Regulation of crystal induced inflammation: current understandings and clinical implications.

Paola Galozzi, Sara Bindoli, Roberto Luisetto, Paolo Sfriso, Roberta Ramonda, Anna Scanu, Francesca Oliviero

Journal: Expert review of clinical immunology 2022;17(7):773-787

PMID: 34053376

Abstract

: 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.: 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.: 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 and 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.

Address: Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy.; Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padova, Padova, Italy.

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