Summary
Electron microscopy was used to investigate the characteristics of calcium pyrophosphate dihydrate (CPPD) crystals in chondrocalcinosis (pseudogout syndrome). Crystals in midzone cartilage were frequently seen adjacent to chondrocytes. Great variation in crystal size and shape was observed. Most of the pyrophosphate crystals that had been phagocytosed by polymorphonuclear leukocytes of synovial fluid from patients with acute pseudogout were small (≦1 μm), indicating that small crystals can cause intense inflammation. Large numbers of polymorphonuclear leukocytes became attached to the eroded articular surface and phagocytosed microcrystals. Interaction of polymorphonuclear leukocytes with CPPD crystals in the superficial region of articular cartilage may stimulate the release of inflammatory mediators.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
McCarty DJ, Hogan JM, Gatter RA (1966) Studies on pathological calcification in human cartilage. Prevalence and types of crystal deposits in menisci of two hundred and fifteen cadavers. J Bone Joint Surg [Am] 48:309–325
Ryan LM, Cheung HS, McCarty DJ (1981) Release of pyrophosphate by normal mammalian articular hyaline and fibrocartilage in organ culture. Arthritis Rheum 24:1522–1527
Howell DS, Muniz O, Pita JC (1975) Extrusion of pyrophosphate into extracellular media by osteoarthritis cartilage incubates. J Clin Invest 56:1473–1480
McCarty DJ (1977) Calcium pyrophosphate dihydrate crystal deposition disease: nomenclature and diagnostic criteria. Ann Int Med 87:240–242
McCarty DJ (1984) Crystal deposition disease. In: McCarty DJ (ed) Landmark advances in rheumatology. American Rheumatism Association, Atlanta, pp 74–88
Gatter RA (1975) The compensated polarized light microscope in clinical rheumatology. Arthritis Rheum 17:235–255
Bjelle A, Crocker P, Willoughby A (1980) Ultra-microcrystals in pyrophosphate arthropathy. Acta Med Scand 207:89–92
Kohn NN, Hughes RE, McCarty DJ (1962) The significance of calcium pyrophosphate crystals in the synovial fluid of arthritic patients: the pseudogout syndrome. II. Identification of crystals. Ann Intern Med 56:738–745
McCarty DJ (1977) Calcium pyrophosphate dihydrate crystal deposition disease (pseudogout syndrome) — clinical aspect. Clin Rheum Dis 3:61–89
Reginato AJ, Schumacher HR, Martinez VA (1974) The articular cartilage in familial chondrocalcinosis and pseudogout. Arthritis Rheum 17:977–992
Schumacher HR (1976) Ultrastructural findings in chondrocalcinosis and pseudogout. Arthritis Rheum 19:413–425
Lagier R, Boivin G, Gerster J (1985) Carpal tunnel syndrome associated with mixed calcium pyrophosphate dihydrate and apatite crystal deposition in tendon synovial sheath. Arthritis Rheum 27:1190–1195
McCarty DJ (1985) Crystal induced inflammation and its treatment. In: Arthritis and allied conditions, 10th edn. Lea and Febiger, Philadelphia, pp 1494–1514
Miltrovic DR (1983) Pathology of articular deposition of calcium salts and their relationship to osteoarthritis. Ann Rheum Dis 42:519–526
Boivin G, Lagier R (1983) An ultrastructural study of articular chondrocalcinosis in cases of knee osteoarthritis. Virchows Arch 400:13–29
Cheung HE, Halverson PB, McCarty DJ (1983) Phagocytosis of hydroxyapatite or calcium pyrophosphate dihydrate crystals by rabbit chondrocytes stimulates release of collagenase, neutral protease and prostagrandins E2 and F2. Proc Soc Exp Biol Med 173:181–189
McCarty DJ (1972) Pseudogout. In: Hollander JL, McCarty DJ (eds) Arthritis and allied conditions. Lea and Febiger, Philadelphia, pp 1140–1160
Ishikawa H, Smiley JD, Ziff M (1976) Electron microscopic demonstration of immunoglobulin deposition in rheumatoid cartilage. Arthritis Rheum 18:563–576
Ugai K, Ishikawa H, Hirohata K (1983) Interaction of polymorphonuclear leukocytes with immune complexes trapped in rheumatoid articular cartilage. Arthritis Rheum 26:1434–1441
Weissman G (1977) Lysosomes and rheumatoid inflammation. Arthritis Rheum 20:s193-s204
Henson PM (1971) The immunologic release of constituents from neutrophilic leukocytes. I. The role of antibody and complement on non-phagocytable surface or phagocytosable particles. J Immunol 107:1535–1546
McCarty DJ (1976) Calcium pyrophosphate dihydrate crystal deposition disease-1975. Arthritis Rheum 19:275–285
Howell DS, Muniz O, Pita JC (1976) Pyrophosphate release by osteoarthritis cartilage incubates. Arthritis Rheum 19:488–494
Rusell RGG, Biasz S, Fleisch H et al (1970) Inorganic pyrophosphate in plasma, urine, and synovial fluid of patients with pyrophosphate arthropathy (chondrocalcinosis or pseudogout). Lancet II:899–902
McCarty DJ, Solomon SD, Warnock ML (1971) Inorganic pyrophosphate concentrations in synovial fluid of arthritis patients. J Lab Clin Med 78:216–229
Silcox DC, McCarty DJ (1974) Elevated inorganic pyrophosphate concentration on synovial fluid in osteoarthritis and pseudogout. J Lab Clin Med 83:518–531
Camerlain M, McCarty DJ, Silcox DC et al (1975) Inorganic pyrophosphate pool size and turnover rate in arthritis joint. J Clin Invest 55:1373–1381
Bennet RM, Lehr JR, McCarty DJ (1976) Crystal shedding and acute pseudogout: a hypothesis based on a therapeutic failure. Arthritis Rheum 19:93–97
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ishikawa, H., Ueba, Y., Isobe, T. et al. Interaction of polymorphonuclear leukocytes with calcium pyrophosphate dihydrate crystals deposited in chondrocalcinosis cartilage. Rheumatol Int 7, 217–221 (1987). https://doi.org/10.1007/BF00541380
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00541380