Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Octacalcium Phosphate (OCP) Crystals Induce Synovial Inflammation and Cartilage.

Busso1,  Nathalie, Chobaz3,  Véronique, Bagnoud3,  Nathaliane, Van Lent5,  Peter, Nguyen4,  Christelle, Liote4,  Frédéric, So2,  Alexander

Department of Rheumatology, DAL CHUV, Lausanne, Switzerland
Department of Rheumatology, DAL, CHUV, Lausanne, Switzerland
Department of Rheumatology, DAL, CHUV, Lausanne, Switzerland
INSERM U606, Hospital Lariboisière, University Paris VII, Paris, France
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Introduction:

The presence of intra-articular basic calcium phosphate (BCP) crystals, including OCP, carbonated-apatite, hydroxyapatite and tricalcium phosphate crystals, is associated with severe osteoarthritis and destructive arthropathies such as Milwaukee shoulder. Although BCP crystals displayed, in vitro, mitogenic, anabolic and catabolic responses, their intra-articular effect was never assessed.

Objective:

To determine the effects of OCP crystals in joints in vivo.

Methods:

OCP crystals (200 ug in 20 ml PBS) were injected into the right knee joint (the contra-lateral knee joint injected with 20 ul of PBS serving as a control) of wild-type mice treated or not by the IL1R antagonist Anakinra or mice deficient for the inflammasome proteins ASC and NALP3. 4 days and 17 days after crystal injection, mice were sacrificed and knee joints dissected. Histological scoring for synovial inflammation and characterisation of macrophages, neutrophils and T cells were performed. Technetium (Tc) uptake was measured at 6h, 1 and 4 days after OCP injection. Cartilage degradation was evaluated by Safranin O staining and VDIPEN immunohistochemistry. Intra-articular localisation of injected OCP crystals was evidenced by Von Kossa staining.

Results:

The intra-articular localisation of injected OCP crystals was evidenced by Von Kossa staining performed on non-decalcified samples embedded in methyl-metacrylate. Injection of OCP crystals into knee joints led at day 4 to an inflammatory response with intense macrophage staining and also some neutrophil recruitment in the synovial membrane. This synovitis was not accompanied by increased Tc uptake into the knee joint, Tc uptake being similar in OCP crystal injected knee or control knee at all time points investigated (6h, 1 day, 4 days). The histological modifications persisted over 17 days, with an additional fibrosis evidenced at this later time-point. The OCP crystal-induced synovitis was totally IL-1a and IL-1 independent as shown by the absence of inhibitory effects of anakinra injected into wild-type mice. Accordingly, OCP crystal-induced synovitis was similar in ASC-/- and NALP3-/- mice as no alterations of inflammation were demonstrated between these mice groups. Concerning cartilage matrix degradation, OCP crystals induced a strong breakdown of proteoglycans 4 and 17 days after injection, as measured by loss of red staining from Safranin O-stained sections of cartilage surfaces. In addition, we also measured advanced cartilage matrix destruction mediated by MMPs, as evidenced by VDIPEN staining of cartilage. OCP-mediated cartilage degradation was similar in all experimental conditions tested (WT+Anakinra, or ASC or NALP3 deficient mice).

Conclusion:

These data indicate in vivo that the intra-articular presence of OCP crystals is associated with cartilage destruction along with synovial inflammation. This is an interesting and new model of destructive arthropathy related to BCP crystals which will allow to assess new therapies in this disease.

To cite this abstract, please use the following information:
Busso, Nathalie, Chobaz, Véronique, Bagnoud, Nathaliane, Van Lent, Peter, Nguyen, Christelle, Liote, Frédéric, et al; Octacalcium Phosphate (OCP) Crystals Induce Synovial Inflammation and Cartilage. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2151
DOI: 10.1002/art.29915

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