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Monosodium urate crystal

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https://www.readbyqxmd.com/read/28089200/limitations-of-the-current-standards-of-care-for-treating-gout-and-crystal-deposition-in-the-primary-care-setting-a-review
#1
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
January 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28078432/-evidence-based-recommendations-for-diagnostics-and-treatment-of-gouty-arthritis-in-the-specialist-sector-s2e-guidelines-of-the-german-society-of-rheumatology-in-cooperation-with-the-awmf
#2
REVIEW
U Kiltz, R Alten, M Fleck, K Krüger, B Manger, U Müller-Ladner, H Nüsslein, M Reuss-Borst, A Schwarting, H Schulze-Koops, A K Tausche, J Braun
Due to the increasing prevalence of gout, particularly in old age, the disease is becoming of increasing importance in Germany. Gout is one of the most common forms of recurrent inflammatory arthritis and is induced by the deposition of monosodium urate crystals in synovial fluid and other tissues. The principal goals of therapy in chronic gout are the symptomatic treatment of the acute joint inflammation and the causal treatment of the underlying metabolic cause, the hyperuricemia. Only a consistent and permanent reduction of the serum uric acid level ultimately results in an efficient avoidance of further gout attacks and therefore the prevention of structural damage...
January 11, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28068647/berberine-an-isoquinoline-alkaloid-suppresses-txnip-mediated-nlrp3-inflammasome-activation-in-msu-crystal-stimulated-raw-264-7-macrophages-through-the-upregulation-of-nrf2-transcription-factor-and-alleviates-msu-crystal-induced-inflammation-in-rats
#3
Palani Dinesh, MahaboobKhan Rasool
The current study was designed to investigate the therapeutic potential of berberine on monosodium urate (MSU) crystal stimulated RAW 264.7 macrophages and in MSU crystal induced rats. Our results indicate that berberine (25, 50 and 75μM) suppressed the levels of pro-inflammatory cytokines (interleukin-1beta (IL-1β) and tumor necrosis factor alpha (TNFα)) and intracellular reactive oxygen species in MSU crystal stimulated RAW 264.7 macrophages. The mRNA expression levels of IL-1β, caspase 1, nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3), thioredoxin interacting protein (TXNIP) and kelch-like ECH-associated protein 1 (Keap1) were found downregulated with the upregulation of nuclear factor erythroid-2-related factor 2 (Nrf2) transcription factor and its associated anti-oxidant enzymes: Heme oxygenase I (HO-1), superoxide dismutase (SOD1), glutathione peroxidase (GPx), NADPH quinone oxidoreductase-1 (NQO1) and catalase (CAT) in MSU crystal stimulated RAW 264...
January 6, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28068545/design-preparation-and-characterization-of-ph-responsive-prodrug-micelles-with-hydrolyzable-anhydride-linkages-for-controlled-drug-delivery
#4
Girija Seetharaman, Adarsh R Kallar, Vineeth M Vijayan, Jayabalan Muthu, Shivaram Selvam
We report a new prodrug micelle-based approach in which a model hydrophobic non-steroidal anti-inflammatory drug (NSAID), ibuprofen (Ibu), is tethered to amphiphilic methoxy polyethylene glycol-polypropylene fumarate (mPEG-PPF) diblock copolymer via hydrolytic anhydride linkages for potential controlled release applications of NSAIDs. Synthesized mPEG-PPF-Ibu polymer drug conjugates (PDCs) demonstrated high drug conjugation efficiency (∼90%) and self-assembled to form micellar nanostructures in aqueous medium with critical micelle concentrations ranging between 16 and 30μg/mL...
December 31, 2016: Journal of Colloid and Interface Science
https://www.readbyqxmd.com/read/28067087/oral-delivery-of-allopurinol-niosomes-in-treatment-of-gout-in-animal-model
#5
Neelu Singh, Poonam Parashar, Chandra Bhushan Tripathi, Jovita Kanoujia, Gaurav Kaithwas, Shubhini A Saraf
CONTEXT: Gout is a painful disorder which does not have an efficient delivery system for its treatment. OBJECTIVE: Development and in vitro, in vivo evaluation of allopurinol loaded nonionic surfactant based niosomes was envisaged. MATERIALS AND METHODS: Niosomes were prepared with Span 20 and Tween 20(1:1 molar ratio) using ether injection method. The formulations were screened for entrapment efficiency, particle size analysis, zeta potential, release kinetics, in vivo activity and stability studies...
January 8, 2017: Journal of Liposome Research
https://www.readbyqxmd.com/read/27995621/annexin-a1-promotes-timely-resolution-of-inflammation-in-murine-gout
#6
Izabela Galvão, Juliana P Vago, Livia C Barroso, Luciana P Tavares, Celso M Queiroz-Junior, Vivian V Costa, Fernanda S Carneiro, Tatiana P Ferreira, Patricia M R Silva, Flávio A Amaral, Lirlândia P Sousa, Mauro M Teixeira
Gout is a self-limited inflammatory disease caused by deposition of monosodium urate (MSU) crystals in the joints. Resolution of inflammation is an active process leading to restoration of tissue homeostasis. Here, we studied the role of Annexin A1 (AnxA1), a glucocorticoid-regulated protein that has anti-inflammatory and pro-resolving actions, in resolution of acute gouty inflammation. Injection of MSU crystals in the knee joint of mice induced inflammation that was associated with expression of AnxA1 during the resolving phase of inflammation...
December 19, 2016: European Journal of Immunology
https://www.readbyqxmd.com/read/27994273/tophi-surgical-treatment
#7
Iwona Słowińska, Radosław Słowiński, Lidia Rutkowska-Sak
Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment...
2016: Reumatologia
https://www.readbyqxmd.com/read/27989588/acute-phospholipid-microspherule-associated-arthritis-is-it-rare
#8
Guillaume Coiffier, Jean-David Albert, François Robin, Pascal Guggenbuhl
Joint fluid analysis must be performed as part of the diagnostic workup for acute arthritis, most notably to rule out septic arthritis and to allow the identification of crystal-induced arthritis (gout or calcium pyrophosphate deposition disease), which is one of the most common causes. However, the detection of monosodium urate or calcium pyrophosphate microcrystals is not the only goal of the polarized light microscopy examination of joint fluid. Other, less common microcrystals may be found. Among them are phospholipid microspherules, which are easily recognized microscopically based on their Maltese cross-like appearance...
December 15, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27960024/-hyperuricemia-and-gout
#9
Elisa Delbarba, Vincenzo Terlizzi, Nadia Dallera, Claudia Izzi, Francesco Scolari
Already known to ancient Egyptians, gout is one of the first diseases which have been described as a clinical entity. To date, gout is the most common form of inflammatory arthritis. Gout is defined by the deposition of monosodium urate crystals within tissues, causing episodes of acute arthritis and the development of tophi, nephrolithiasis, and urate nephropathy. Hyperuricemia, i.e. levels of serum uric acid above 6.8 mg / dL(404mol/L), is a condition necessary, yet not sufficient for gout to develop. The increasing incidence of risk factors such as hypertension, obesity, and renal failure together with an ever-growing life expectancy has led in recent decades to a significant increase in gout prevalence, which has more than doubled when compared to the 1960s...
2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27941389/factors-modulating-the-inflammatory-response-in-acute-gouty-arthritis
#10
Maartje C Cleophas, Tania O Crişan, Leo A B Joosten
PURPOSE OF REVIEW: Gout is a common debilitating form of arthritis and despite our extensive knowledge on the pathogenesis its prevalence is still rising quickly. In the current review, we provide a concise overview of recent discoveries in factors tuning the inflammatory response to soluble uric acid and monosodium urate crystals. RECENT FINDINGS: It appears that soluble uric acid has a much larger role to play than just being a risk factor for gout. It may have widespread consequences for systemic inflammation and the development of metabolic syndrome...
December 9, 2016: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27931959/imaging-of-gout-new-tools-and-biomarkers
#11
REVIEW
Elizabeth G Araujo, Bernhard Manger, Fernando Perez-Ruiz, Ralf G Thiele
While joint aspiration and crystal identification by polarizing microscopy remain the gold standard for diagnosing tophaceous gout, agreement among medical and ancillary health personnel examining synovial fluid using polarizing microscopy for the detection of monosodium urate (MSU) crystals appears to be poor. Imaging modalities, including conventional radiography (CR), ultrasonography (US), magnetic resonance imaging (MRI), and dual-energy computed tomography (DECT), have been found to provide information on the deposition of MSU crystals in tissues, and the consequences of such deposition...
August 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27929277/acute-monoarthritis-diagnosis-in-adults
#12
Jonathan A Becker, Jennifer P Daily, Katherine M Pohlgeers
Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities. A delay in diagnosis and treatment, particularly in septic arthritis, can have catastrophic results including sepsis, bacteremia, joint destruction, or death. The history and physical examination can help guide the use of laboratory and imaging studies...
November 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27927043/allopurinol-insights-from-studies-of-dose-response-relationships
#13
Richard O Day, Diluk R W Kannangara, Sophie L Stocker, Jane E Carland, Kenneth M Williams, Garry G Graham
Gout is the most common inflammatory arthritis in men and is increasingly prevalent. Allopurinol is very effective at reducing plasma urate concentrations to a level sufficient to dissolve monosodium urate crystals. However, many patients fail to achieve a sufficient therapeutic response to allopurinol. Areas covered: This review covers the metabolism and pharmacokinetics of allopurinol and its active metabolite, oxypurinol and how these factors affect the plasma concentrations of urate at initiation and during long-term therapy with allopurinol...
December 20, 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27917897/blood-borne-phagocytes-internalize-urate-microaggregates-and-prevent-intravascular-netosis-by-urate-crystals
#14
Elmar Pieterse, Ivica Jeremic, Christine Czegley, Daniela Weidner, Mona H C Biermann, Susan Veissi, Christian Maueröder, Christine Schauer, Rostyslav Bilyy, Tetiana Dumych, Markus Hoffmann, Luis E Munoz, Anders A Bengtsson, Georg Schett, Johan van der Vlag, Martin Herrmann
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...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27903743/uric-acid-crystals-induce-placental-inflammation-and-alter-trophoblast-function-via-an-il-1-dependent-pathway-implications-for-fetal-growth-restriction
#15
Marie-Eve Brien, Cyntia Duval, Julia Palacios, Ines Boufaied, Andrée-Anne Hudon-Thibeault, Mathieu Nadeau-Vallée, Cathy Vaillancourt, Colin P Sibley, Vikki M Abrahams, Rebecca L Jones, Sylvie Girard
Excessive placental inflammation is associated with several pathological conditions, including stillbirth and fetal growth restriction. Although infection is a known cause of inflammation, a significant proportion of pregnancies have evidence of inflammation without any detectable infection. Inflammation can also be triggered by endogenous mediators, called damage associated molecular patterns or alarmins. One of these damage-associated molecular patterns, uric acid, is increased in the maternal circulation in pathological pregnancies and is a known agonist of the Nlrp3 inflammasome and inducer of inflammation...
January 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27903742/p2y6-receptor-antagonist-mrs2578-inhibits-neutrophil-activation-and-aggregated-neutrophil-extracellular-trap-formation-induced-by-gout-associated-monosodium-urate-crystals
#16
Payel Sil, Craig P Hayes, Barbara J Reaves, Patrick Breen, Shannon Quinn, Jeremy Sokolove, Balázs Rada
Human neutrophils (polymorphonuclear leukocytes [PMNs]) generate inflammatory responses within the joints of gout patients upon encountering monosodium urate (MSU) crystals. Neutrophil extracellular traps (NETs) are found abundantly in the synovial fluid of gout patients. The detailed mechanism of MSU crystal-induced NET formation remains unknown. Our goal was to shed light on possible roles of purinergic signaling and neutrophil migration in mediating NET formation induced by MSU crystals. Interaction of human neutrophils with MSU crystals was evaluated by high-throughput live imaging using confocal microscopy...
January 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27900275/spinal-gout-a-review-with-case-illustration
#17
Hossein Elgafy, Xiaochen Liu, Joseph Herron
AIM: To summarize clinical presentations and treatment options of spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation. METHODS: The authors reviewed 68 published cases of spinal gout, which were collected by searching "spinal gout" on PubMed from 2000 to 2014. The data were analyzed for clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27863506/interleukin-37-limits-monosodium-urate-crystal-induced-innate-immune-responses-in-human-and-murine-models-of-gout
#18
Lei Liu, Yu Xue, Yingfeng Zhu, Dandan Xuan, Xue Yang, Minrui Liang, Juan Wang, Xiaoxia Zhu, Jiong Zhang, Hejian Zou
BACKGROUND: Interleukin (IL)-37 has emerged as a fundamental inhibitor of innate immunity. Acute gout is a self-limiting inflammatory response to monosodium urate (MSU) crystals. In the current study, we assessed the preventive and therapeutic effect of recombinant human IL-37 (rhIL-37) in human and murine gout models. METHODS: We investigated the expression of IL-37 in patients with active and inactive gouty arthritis and assessed the effect of rhIL-37 in human and murine gout models: a human monocyte cell line (THP-1) and human synovial cells (containing macrophage-like and fibroblast-like synoviocytes) exposed to MSU crystals, a peritoneal murine model of gout and a murine gouty arthritis model...
November 18, 2016: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/27853847/macrophage-derived-il-1%C3%AE-enhances-monosodium-urate-crystal-triggered-net-formation
#19
Payel Sil, Haley Wicklum, Chandler Surell, Balázs Rada
OBJECTIVE AND DESIGN: Arthritic gout is caused by joint inflammation triggered by the damaging effects of monosodium uric acid (MSU) crystal accumulation in the synovial space. Neutrophils play a major role in mediating joint inflammation in gout. Along with neutrophils, other immune cells, such as macrophages, are present in inflamed joints and contribute to gout pathogenesis. Neutrophils form neutrophil extracellular traps (NETs) in response to MSU crystals. In the presence of MSU crystals, macrophages release IL-1β, a cytokine crucial to initiate gout pathogenesis and neutrophil recruitment...
November 16, 2016: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
https://www.readbyqxmd.com/read/27837341/crystal-identification-of-synovial-fluid-aspiration-by-polarized-light-microscopy-an-online-test-suggesting-that-our-traditional-rheumatologic-competence-needs-renewed-attention-and-training
#20
D Berendsen, T Neogi, W J Taylor, N Dalbeth, T L Jansen
Testing a reading exercise for identification of several typical crystal such as the negatively birefringent needle-shaped crystals that are under polarized light microscopy is the gold standard for diagnosing gout. The objective of this study was to assess current performance of crystal identification by professionals involved in examining synovial fluid in routine care. Rheumatologists, trainees, lab technicians, and other physicians with an interest in crystal arthritis completed an online test. The test consisted of 30 images: 8 monosodium urate (MSU) crystals, 5 calcium pyrophosphate (CPP), 4 cholesterol, 2 depot methylprednisolone, 2 calcium oxalate, 2 rice bodies, 1 hydroxyapatite, 1 liquid lipid, 1 fibrin, 1 Charcot-Leyden, and 5 different artifacts...
November 11, 2016: Clinical Rheumatology
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