1
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Natural antibodies and CRP drive anaphylatoxin production by urate crystals. Sci Rep 2022; 12:4483. [PMID: 35296708 PMCID: PMC8924570 DOI: 10.1038/s41598-022-08311-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/28/2022] [Indexed: 01/02/2023] Open
Abstract
In gout, crystallization of uric acid in the form of monosodium urate (MSU) leads to a painful inflammatory response. MSU crystals induce inflammation by activating the complement system and various immune cell types, and by inducing necrotic cell death. We previously found that the soluble pattern recognition molecule C-reactive protein (CRP) recognizes MSU crystals, while enhancing complement activation. In the absence of CRP, MSU crystals still induced complement activation, suggesting additional CRP-independent mechanisms of complement activation. In the present study, we searched for additional MSU crystal-binding complement activators. We found that all healthy individuals, even unborn children, have MSU crystal-specific immunoglobulin M (IgM) in their blood. This indicates that innate IgM, also known as natural IgM, recognizes these crystals. In serum lacking IgM and CRP, MSU crystals showed negligible complement activation as assessed by the production of the anaphylatoxins C4a, C3a, and C5a (listed in order of production via the classical complement pathway). We show that IgM and CRP both activate the classical complement pathway on MSU crystals. CRP was more efficient at fixating active C1 on the crystals and inducing release of the most inflammatory anaphylatoxin C5a, indicating non-redundant functions of CRP. Notably, while CRP recognizes MSU crystals but not the related calcium pyrophosphate dihydrate (CPPD) crystals, natural IgM bound to both, suggesting common and distinct mechanisms of recognition of individual crystal types by complement activators.
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2
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Nidorf SM, Fiolet A, Abela GS. Viewing atherosclerosis through a crystal lens: How the evolving structure of cholesterol crystals in atherosclerotic plaque alters its stability. J Clin Lipidol 2020; 14:619-630. [DOI: 10.1016/j.jacl.2020.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 01/08/2023]
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3
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Khameneh HJ, Ho AWS, Laudisi F, Derks H, Kandasamy M, Sivasankar B, Teng GG, Mortellaro A. C5a Regulates IL-1β Production and Leukocyte Recruitment in a Murine Model of Monosodium Urate Crystal-Induced Peritonitis. Front Pharmacol 2017; 8:10. [PMID: 28167912 PMCID: PMC5253373 DOI: 10.3389/fphar.2017.00010] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022] Open
Abstract
Gouty arthritis results from the generation of monosodium urate (MSU) crystals within joints. These MSU crystals elicit acute inflammation characterized by massive infiltration of neutrophils and monocytes that are mobilized by the pro-inflammatory cytokine IL-1β. MSU crystals also activate the complement system, which regulates the inflammatory response; however, it is unclear whether or how MSU-mediated complement activation is linked to IL-1β release in vivo, and the various roles that might be played by individual components of the complement cascade. Here we show that exposure to MSU crystals in vivo triggers the complement cascade, leading to the generation of the biologically active complement proteins C3a and C5a. C5a, but not C3a, potentiated IL-1β and IL-1α release from LPS–primed MSU-exposed peritoneal macrophages and human monocytic cells in vitro; while in vivo MSU–induced C5a mediated murine neutrophil recruitment as well as IL-1β production at the site of inflammation. These effects were significantly ameliorated by treatment of mice with a C5a receptor antagonist. Mechanistic studies revealed that C5a most likely increased NLRP3 inflammasome activation via production of reactive oxygen species (ROS), and not through increased transcription of inflammasome components. Therefore we conclude that C5a generated upon MSU-induced complement activation increases neutrophil recruitment in vivo by promoting IL-1 production via the generation of ROS, which activate the NLRP3 inflammasome. Identification of the C5a receptor as a key determinant of IL-1-mediated recruitment of inflammatory cells provides a novel potential target for therapeutic intervention to mitigate gouty arthritis.
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Affiliation(s)
- Hanif J Khameneh
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Adrian W S Ho
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Federica Laudisi
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Heidi Derks
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Matheswaran Kandasamy
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Baalasubramanian Sivasankar
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
| | - Gim Gee Teng
- Division of Rheumatology, University Medicine Cluster, National University Health System (NUHS)Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS) and National University Health System (NUHS)Singapore, Singapore
| | - Alessandra Mortellaro
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) Singapore, Singapore
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4
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Pieterse E, Jeremic I, Czegley C, Weidner D, Biermann MHC, Veissi S, Maueröder C, Schauer C, Bilyy R, Dumych T, Hoffmann M, Munoz LE, Bengtsson AA, Schett G, van der Vlag J, Herrmann M. Blood-borne phagocytes internalize urate microaggregates and prevent intravascular NETosis by urate crystals. Sci Rep 2016; 6:38229. [PMID: 27917897 PMCID: PMC5137018 DOI: 10.1038/srep38229] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 11/07/2016] [Indexed: 12/31/2022] Open
Abstract
Hyperuricemia is strongly linked to cardiovascular complications including atherosclerosis and thrombosis. In individuals with hyperuricemia, needle-shaped monosodium urate crystals (nsMSU) frequently form within joints or urine, giving rise to gouty arthritis or renal calculi, respectively. These nsMSU are potent instigators of neutrophil extracellular trap (NET) formation. Little is known on the mechanism(s) that prevent nsMSU formation within hyperuricemic blood, which would potentially cause detrimental consequences for the host. Here, we report that complement proteins and fetuins facilitate the continuous clearance by blood-borne phagocytes and resident macrophages of small urate microaggregates (UMA; <1 μm in size) that initially form in hyperuricemic blood. If this clearance fails, UMA exhibit bipolar growth to form typical full-sized nsMSU with a size up to 100 μm. In contrast to UMA, nsMSU stimulated neutrophils to release NETs. Under conditions of flow, nsMSU and NETs formed densely packed DNase I-resistant tophus-like structures with a high obstructive potential, highlighting the importance of an adequate and rapid removal of UMA from the circulation. Under pathological conditions, intravascularly formed nsMSU may hold the key to the incompletely understood association between NET-driven cardiovascular disease and hyperuricemia.
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Affiliation(s)
- Elmar Pieterse
- Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ivica Jeremic
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.,Institute of Rheumatology, Resavska 69, Belgrade, Serbia
| | - Christine Czegley
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Daniela Weidner
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Mona H C Biermann
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Susan Veissi
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Christian Maueröder
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Christine Schauer
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Rostyslav Bilyy
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.,Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Tetiana Dumych
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Markus Hoffmann
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Luis E Munoz
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Johan van der Vlag
- Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Martin Herrmann
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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5
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Triantafilou M, Hughes TR, Morgan BP, Triantafilou K. Complementing the inflammasome. Immunology 2016; 147:152-64. [PMID: 26572245 DOI: 10.1111/imm.12556] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 11/03/2015] [Accepted: 11/06/2015] [Indexed: 01/02/2023] Open
Abstract
The innate immune system is an ancient surveillance system able to sense microbial invaders as well as aberrations in normal cell function. No longer viewed as a static and non-specific part of immunity, the innate immune system employs a plethora of specialized pattern recognition sensors to monitor and achieve homeostasis; these include the Toll-like receptors, the retinoic acid-inducible gene-like receptors, the nucleotide-binding oligomerization domain receptors (NLRs), the C-type lectins and the complement system. In order to increase specificity and diversity, innate immunity uses homotypic and heterotypic associations among these different components. Multi-molecular assemblies are formed both on the cell surface and in the cytosol to respond to pathogen and danger signals. Diverse, but tailored, responses to a changing environment are orchestrated depending on the the nature of the challenge and the repertoire of interacting receptors and components available in the sensing cell. It is now emerging that innate immunity operates a system of 'checks and balances' where interaction among the sensors is key in maintaining normal cell function. Complement sits at the heart of this alarm system and it is becoming apparent that it is capable of interacting with all the other pathways to effect a tailored immune response. In this review, we will focus on complement interactions with NLRs, the so-called 'inflammasomes', describing the molecular mechanisms that have been revealed so far and discussing the circumstantial evidence that exists for these interactions in disease states.
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Affiliation(s)
- Martha Triantafilou
- Institute of Infection and Immunity, School of Medicine, University Hospital of Wales, Cardiff University, Cardiff, UK
| | - Timothy R Hughes
- Institute of Infection and Immunity, School of Medicine, University Hospital of Wales, Cardiff University, Cardiff, UK
| | - Bryan Paul Morgan
- Institute of Infection and Immunity, School of Medicine, University Hospital of Wales, Cardiff University, Cardiff, UK
| | - Kathy Triantafilou
- Institute of Infection and Immunity, School of Medicine, University Hospital of Wales, Cardiff University, Cardiff, UK
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6
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Scanu A, Oliviero F, Gruaz L, Galozzi P, Luisetto R, Ramonda R, Burger D, Punzi L. Synovial fluid proteins are required for the induction of interleukin-1β production by monosodium urate crystals. Scand J Rheumatol 2016; 45:384-93. [DOI: 10.3109/03009742.2015.1124452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A Scanu
- Rheumatology Unit, Department of Medicine, University of Padova, Italy
| | - F Oliviero
- Rheumatology Unit, Department of Medicine, University of Padova, Italy
| | - L Gruaz
- Division of Immunology and Allergy, Inflammation and Allergy Research Group, Hans Wilsdorf Laboratory, University Hospital and Faculty of Medicine, University of Geneva, Switzerland
| | - P Galozzi
- Rheumatology Unit, Department of Medicine, University of Padova, Italy
| | - R Luisetto
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
| | - R Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Italy
| | - D Burger
- Division of Immunology and Allergy, Inflammation and Allergy Research Group, Hans Wilsdorf Laboratory, University Hospital and Faculty of Medicine, University of Geneva, Switzerland
| | - L Punzi
- Rheumatology Unit, Department of Medicine, University of Padova, Italy
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7
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Chiu CW, Chen HM, Wu TT, Shih YC, Huang KK, Tsai YF, Hsu YL, Chen SF. Differential proteomics of monosodium urate crystals-induced inflammatory response in dissected murine air pouch membranes by iTRAQ technology. Proteomics 2015. [PMID: 26205848 DOI: 10.1002/pmic.201400626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The precipitation of monosodium urate crystals within joints triggers an acute inflammatory reaction that is the root cause of gout. The inflammation induced by the injection of MSU crystals into the murine air pouch for 1, 3, and 5 h was examined by iTRAQ-based proteomic profiling. The iTRAQ-labeled peptides were fractionated by SCX, basic-RP or solution-IEF, followed by LC-MS/MS analysis. A total of 951 proteins were quantified from the total combined fractions. Among them, 317 proteins exhibited a differential expression, compared to that of the controls at one time point or more. The majority of the differentially expressed proteins were found in the sample after a 5-h MSU treatment. Western blot revealed that the expression levels of cathelin-related antimicrobial peptide and S100A9 were positively correlated with the time-course treated with MSU. Further analysis of GeneGO pathway demonstrated that these differentially expressed proteins are primarily related to the immune-related complement system and the tricarboxylic acid cycle. Moreover, seven genes from the TCA cycle were found to be significantly downregulated at the transcriptional level and its correlation with gout and possible therapeutic applications are worth further investigation. Last, we found that pyruvate carboxylation could be potential targets for antigout treatment.
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Affiliation(s)
- Chih-Wei Chiu
- Department of Chemistry, National Taiwan Normal University, Taipei 116, Taiwan
| | - Han-Min Chen
- Department of Life Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - Tzong-Ta Wu
- Department of Life Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - Ying-Chu Shih
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Kuo-Kuei Huang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Ying-Fei Tsai
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Yi-Ling Hsu
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Sung-Fang Chen
- Department of Chemistry, National Taiwan Normal University, Taipei 116, Taiwan
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8
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An LL, Mehta P, Xu L, Turman S, Reimer T, Naiman B, Connor J, Sanjuan M, Kolbeck R, Fung M. Complement C5a potentiates uric acid crystal-induced IL-1β production. Eur J Immunol 2014; 44:3669-79. [PMID: 25229885 DOI: 10.1002/eji.201444560] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 08/05/2014] [Accepted: 09/11/2014] [Indexed: 12/11/2022]
Abstract
Anaphylatoxin C5a released upon complement activation is associated with both acute and chronic inflammations such as gout. The pathogenesis of gout was identified as uric acid crystal deposition in the joints that activates inflammasome, leading to IL-1β release. However, little is known about the interaction between complement activation and monosodium urate/uric acid (MSU) crystal-induced inflammasome activation or IL-1β production. Here, we report that MSU crystal-induced proinflammatory cytokines/chemokines in human whole blood is predominantly regulated by C5a through its interaction with C5a receptor. C5a induces pro-IL-1β and IL-1β production in human primary monocytes, and potentiates MSU or cholesterol crystals in IL-1β production. This potentiation is caspase-1 dependent and requires intracellular Ca(2+) mobilization, K(+) efflux, and cathepsin B activity. Our results provide insight into the role of C5a as an endogenous priming signal that is required for the initiation of uric acid crystal-induced IL-1β production. C5a could potentially be a therapeutic target together with IL-1β antagonists for the treatment of complement-dependent and inflammasome-associated diseases.
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Affiliation(s)
- Ling-Ling An
- Department of Respiratory, Inflammation and Autoimmune Diseases, MedImmune, LLC, Gaithersburg, MD, USA
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9
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Leighton S, Kok LF, Halliday GM, Byrne SN. Inhibition of UV-induced uric acid production using Allopurinol prevents suppression of the contact hypersensitivity response. Exp Dermatol 2013; 22:189-94. [DOI: 10.1111/exd.12096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Gary M. Halliday
- Discipline of Dermatology; Bosch Institute; Faculty of Medicine; Sydney Medical School; University of Sydney; Sydney; NSW; Australia
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10
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Neutrophils, IL-1β, and gout: is there a link? Semin Immunopathol 2013; 35:501-12. [DOI: 10.1007/s00281-013-0361-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 01/09/2013] [Indexed: 01/09/2023]
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11
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Tegla CA, Cudrici C, Patel S, Trippe R, Rus V, Niculescu F, Rus H. Membrane attack by complement: the assembly and biology of terminal complement complexes. Immunol Res 2012; 51:45-60. [PMID: 21850539 DOI: 10.1007/s12026-011-8239-5] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Complement system activation plays an important role in both innate and acquired immunity. Activation of the complement and the subsequent formation of C5b-9 channels (the membrane attack complex) on the cell membranes lead to cell death. However, when the number of channels assembled on the surface of nucleated cells is limited, sublytic C5b-9 can induce cell cycle progression by activating signal transduction pathways and transcription factors and inhibiting apoptosis. This induction by C5b-9 is dependent upon the activation of the phosphatidylinositol 3-kinase/Akt/FOXO1 and ERK1 pathways in a Gi protein-dependent manner. C5b-9 induces sequential activation of CDK4 and CDK2, enabling the G1/S-phase transition and cellular proliferation. In addition, it induces RGC-32, a novel gene that plays a role in cell cycle activation by interacting with Akt and the cyclin B1-CDC2 complex. C5b-9 also inhibits apoptosis by inducing the phosphorylation of Bad and blocking the activation of FLIP, caspase-8, and Bid cleavage. Thus, sublytic C5b-9 plays an important role in cell activation, proliferation, and differentiation, thereby contributing to the maintenance of cell and tissue homeostasis.
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Affiliation(s)
- Cosmin A Tegla
- Department of Neurology, School of Medicine, University of Maryland, 655 W. Baltimore Street, BRB 12-033, Baltimore, MD 21201, USA
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12
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Ng G, Chau EMT, Shi Y. Recent Developments in Immune Activation by Uric Acid Crystals. Arch Immunol Ther Exp (Warsz) 2010; 58:273-7. [DOI: 10.1007/s00005-010-0082-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 02/11/2010] [Indexed: 12/21/2022]
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13
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Abstract
Uric acid crystals [monosodium urate (MSU)] have emerged as an important factor for both gouty arthritis and immune regulation. This simple crystalline structure appears to activate innate host defense mechanisms in multiple ways and triggers robust inflammation and immune activation. The recognition mechanisms of MSU following its phase change from soluble uric acid are diverse, involving both protein receptors and non-specific plasma membrane attachment. Upon contact with host cells, MSU induces a set of membrane events that trigger Syk and PI3K activation, phagocytosis, and cytokine production. Having entered the cell, MSU further triggers NALP3 inflammasome activation and induces the production of IL-1 beta, likely inducing a full spectrum of inflammation. This review describes the recognition mechanisms and activation pathways involved in MSU-mediated inflammation and adjuvanticity and hypothesizes that direct membrane binding by solid surfaces, such as MSU, may function as a generic mechanism in tissue responses to particulate and crystalline structures.
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Affiliation(s)
- Yan Shi
- Department of Microbiology and Infectious Diseases, and Immunology Research Group, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
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14
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15
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Nuki G. Colchicine: its mechanism of action and efficacy in crystal-induced inflammation. Curr Rheumatol Rep 2008; 10:218-27. [PMID: 18638431 DOI: 10.1007/s11926-008-0036-3] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
New light has been shed on the mechanisms of action of colchicine in crystal-associated arthropathies. Colchicine, long used to treat gout, arrests microtubule assembly and inhibits many cellular functions. At micromolar concentrations, it suppresses monosodium urate crystal-induced NACHT-LRR-PYD-containing protein-3 (NALP3) inflammasome-driven caspase-1 activation, IL-1beta processing and release, and L-selectin expression on neutrophils. At nanomolar concentrations, colchicine blocks the release of a crystal-derived chemotactic factor from neutrophil lysosomes, blocks neutrophil adhesion to endothelium by modulating the distribution of adhesion molecules on the endothelial cells, and inhibits monosodium urate crystal-induced production of superoxide anions from neutrophils. Cyto-chrome P450 3A4, the multidrug transporter P-glycoprotein, and the drugs that bind these proteins influence its pharmacokinetics and pharmacodynamics. Trial evidence supports its efficacy in acute gout and in preventing gout flares, but it has narrow therapeutic index, and overdosage is associated with gastrointestinal, hepatic, renal, neuromuscular, and cerebral toxicity; bone marrow damage; and high mortality.
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Affiliation(s)
- George Nuki
- University of Edinburgh, Osteoarticular Research Group, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, United Kingdom.
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Chen CJ, Shi Y, Hearn A, Fitzgerald K, Golenbock D, Reed G, Akira S, Rock KL. MyD88-dependent IL-1 receptor signaling is essential for gouty inflammation stimulated by monosodium urate crystals. J Clin Invest 2006; 116:2262-71. [PMID: 16886064 PMCID: PMC1523415 DOI: 10.1172/jci28075] [Citation(s) in RCA: 349] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 06/06/2006] [Indexed: 01/17/2023] Open
Abstract
While it is known that monosodium urate (MSU) crystals cause the disease gout, the mechanism by which these crystals stimulate this inflammatory condition has not been clear. Here we find that the Toll/IL-1R (TIR) signal transduction adaptor myeloid differentiation primary response protein 88 (MyD88) is required for acute gouty inflammation. In contrast, other TIR adaptor molecules, TIRAP/Mal, TRIF, and TRAM, are not required for this process. The MyD88-dependent TLR1, -2, -4, -6, -7, -9, and -11 and IL-18 receptor (IL-18R) are not essential for MSU-induced inflammation. Moreover, MSU does not stimulate HEK cells expressing TLR1-11 to activate NF-kappaB. In contrast, mice deficient in the MyD88-dependent IL-1R showed reduced inflammatory responses, similar to those observed in MyD88-deficient mice. Similarly, mice treated with IL-1 neutralizing antibodies also showed reduced MSU-induced inflammation, demonstrating that IL-1 production and IL-1R activation play essential roles in MSU-triggered inflammation. IL-1R deficiency in bone marrow-derived cells did not affect the inflammatory response; however, it was required in non-bone marrow-derived cells. These results indicate that IL-1 is essential for the MSU-induced inflammatory response and that the requirement of MyD88 in this process is primarily through its function as an adaptor molecule in the IL-1R signaling pathway.
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Affiliation(s)
- Chun-Jen Chen
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Yan Shi
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Arron Hearn
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Kate Fitzgerald
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Douglas Golenbock
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - George Reed
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Shizuo Akira
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Kenneth L. Rock
- Department of Pathology and
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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17
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Liu-Bryan R, Scott P, Sydlaske A, Rose DM, Terkeltaub R. Innate immunity conferred by Toll-like receptors 2 and 4 and myeloid differentiation factor 88 expression is pivotal to monosodium urate monohydrate crystal-induced inflammation. ACTA ACUST UNITED AC 2005; 52:2936-46. [PMID: 16142712 DOI: 10.1002/art.21238] [Citation(s) in RCA: 280] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In gout, incompletely defined molecular factors alter recognition of dormant articular and bursal monosodium urate monohydrate (MSU) crystal deposits, thereby inducing self-limiting bouts of characteristically severe neutrophilic inflammation. To define primary determinants of cellular recognition, uptake, and inflammatory responses to MSU crystals, we conducted a study to test the role of Toll-like receptor 2 (TLR-2), TLR-4, and the cytosolic TLR adapter protein myeloid differentiation factor 88 (MyD88), which are centrally involved in innate immune recognition of microbial pathogens. METHODS We isolated bone marrow-derived macrophages (BMDMs) in TLR-2-/-, TLR-4-/-, MyD88-/-, and congenic wild-type mice, and assessed phagocytosis and cytokine expression in response to endotoxin-free MSU crystals under serum-free conditions. MSU crystals also were injected into mouse synovium-like subcutaneous air pouches. RESULTS TLR-2-/-, TLR-4-/-, and MyD88-/- BMDMs demonstrated impaired uptake of MSU crystals in vitro. MSU crystal-induced production of interleukin-1beta (IL-1beta), tumor necrosis factor alpha, keratinocyte-derived cytokine/growth-related oncogene alpha, and transforming growth factor beta1 also were significantly suppressed in TLR-2-/- and TLR-4-/- BMDMs and were blunted in MyD88-/- BMDMs in vitro. Neutrophil influx and local induction of IL-1beta in subcutaneous air pouches were suppressed 6 hours after injection of MSU crystals in TLR-2-/- and TLR-4-/- mice and were attenuated in MyD88-/- mice. CONCLUSION The murine host requires TLR-2, TLR-4, and MyD88 for macrophage activation and development of full-blown neutrophilic, air pouch inflammation in response to MSU crystals. Our findings implicate innate immune cellular recognition of naked MSU crystals by specific TLRs as a major factor in determining the inflammatory potential of MSU crystal deposits and the course of gouty arthritis.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Animals
- Antigens, Differentiation/genetics
- Antigens, Differentiation/metabolism
- Arthritis, Gouty/genetics
- Arthritis, Gouty/immunology
- Arthritis, Gouty/metabolism
- Bone Marrow Cells/drug effects
- Bone Marrow Cells/metabolism
- Cytokines/metabolism
- Disease Models, Animal
- Immunity, Innate/immunology
- Macrophages/drug effects
- Macrophages/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Myeloid Differentiation Factor 88
- Phagocytosis/drug effects
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Specific Pathogen-Free Organisms
- Toll-Like Receptor 2
- Toll-Like Receptor 4
- Uric Acid/immunology
- Uric Acid/toxicity
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Affiliation(s)
- Ru Liu-Bryan
- VA Medical Center, University of California, San Diego 92161, USA.
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Affiliation(s)
- N Dalbeth
- Eric Bywaters Centre, Faculty of Medicine, Imperial College London, UK
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19
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Abstract
PURPOSE OF REVIEW The crystal-induced arthropathies are characterized by self-limiting episodes of acute inflammation and chronic tissue damage. This review summarizes recent advances in the understanding of the cellular responses to monosodium urate, calcium pyrophosphate dihydrate and basic calcium phosphate crystals. RECENT FINDINGS Factors such as the myeloid related proteins, endothelin-1 and the complement membrane attack complex have been recently identified as mediators of acute crystal-induced inflammation. In addition, signalling pathways involved in both acute inflammation and tissue damage in crystal arthropathies have been further clarified. The potential of macrophage-derived transforming growth factor beta1 to play a key role in the resolution phase of acute gout has also been demonstrated. SUMMARY Recent work has provided new insights into the regulation of both acute and chronic articular responses to inflammatory microcrystals. Further analysis of these responses may identify potential therapeutic targets for management of the crystal-induced arthropathies.
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Affiliation(s)
- Nicola Dalbeth
- Eric Bywaters Centre, Faculty of Medicine, Imperial College London, Hammersmith Campus, London, UK
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Szebeni J, Alving CR, Savay S, Barenholz Y, Priev A, Danino D, Talmon Y. Formation of complement-activating particles in aqueous solutions of Taxol: possible role in hypersensitivity reactions. Int Immunopharmacol 2001; 1:721-35. [PMID: 11357884 DOI: 10.1016/s1567-5769(01)00006-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We reported earlier that the anticancer drug paclitaxel (Taxol) activated the complement (C) system in human serum in vitro, raising the possibility that C activation might play a role in the ill-understood hypersensitivity reactions (HSRs) to this drug [J. Natl. Cancer Inst. 90 (1998) 300]. In pursuing the mechanism of C activation by Taxol, the present study provided evidence that dilution of the injection concentrate in aqueous solvents led to the formation of micelles and needle-like structures, both of which caused C activation in vitro. Micelles were formed mainly from Cremophor EL (CrEL), the nonionic emulsifier vehicle of paclitaxel, whose level in Taxol infusion exceeded its critical micelle concentration by at least 400-fold. CrEL micelles were shown by quasi-elastic light scattering and cryo-transmission electron microscopy (cryo-TEM) to be spherical with diameters in the 8-22 nm range; however, de novo formation of 50-300 nm microdroplets following incubation with human plasma suggested further fundamental structural transformation in blood. The needle-like structures extended to the multimicron range and were shown by electron diffraction to be crystalline paclitaxel. Taxol-induced C activation was manifested in varying rises of serum C3a-desarg, iC3b and SC5b-9. The causal role of CrEL micelles in C activation was demonstrated by the fact that filtration of aqueous solutions of Taxol or pure CrEL via 30-kDa cutoff filters eliminated, while the filter retentate restored C activation. C activation by Taxol was also inhibited by 10 mg/ml human immunoglobulin (IVIG). If proven clinically, HSRs to Taxol may represent a hitherto vaguely classified adverse drug reaction recently called C activation-related pseudoallergy (CARPA) [Circulation 99 (1999) 2302].
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Affiliation(s)
- J Szebeni
- Department of Membrane Biochemistry, Walter Reed Army Institute of Research, Silver Spring, MD 20910-3780, USA.
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21
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Affiliation(s)
- L Morris
- Rheumatology Unit, City Hospital, Nottingham, United Kingdom
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22
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Klaassen-Broekema N, Veldkamp KE, Van Bijsterveld OP. Can hydroxyapatite deposition in the eye cause a neutrophil-related inflammatory reaction? Doc Ophthalmol 1995; 90:325-30. [PMID: 8620817 DOI: 10.1007/bf01268120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Patients with chronic renal failure on intermittent dialysis sometimes develop an acute diffuse conjunctival and episcleral hyperaemia. In this study the hypothesis was tested whether the precipitation of hydroxyapatite crystals could result in an inflammatory reaction mediated by enzymes liberated from polymorphonuclear leucocytes (PMN). Ingestion of the crystals by PMN's can result in cell death and membranolysis and subsequent release of intracellular enzymes into the surrounding tissues. This 'suicide sac' hypothesis for the inflammatory reactions of the conjunctiva and episclera was rejected after histopathological examination of conjunctival biopsies failed to show complement activation or crystal ingestion by PMN's despite the presence of small subepithelial hydroxyapatite crystals.
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23
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Abbink JJ, Kamp AM, Nuijens JH, Erenberg AJ, Swaak AJ, Hack CE. Relative contribution of contact and complement activation to inflammatory reactions in arthritic joints. Ann Rheum Dis 1992; 51:1123-8. [PMID: 1444625 PMCID: PMC1012416 DOI: 10.1136/ard.51.10.1123] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Although both the complement and contact system are thought to contribute to the inflammatory reaction in arthritic joints, only activation of complement has so far been well established, whereas contact activation and its contribution to arthritis has not been systematically explored. Complement and contact activation were assessed in 71 patients with inflammatory arthropathies and 11 with osteoarthritis using sensitive assays for C3a, and C1-inhibitor (C1INH)-kallikrein and C1INH-factor XIIa complexes respectively. Increased plasma concentrations of kallikrein-and factor XIIa-C1INH complexes were found in two and seven of the 71 patients with inflammatory arthropathies, respectively, and in none of the patients with osteoarthritis. Increased synovial fluid concentrations of kallikrein and factor XIIa complexes occurred in 13 and 15 patients with inflammatory joint diseases respectively, and in two patients with osteoarthritis. Contact system parameters did not correlate with clinical symptoms, local activity, or neutrophil activation. In contrast, synovial fluid concentrations of C3a and C1INH-C1 complexes were increased in all patients and in 20 patients with inflammatory arthropathies respectively, and were higher in patients with a higher local activity score. Synovial fluid C3a correlated with parameters of neutrophil activation such as lactoferrin. Increased plasma concentrations of C3a and C1INH-C1 complexes occurred in 13 and 11 patients with inflammatory joint diseases, and in one and two patients with osteoarthritis respectively. Plasma concentrations of C3a correlated with the number of painful joints. Thus contact activation occurs only sporadically in patients with arthritis and contributes little if anything to the local inflammatory reaction and neutrophil activation. These latter events are significantly related to the extent of complement activation.
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Affiliation(s)
- J J Abbink
- Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, Amsterdam
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24
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Hajjar S, Mujais S. Crystal Induced Arthropathy in Uremia. Int J Artif Organs 1989. [DOI: 10.1177/039139888901201001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S.M Hajjar
- Department of Medicine, Northwestern University and VA Lakeside Medical Center, Chicago, IL-USA
| | - S.K. Mujais
- Department of Medicine, Northwestern University and VA Lakeside Medical Center, Chicago, IL-USA
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26
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Doherty M, Richards N, Hornby J, Powell R. Relation between synovial fluid C3 degradation products and local joint inflammation in rheumatoid arthritis, osteoarthritis, and crystal associated arthropathy. Ann Rheum Dis 1988; 47:190-7. [PMID: 2833185 PMCID: PMC1003482 DOI: 10.1136/ard.47.3.190] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
C3 degradation products (C3dg/d) were estimated in 288 synovial fluid (SF) samples (rheumatoid arthritis (RA) 93, osteoarthritis (OA) 68, chronic pyrophosphate arthropathy 80, acute pseudogout 20, others 27) from knees of 138 patients (bilateral 67, serial sampling on two to six occasions 40). At each aspiration knees were defined as 'active' or 'inactive' by single observer global assessment using six clinical parameters of inflammation. Lack of correlation between paired SF and plasma C3dg/d implied local C3 activation within joints. Raised SF C3d levels were found in active compared with inactive RA joints (mean (range) 51 (15-105) and 6 (0-15) units/ml respectively). Low SF C3dg/d levels were found in OA (mean (range) 0.8 (0-7) units/ml) and chronic pyrophosphate arthropathy (mean (range) 4 (0-16) units/ml), irrespective of clinical activity. In contrast, very high levels (mean (range) 61 (16-126) units/ml) were present in all cases of pseudogout. These differences remained after correction for SF C3 or albumin. This study is the first to show a positive correlation between SF C3dg/d and local inflammation in RA joints. It further suggests that C3 activation is a constant feature of pseudogout but not an accompaniment of inflammation associated with chronic crystal associated synovitis or OA.
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Affiliation(s)
- M Doherty
- Rheumatology Unit, City Hospital, Nottingham
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27
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Kennedy TD, Higgens CS, Woodrow DF, Scott JT. Crystal deposition in the knee and great toe joints of asymptomatic gout patients. J R Soc Med 1984; 77:747-50. [PMID: 6481756 PMCID: PMC1440018 DOI: 10.1177/014107688407700907] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Crystal deposition in asymptomatic knee and first metatarsophalangeal (MTP) joints has been studied in 31 patients with previously proven gout. All had had clinical gout in their MTP joints but their knee joints had never been the site of acute gout. Knee arthroscopy was performed permitting synovial membrane inspection, photography and biopsy. Crystalline material was seen in 9 knees (28%) and confirmed histologically as monosodium urate (MSU) in 4 (12.5%). Synovial fluid analysis on 26 samples using a polarizing light microscope demonstrated MSU crystals in 4 (12.5%) and calcium pyrophosphate dihydrate (CPPD) in 2 (6%). Fluid aspirated from 27 of the metatarsophalangeal joints revealed MSU crystals in 14 (52%) and no CPPD crystals.
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Proceedings of a symposium on crystal-related arthropathies. 22 October and 23 October, 1982, Bristol Polytechnic, Bristol. Ann Rheum Dis 1983; 42 Suppl 1:1-114. [PMID: 6615023 PMCID: PMC1035029 DOI: 10.1136/ard.42.suppl_1.1-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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