Fernández-Torres Javier, Martínez-Flores Karina, Puerta-Escalante Indira Xiomara, Montaño-Armendariz Nathalie, Suárez-Ahedo Carlos, Ilizaliturri-Sánchez Víctor, Espinosa-Morales Rolando, Lozada-Pérez Carlos Alberto, Zamudio-Cuevas Yessica
Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Alcaldía Tlalpan, Calzada México-Xochimilco 289, C.P. 14389, Mexico City, Mexico.
División de Reumatología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Alcaldía Tlalpan, Calzada México-Xochimilco 289, C.P. 14389, Mexico City, Mexico.
Clin Rheumatol. 2025 Jan;44(1):433-441. doi: 10.1007/s10067-024-07220-y. Epub 2024 Nov 6.
Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).
To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.
Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and HO levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.
Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r = - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r = - 0.431, P = 0.011), WBC with HO (r = 0.454, P = 0.007), and ROS with HO (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between HO and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).
ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.
在大多数受严重骨关节炎（OA）影响的关节中观察到焦磷酸钙（CPP）晶体沉积。CPP可能通过引发炎症过程和氧化应激（OS）导致局部损伤。
评估CPP沉积诱导的炎症和OS及其与膝关节OA程度的关联。
分析根据美国风湿病学会（ACR）标准分类为3级和4级OA患者的滑液（SF）。对活性氧（ROS）和羟基（HO）水平进行定量，并通过白细胞（WBC）计数评估炎症。通过偏振光显微镜检测CPP晶体。采用多因素降维法（MDR）来可视化变量之间可能的交互作用。
分析了56份SF，其中22份（39.28%）为中度OA，34份（60.71%）为重度OA。在17份中度OA和18份重度OA样本中鉴定出CPP晶体。在中度OA中，CPP阳性组的ROS水平显著更高（5.0%对2.0%，P = 0.03）。体重指数与CPP显著相关（r = -0.439，P = 0.041）。在重度OA组中，年龄与WBC显著相关（r = -0.431，P = 0.
