, Scanu A, Oliviero F. Regulation of crystal induced inflammation: current understandings and clinical implications. Expert Rev Clin Immunol 2021; 17:773-787. [PMID: 34053376 DOI: 10.1080/1744666x.2021.1937129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Accumulation of abnormal crystals in the body, derived from endogenous or exogenous materials can drive a wide spectrum of inflammatory disease states. It is well established that intra-articular deposition of monosodium urate (MSU) and calcium pyrophoshate (CPP) crystals contributes to joint destruction through pro-inflammatory processes.Areas covered: This review will focus on current understanding and recent novelty about the mechanisms and the clinical implications of the inflammation induced by MSU and CPP crystals.Expert opinion: Advances in molecular biology reveal that at the base of the inflammatory cascade, stimulated by MSU or CPP crystals, there are many complex cellular mechanisms mainly involving the NLRP3 inflammasome, the hallmark of autoinflammatory syndromes. The extensive studies carried out through in vitro and in vivo models along with a better clinical definition of the disease has led to an optimized use of existing drugs and the introduction of novel therapeutic strategies. In particular, the identification of IL-1 as the most important target in gout and pseudogout has made it possible to expand the pharmacological indications of anti-IL-1 biological drugs, opening new therapeutic perspectives for patients.
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Affiliation(s)
- Paola Galozzi
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Sara Bindoli
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Roberto Luisetto
- Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padova, Padova, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Anna Scanu
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
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Simple, efficient and reliable method for the preparation of β-tricalcium phosphate. MENDELEEV COMMUNICATIONS 2021. [DOI: 10.1016/j.mencom.2021.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Simple, efficient and reliable method for the preparation of β-tricalcium phosphate. MENDELEEV COMMUNICATIONS 2021. [DOI: 10.1016/j.mencom.2021.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Herman J, Le Goff B, De Lima J, Brion R, Chevalier C, Blanchard F, Darrieutort-Laffite C. Pro-inflammatory effects of human apatite crystals extracted from patients suffering from calcific tendinopathy. Arthritis Res Ther 2021; 23:131. [PMID: 33926523 PMCID: PMC8082912 DOI: 10.1186/s13075-021-02516-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Calcific tendonitis of the rotator cuff is due to carbonated apatite deposits in the shoulder tendons. During the evolution of the disease, an acute inflammatory episode may occur leading to the disappearance of the calcification. Although hydroxyapatite crystal-induced inflammation has been previously studied with synthetic crystals, no data are available with calcifications extracted from patients suffering from calcific tendinopathy. The objective of the study was to explore the inflammatory properties of human calcifications and the pathways involved. METHODS Human calcifications and synthetic hydroxyapatite were used in vitro to stimulate human monocytes and macrophages, the human myeloid cell line THP-1, and human tenocytes. The release of IL-1β, IL-6, and IL-8 by cells was quantified by ELISA. The gene expression of pro- and anti-inflammatory cytokines was evaluated by quantitative PCR. NF-kB activation and NLRP3 involvement were assessed in THP-1 cells using a NF-kB inhibitor and a caspase-1 inhibitor. The inflammatory properties were then assessed in vivo using a mouse air pouch model. RESULTS Human calcifications were able to induce a significant release of IL-1β when incubated with monocytes, macrophages, and THP-1 only if they were first primed with LPS (monocytes and macrophages) or PMA (THP-1). Stimulation of THP-1 by human calcifications led to similar levels of IL-1β when compared to synthetic hydroxyapatite although these levels were significantly inferior in monocytes and macrophages. The patient's crystals enhanced mRNA expression of pro-IL-1β, as well as IL-18, NF-kB, and TGFβ when IL-6 and TNFα expression were not. IL-1β production was reduced by the inhibition of caspase-1 indicating the role of NLRP3 inflammasome. In vivo, injection of human calcifications or synthetic hydroxyapatite in the air pouch led to a significant increase in membrane thickness although significant overexpression of IL-1β was only observed for synthetic hydroxyapatite. CONCLUSIONS As synthetic hydroxyapatite, human calcifications were able to induce an inflammatory response resulting in the production of IL-1β after NF-kB activation and through NLRP3 inflammasome. In some experiments, IL-1β induction was lower with human calcifications compared to synthetic apatite. Differences in size, shape, and protein content may explain this observation.
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Affiliation(s)
- Julien Herman
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France.,Rheumatology Department, Nantes University Hospital, 44093, Nantes, France
| | - Benoit Le Goff
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France.,Rheumatology Department, Nantes University Hospital, 44093, Nantes, France
| | - Julien De Lima
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France
| | - Régis Brion
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France.,Nantes University Hospital, 44093, Nantes, France
| | - Catherine Chevalier
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France
| | - Frédéric Blanchard
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France
| | - Christelle Darrieutort-Laffite
- INSERM UMR1238, Bone Sarcoma and Remodeling of Calcified Tissues, Faculté de Médecine de Nantes, 1 rue Gaston Veil, 44035, Nantes Cedex 1, France. .,Rheumatology Department, Nantes University Hospital, 44093, Nantes, France. .,Current Address: McKay Orthopedic Research Laboratory, University of Pennsylvania, 307A Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA, 19104-6081, USA.
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Casal-Beiroa P, Balboa-Barreiro V, Oreiro N, Pértega-Díaz S, Blanco FJ, Magalhães J. Optical Biomarkers for the Diagnosis of Osteoarthritis through Raman Spectroscopy: Radiological and Biochemical Validation Using Ex Vivo Human Cartilage Samples. Diagnostics (Basel) 2021; 11:diagnostics11030546. [PMID: 33803917 PMCID: PMC8003208 DOI: 10.3390/diagnostics11030546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/08/2021] [Accepted: 03/17/2021] [Indexed: 12/30/2022] Open
Abstract
Osteoarthritis (OA) is the most common rheumatic disease, characterized by progressive articular cartilage degradation. Raman spectroscopy (RS) has been recently proposed as a label-free tool to detect molecular changes in musculoskeletal tissues. We used cartilage samples derived from human femoral heads to perform an ex vivo study of different Raman signals and ratios, related to major and minor molecular components of articular cartilage, hereby proposed as candidate optical biomarkers for OA. Validation was performed against the radiological Kellgren-Lawrence (K-L) grading system, as a gold standard, and cross-validated against sulfated glycosaminoglycans (sGAGs) and total collagens (Hyp) biochemical contents. Our results showed a significant decrease in sGAGs (SGAGs, A1063 cm-1/A1004 cm-1) and proteoglycans (PGs, A1375 cm-1/A1004 cm-1) and a significant increase in collagen disorganization (ColD/F, A1245 cm-1/A1270 cm-1), with OA severity. These were correlated with sGAGs or Hyp contents, respectively. Moreover, the SGAGs/HA ratio (A1063 cm-1/A960 cm-1), representing a functional matrix, rich in proteoglycans, to a mineralized matrix-hydroxyapatite (HA), was significantly lower in OA cartilage (K-L I vs. III-IV, p < 0.05), whilst the mineralized to collagenous matrix ratio (HA/Col, A960 cm-1/A920 cm-1) increased, being correlated with K-L. OA samples showed signs of tissue mineralization, supported by the presence of calcium crystals-related signals, such as phosphate, carbonate, and calcium pyrophosphate dihydrate (MGP, A960 cm-1/A1004 cm-1, MGC, A1070 cm-1/A1004 cm-1 and A1050 cm-1/A1004 cm-1). Finally, we observed an increase in lipids ratio (IL, A1450 cm-1/A1670 cm-1) with OA severity. As a conclusion, we have described the molecular fingerprint of hip cartilage, validating a panel of optical biomarkers and the potential of RS as a complementary diagnostic tool for OA.
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Affiliation(s)
- Paula Casal-Beiroa
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Unidad de Epidemiología Clínica e Investigación Bioestadística, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (V.B.-B.); (S.P.-D.)
| | - Natividad Oreiro
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Sonia Pértega-Díaz
- Unidad de Epidemiología Clínica e Investigación Bioestadística, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (V.B.-B.); (S.P.-D.)
| | - Francisco J. Blanco
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Grupo de Investigación de Reumatología y Salud (GIR-S), Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Universidade da Coruña (UDC), Campus de Oza, 15008 A Coruña, Spain
- Correspondence: (F.J.B.); (J.M.)
| | - Joana Magalhães
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
- Correspondence: (F.J.B.); (J.M.)
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Oliviero F, Galozzi P, Scanu A, Galuppini F, Lazzarin V, Brocco S, Ravagnan G, Sfriso P, Ramonda R, Spinella P, Punzi L, Pennelli G, Luisetto R. Polydatin Prevents Calcium Pyrophosphate Crystal-Induced Arthritis in Mice. Nutrients 2021; 13:nu13030929. [PMID: 33805648 PMCID: PMC7998880 DOI: 10.3390/nu13030929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Polydatin is a stilbenoid with important antioxidant, anti-inflammatory, and immunomodulating properties. The aim of this study was to assess the anti-inflammatory preventive effect of polydatin in the mouse model of acute arthritis induced by calcium pyrophosphate (CPP) crystals. METHODS Acute arthritis was induced by the injection of a suspension of sterile CPP crystals into the ankle joint of Balb/c mice. Animals were randomized to receive polydatin or colchicine (the control drug) according to a prophylactic and a therapeutic protocol. The primary outcome was the variation of ankle swelling obtained after crystal injection and treatment, while histological parameters such as leukocyte infiltration, IL-1ß and CXCL1 levels and tissue expression were considered as secondary outcomes. RESULTS Prophylactic treatment with PD significantly diminished ankle swelling after 48 h from crystal injection. Secondary outcomes such as leukocyte infiltration, necrosis, edema, and synovitis were also decreased. PD caused a reduction in circulating levels of IL-1ß and CXCL1, as well as their tissue expression. By contrast, the therapeutic administration of PD did not have any beneficial effect. CONCLUSIONS PD can effectively prevent acute inflammatory response to crystals in the mouse model of CPP crystal-induced arthritis. These results suggest that this bioactive compound might be used in the prevention of crystal-induced acute attacks in humans.
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Affiliation(s)
- Francesca Oliviero
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (P.G.); (A.S.); (P.S.); (R.R.)
- Correspondence: ; Tel.: +39-049-821-8682
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (P.G.); (A.S.); (P.S.); (R.R.)
| | - Anna Scanu
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (P.G.); (A.S.); (P.S.); (R.R.)
| | - Francesca Galuppini
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (F.G.); (V.L.); (G.P.)
| | - Vanni Lazzarin
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (F.G.); (V.L.); (G.P.)
| | - Silvia Brocco
- Radiology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy;
| | - Giampietro Ravagnan
- Institute of Translational Pharmacology-National Research Council, 00133 Rome, Italy;
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (P.G.); (A.S.); (P.S.); (R.R.)
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (P.G.); (A.S.); (P.S.); (R.R.)
| | - Paolo Spinella
- Clinical Nutrition Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy;
| | - Leonardo Punzi
- Centre for Gout and Metabolic Bone and Joint Diseases, Rheumatology, SS Giovanni and Paolo Hospital, 30122 Venice, Italy;
| | - Gianmaria Pennelli
- Surgical Pathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (F.G.); (V.L.); (G.P.)
| | - Roberto Luisetto
- Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padova, 35128 Padova, Italy;
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Bernabei I, Sayous Y, Raja AY, Amma MR, Viry A, Steinmetz S, Falgayrac G, van Heeswijk RB, Omoumi P, Pascart T, Stamp LK, Nasi S, Hügle T, Busso N, So AK, Becce F. Multi-energy photon-counting computed tomography versus other clinical imaging techniques for the identification of articular calcium crystal deposition. Rheumatology (Oxford) 2021; 60:2483-2485. [DOI: 10.1093/rheumatology/keab125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/23/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Ilaria Bernabei
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yann Sayous
- Department of Physics and Astronomy, University of Canterbury
| | - Aamir Y Raja
- Department of Radiology, University of Otago, Christchurch, New Zealand
- Department of Physics, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Maya R Amma
- Department of Radiology, University of Otago, Christchurch, New Zealand
| | | | - Sylvain Steinmetz
- Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Guillaume Falgayrac
- Marrow Adiposity and Bone Laboratory (MABLab), UR 4490, University of Lille, Lille, France
| | - Ruud B van Heeswijk
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tristan Pascart
- Marrow Adiposity and Bone Laboratory (MABLab), UR 4490, University of Lille, Lille, France
- Department of Rheumatology, Lille Catholic University Hospitals, University of Lille, Lille, France
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Sonia Nasi
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Hügle
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nathalie Busso
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alexander K So
- Department of Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Nasi S, Castelblanco M, Chobaz V, Ehirchiou D, So A, Bernabei I, Kusano T, Nishino T, Okamoto K, Busso N. Xanthine Oxidoreductase Is Involved in Chondrocyte Mineralization and Expressed in Osteoarthritic Damaged Cartilage. Front Cell Dev Biol 2021; 9:612440. [PMID: 33634117 PMCID: PMC7900416 DOI: 10.3389/fcell.2021.612440] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pathologic calcification of cartilage consists of the formation of basic calcium phosphate (BCP) and/or calcium pyrophosphate dihydrate (CPPD) containing calcium crystals in mature hyaline or articular cartilage and is associated with aging, cartilage injury and likely plays a role in accelerating the pathology of osteoarthritis (OA). The pathways regulating joint calcification, in particular cartilage calcification, are not completely understood, but inflammation and the formation of reactive oxygen species (ROS) are contributory factors. The xanthine oxidase (XO) form of xanthine oxidoreductase (XOR), the key enzyme in xanthine and uric acid metabolism, is a major cellular source of superoxide. We hypothesized that XOR could be implicated in chondrocyte mineralization and cartilage calcification and degradation in OA. We showed both in murine primary chondrocyte and chondrogenic ATDC5 cells, that mineralization was inhibited by two different XOR inhibitors, febuxostat and allopurinol. In addition, XOR inhibition reduced the expression of the pro-mineralizing cytokine interleukin-6 (IL-6). We next generated XOR knock-out chondrocyte cell lines with undetectable XOR expression and XO activity. XOR knock-out chondrocyte cells showed decreased mineralization and reduced alkaline phosphatase (Alp) activity. To assess the precise form of XOR involved, primary chondrocytes of XOR mutant mice expressing either the XDH form (XDH ki) or the XO form (XO ki) were studied. We found that XO ki chondrocytes exhibited increased mineralization compared to XDH ki chondrocytes, and this was associated with enhanced Alp activity, ROS generation and IL-6 secretion. Finally, we found increased XOR expression in damaged vs. undamaged cartilage obtained from OA patients and XOR expression partially co-localized with areas showing pathologic calcification. Altogether, our results suggest that XOR, via its XO form, contribute to chondrocyte mineralization and pathological calcification in OA cartilage.
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Affiliation(s)
- Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Mariela Castelblanco
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Véronique Chobaz
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Driss Ehirchiou
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Teruo Kusano
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Takeshi Nishino
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Ken Okamoto
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
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Garcia-Gonzalez E, Gamberucci A, Lucherini OM, Alì A, Simpatico A, Lorenzini S, Lazzerini PE, Tripodi S, Frediani B, Selvi E. NEUTROPHIL EXTRACELLULAR TRAPS RELEASE IN GOUT AND PSEUDOGOUT DEPENDS ON THE NUMBER OF CRYSTALS REGARDLESS OF LEUKOCYTE COUNT. Rheumatology (Oxford) 2021; 60:4920-4928. [PMID: 33521820 DOI: 10.1093/rheumatology/keab087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Microcrystal-induced arthritis is still an unresolved paradigm for medicine. Overt inflammation may be absent even when crystals occur in synovial fluid. Recently, the production of neutrophil extracellular traps (NETs) embedding monosodium urate crystals (MSU) has been proposed as a possible mechanism of the auto-resolution of the inflammatory phase during gout. We aimed to verify and quantify the release of NETs in synovial fluids during gout and pseudogout attacks and to compare any differences with respect to crystals and neutrophils number, and to analyze activation of necroptosis pathway in synovial fluid from crystal-induced arthritis. METHODS Synovial fluid samples were obtained by arthrocentesis from 22 patients presenting acute crystal-induced arthritis, gout or pseudogout (n = 11 each group), and from 10 patients with acute non-crystal arthritis as controls. NETosis was quantified in synovial fluid by nucleic acid stain and by quantification of human neutrophil elastase. Activation of p-MLKL was assessed by western blot. RESULTS We observed that synovial fluid neutrophils encountering MSU and CPPD crystals during episodes of gout and pseudogout release NETs in relation to the number of crystals in synovial fluid and irrespective of neutrophil density and type of crystal. This release was accompanied by necroptosis through the activation of the MLKL pathway. CONCLUSIONS Our findings suggest that a role of NETs in crystal-induced arthritis is to "trap extracellular particles", including microcrystals. Embedding crystals in aggregates of NETs may be the basis of tophi and CPPD deposition and may have implications for disease evolution, rather than for spontaneous resolution of the acute attack.
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Affiliation(s)
- Estrella Garcia-Gonzalez
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Alessandra Gamberucci
- Department of Molecular and Developmental Medicine, Università degli Studi di Siena, Siena, Italy
| | - Orso-Maria Lucherini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Alessandra Alì
- Department of Molecular and Developmental Medicine, Università degli Studi di Siena, Siena, Italy
| | - Antonella Simpatico
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Sauro Lorenzini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Pietro-Enea Lazzerini
- Internal Medicine Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Sergio Tripodi
- Anatomical Pathology Unit, Department of Oncology, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Enrico Selvi
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte, Siena, Italy
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Bamgboje AO, Mohandas N. Crowned Dens Syndrome Masquerading as Meningitis. Cureus 2021; 13:e12678. [PMID: 33598372 PMCID: PMC7880003 DOI: 10.7759/cureus.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The classic symptoms of meningismus, including fever, neck stiffness, and headache, should automatically trigger a prime differential of meningitis, but a close masquerader, albeit rare, is crowned dens syndrome. Herein, we report the case of a 71-year-old woman with clinical features of meningismus with elevated inflammatory biomarkers. However, computed tomography of the cervical spine revealed the presence of calcium deposits encircling the dens. Hence, an alternate diagnosis of crowned dens syndrome was considered. This was confirmed by the presence of similar pathology in other joints and the dramatic resolution of symptoms and inflammatory markers with the administration of nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Abayomi O Bamgboje
- Internal Medicine, New York City Health + Hospitals/Metropolitan, New York, USA
| | - Nirupa Mohandas
- Internal Medicine/Rheumatology, New York City Health + Hospitals/Metropolitan, New York, USA
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Boraldi F, Lofaro FD, Quaglino D. Apoptosis in the Extraosseous Calcification Process. Cells 2021; 10:cells10010131. [PMID: 33445441 PMCID: PMC7827519 DOI: 10.3390/cells10010131] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 12/13/2022] Open
Abstract
Extraosseous calcification is a pathologic mineralization process occurring in soft connective tissues (e.g., skin, vessels, tendons, and cartilage). It can take place on a genetic basis or as a consequence of acquired chronic diseases. In this last case, the etiology is multifactorial, including both extra- and intracellular mechanisms, such as the formation of membrane vesicles (e.g., matrix vesicles and apoptotic bodies), mitochondrial alterations, and oxidative stress. This review is an overview of extraosseous calcification mechanisms focusing on the relationships between apoptosis and mineralization in cartilage and vascular tissues, as these are the two tissues mostly affected by a number of age-related diseases having a progressively increased impact in Western Countries.
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Affiliation(s)
- Federica Boraldi
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (F.D.L.); (D.Q.)
- Correspondence:
| | - Francesco Demetrio Lofaro
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (F.D.L.); (D.Q.)
| | - Daniela Quaglino
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (F.D.L.); (D.Q.)
- Interuniversity Consortium for Biotechnologies (CIB), Italy
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Scanu A, Oliviero F, Luisetto R, Ramonda R, Doria A, Punzi L, Dayer JM. Effect of pathogenic crystals on the production of pro- and anti-inflammatory cytokines by different leukocyte populations. Immunobiology 2020; 226:152042. [PMID: 33285354 DOI: 10.1016/j.imbio.2020.152042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 03/04/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate cytokine production in vitro by different types of leukocytes stimulated with monosodium urate (MSU), calcium pyrophosphate (CPP) and basic calcium phosphate (BCP) crystals. MATERIAL AND METHODS Polymorphonuclear cells (PMN), monocytes and lymphocytes, isolated from healthy volunteer blood, were stimulated for different time periods with increasing MSU, CPP or BCP crystal concentrations. IL-1β, IL-8, IL-6, CCL2, IL-1Ra and TGFβ1 were determined by ELISA. RESULTS Exposure of PMN to different crystals resulted in a moderate IL-8 and IL-1Ra release. Stimulation of monocytes induced a significant production of all the cytokines evaluated. The highest levels of IL-1β, IL-6, CCL2 and IL-8 were observed with MSU at 0.5 mg/ml, CPP at 0.01-0.05 mg/ml and BCP at 1 mg/ml after 18-48 h and then decreased. At the same crystal concentrations, IL-1Ra and TGFβ1 increased until the end of the experiment. Treatment of lymphocytes with different crystals did not induce cytokine release. CONCLUSION This study demonstrates that PMN, monocytes and lymphocytes from the same donor respond differently after stimulation with MSU, CPP or BCP crystals, depending on the dose and the time of exposure. Crystals induce a rapid increase of pro-inflammatory cytokines, whereas longer time is required to release high levels of anti-inflammatory cytokines.
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Affiliation(s)
- Anna Scanu
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy.
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy
| | - Roberto Luisetto
- Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Italy
| | - Leonardo Punzi
- Centre for Gout and Metabolic Bone and Joint Diseases, Rheumatology, SS Giovanni and Paolo Hospital, Venice, Italy
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Cho N, Lee SG, Kim JO, Kim YA, Kim EM, Park C, Ji JH, Kim KK. Identification of Differentially Expressed Genes Associated with Extracellular Matrix Degradation and Inflammatory Regulation in Calcific Tendinopathy Using RNA Sequencing. Calcif Tissue Int 2020; 107:489-498. [PMID: 32776213 DOI: 10.1007/s00223-020-00743-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/31/2020] [Indexed: 12/19/2022]
Abstract
Calcific tendinopathy (CT), developed due to calcium hydroxyapatite deposition in the rotator cuff tendon, mostly affects women in their 40 s and 50 s and causes severe shoulder pain. However, the molecular basis of its pathogenesis and appropriate treatment methods are largely unknown. In this study, we identified 202 differentially expressed genes (DEGs) between calcific and adjacent normal tendon tissues of rotator cuff using RNA sequencing-based transcriptome analysis. The DEGs were highly enriched in extracellular matrix (ECM) degradation and inflammation-related processes. Further, matrix metalloproteinase 9 (MMP9) and matrix metalloproteinase 13 (MMP13), two of the enzymes associated with ECM degradation, were found to be highly upregulated 25.85- and 19.40-fold, respectively, in the calcific tendon tissues compared to the adjacent normal tendon tissues. Histopathological analyses indicated collagen degradation and macrophage infiltration at the sites of calcific deposit in the rotator cuff tendon. Our study acts as a foundation that may help in better understanding of the pathogenesis associated with CT, and thus in better management of the disease.
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Affiliation(s)
- Namjoon Cho
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
| | - Sung-Gwon Lee
- School of Biological Science and Technology, Chonnam National University, Gwangju, Republic of Korea
| | - Jong Ok Kim
- Department of Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Yong-An Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
| | - Eun-Mi Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Chungoo Park
- School of Biological Science and Technology, Chonnam National University, Gwangju, Republic of Korea.
| | - Jong-Hun Ji
- Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.
| | - Kee K Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea.
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Slouma M, Rahmouni S, Dhahri R, Litaiem N, Gharsallah I, Metoui L, Louzir B. Bicipitoradial bursitis: A diagnosis challenge! Clin Case Rep 2020; 8:2265-2268. [PMID: 33235773 PMCID: PMC7669374 DOI: 10.1002/ccr3.3125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/28/2020] [Accepted: 06/13/2020] [Indexed: 11/17/2022] Open
Abstract
Bicipitoradial bursitis should be considered in patients with antecubital mass and painful forearm pronation and supination movement. It can be due to several conditions such as calcium pyrophosphate dihydrate deposition, even in young patients. Ultrasound is useful to confirm the diagnosis, determine the etiology and to guide the treatment of bicipitoradial bursitis.
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Affiliation(s)
- Maroua Slouma
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
| | - Safa Rahmouni
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
| | - Rim Dhahri
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
| | - Noureddine Litaiem
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Imen Gharsallah
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
| | - Leila Metoui
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
| | - Bassem Louzir
- Department of Internal MedicineMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
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Filippucci E, Reginato AM, Thiele RG. Imaging of crystalline arthropathy in 2020. Best Pract Res Clin Rheumatol 2020; 34:101595. [PMID: 33012644 DOI: 10.1016/j.berh.2020.101595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Crystal-related arthropathies are the result of crystal deposition in joint and periarticular soft tissues. Identification of urate crystals is mandatory to distinguish gout from other crystalline arthropathies, including calcium pyrophosphate dihydrate and basic calcium phosphate crystal deposition diseases. ACR/EULAR classification criteria for gout included dual-energy computed tomography and ultrasound with equal impact to the final score. Different diagnostic strengths of these imaging modalities depend on disease duration and scanned anatomic site. While ultrasound has been indicated as the first-choice imaging technique, especially in the early stages of the disease, dual-energy computed tomography has shown to be highly specific, allowing the detection of crystal deposits in anatomic sites not accessible by ultrasound, such as the spine. At the spinal level, MRI findings are usually nonspecific. Finally, there is preliminary evidence that at the knee, dual-energy computed tomography may discriminate calcium pyrophosphate dihydrate from basic calcium phosphate crystal deposits.
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Affiliation(s)
- Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, "Carlo Urbani" Hospital, Jesi, Ancona, Italy.
| | - Anthony M Reginato
- Division of Rheumatology, Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Ralf G Thiele
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of Rochester, Rochester, NY, USA.
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Huber FA, Gkoumas S, Thüring T, Becce F, Guggenberger R. Detection and Characterization of Monosodium Urate and Calcium Hydroxyapatite Crystals Using Spectral Photon-Counting Radiography: A Proof-of-Concept Study. Eur J Radiol 2020; 129:109080. [DOI: 10.1016/j.ejrad.2020.109080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 02/07/2023]
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50
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Bianchi ML, Bishop NJ, Guañabens N, Hofmann C, Jakob F, Roux C, Zillikens MC. Hypophosphatasia in adolescents and adults: overview of diagnosis and treatment. Osteoporos Int 2020; 31:1445-1460. [PMID: 32162014 DOI: 10.1007/s00198-020-05345-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
This article provides an overview of the current knowledge on hypophosphatasia-a rare genetic disease of very variable presentation and severity-with a special focus on adolescents and adults. It summarizes the available information on the many known mutations of tissue-nonspecific alkaline phosphatase (TNSALP), the epidemiology and clinical presentation of the disease in adolescents and adults, and the essential diagnostic clues. The last section reviews the therapeutic approaches, including recent reports on enzyme replacement therapy (EnzRT).
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Affiliation(s)
- M L Bianchi
- Laboratorio sperimentale di ricerche sul metabolismo osseo infantile, Centro Malattie Metaboliche Ossee, Istituto Auxologico Italiano IRCCS, Milan, Italy.
| | - N J Bishop
- Department of Oncology and Metabolism, University of Sheffield, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - N Guañabens
- Servicio de Reumatología, Hospital Clínic, Universidad de Barcelona, IDIBAPS CIBERehd, Barcelona, Spain
| | - C Hofmann
- Children's Hospital, University of Würzburg, Würzburg, Germany
| | - F Jakob
- Orthopedic Centre for Musculoskeletal Research, University of Würzburg, Würzburg, Germany
| | - C Roux
- INSERM U1153 APHP Centre, Université de Paris, Department of Rheumatology, Paris, France
| | - M C Zillikens
- Department of Internal Medicine, Endocrinology Section, Erasmus Medical Centre, Rotterdam, The Netherlands
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