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Quaternary structure and metal ion requirement of family II pyrophosphatases from Bacillus subtilis, Streptococcus gordonii, and Streptococcus mutans.

Pyrophosphatase (PPase) from Bacillus subtilis has recently been found to be the first example of a family II soluble PPase with a unique requirement for Mn2+. In the present work, we cloned and overexpressed in Escherichia coli putative genes for two more family II PPases (from Streptococcus mutans and Streptococcus gordonii), isolated the recombinant proteins, and showed them to be highly specific and active PPases (catalytic constants of 1700-3300 s(-)1 at 25 degrees C in comparison with 200-400 s(-)1 for family I). All three family II PPases were found to be dimeric manganese metalloenzymes, dissociating into much less active monomers upon removal of Mn2+. The dimers were found to have one high affinity manganese-specific site (K(d) of 0.2-3 nm for Mn2+ and 10-80 microm for Mg2+) and two or three moderate affinity sites (K(d) approximately 1 mm for both cations) per subunit. Mn2+ binding to the high affinity site, which occurs with a half-time of less than 10 s at 1.5 mm Mn2+, dramatically shifts the monomer <--> dimer equilibrium in the direction of the dimer, further activates the dimer, and allows substantial activity (60-180 s(-)1) against calcium pyrophosphate, a potent inhibitor of family I PPases.

Bacillus subtilis↗

Crystal deposition in hypophosphatasia: a reappraisal.

Six subjects (three female, three male; age range 38-85 years) with adult onset hypophosphatasia are described. Three presented atypically with calcific periarthritis (due to apatite) in the absence of osteopenia; two had classical presentation with osteopenic fracture; and one was the asymptomatic father of one of the patients with calcific periarthritis. All three subjects over age 70 had isolated polyarticular chondrocalcinosis due to calcium pyrophosphate dihydrate crystal deposition; four of the six had spinal hyperostosis, extensive in two (Forestier's disease). The apparent paradoxical association of hypophosphatasia with calcific periarthritis and spinal hyperostosis is discussed in relation to the known effects of inorganic pyrophosphate on apatite crystal nucleation and growth.

Adult↗

Milwaukee shoulder syndrome. Fifteen additional cases and a description of contributing factors.

Fifteen additional patients with Milwaukee shoulder syndrome are described, bringing our total series to 30 cases. The condition occurred predominantly in elderly women and was characterized by severe glenohumeral joint degeneration and dissolution of the fibrous rotator cuff. Synovial fluids contained few leukocytes, but were often blood tinged. Basic calcium phosphate crystal aggregates and particulate collagens were noted in nearly all fluids, and collagenase activity was detectable in some, but not all, fluids. The knee joints were involved with a similar process in about half of our patients. In contrast to primary osteoarthritis, lateral tibiofemoral compartment involvement was common. Factors that may predispose to this syndrome included deposition of calcium pyrophosphate dihydrate crystals, direct trauma or chronic joint overuse, chronic renal failure, and denervation.

Aged↗

Calcium crystal deposition in the ligamentum flavum of the lumbar spine.

OBJECTIVE: To investigate the histological and immunohistochemical properties of the lumbar ligamentum flavum with calcium crystal deposition. METHODS: We examined the histological characteristics of the ligamentum flavum of the lumbar spine containing calcium deposits, obtained from 16 surgical cases with symptomatic lumbar spinal stenosis. Sections of the ligaments were also immunostained for elastase, chymotrypsin and S-100 protein, and examined by energy dispensive X-ray microanalysis and scanning electron microscopy. The results were compared with those of ligaments without calcium deposits. RESULTS: The elastic fibres of ligaments with calcium deposits showed marked degeneration (irregular arrangement and fragmentation of the fibre bundles) and nodular granulomatous lesions. Calcium crystal deposits were present in this area and in the nodular granulomatous areas. The calcified areas were surrounded by neutrophils and new small blood vessels. Immunostaining for elastase and chymotrypsin was positive in these areas, and S-100 protein-containing chondrocytes were detected around and within the calcified areas. Calcium pyrophosphate dihydrate crystals were identified in the calcified areas in all patients. CONCLUSION: Nodular degeneration of the elastic fibres of the ligament is probably caused by the action of proteolytic enzymes. Degeneration results in small granulomatous areas that form the nidus for calcium crystal deposition. Accumulated neutrophils, and S-100 protein-containing chondrocytes appear to precipitate the deposition of calcium crystals in the granulomatous lesions of the degenerated lumbar ligamentum flavum.

Adult↗

Calcification of the cervical ligamentum flavum--case report.

A 52-year-old male presented with calcification of the cervical ligamentum flavum manifesting as hypesthesia of the bilateral middle, ring, and little fingers and ulnar halves of both forearms, as well as motor weakness in the bilateral upper extremities and gait disturbance. Cervical x-ray tomography detected a round calcified mass on the posterior wall of the cervical canal at the C-5 level. Computed tomography showed the round, nodular calcified mass more clearly. Magnetic resonance imaging showed an epidural low intensity mass compressing and distorting the cervical cord at the C-5 level on both T1- and T2-weighted images. Administration of gadolinium-diethylenetriaminepenta-acetic acid caused marginal enhancement of the mass. The lesion was eventually removed by posterior laminectomy. The mass was composed of a very hard crystal-like calcified deposition in the ligamentum flavum. X-ray diffraction analysis of the histological specimen showed calcium pyrophosphate dihydrate (CPPD) and hydroxyapatite in the crystal-like substance, confirming that CPPD is responsible for calcification of the cervical ligamentum flavum.

Calcinosis↗

Inhibition of crystal-induced neutrophil activation by a protein tyrosine kinase inhibitor.

The objective of this work was to investigate the role of tyrosine kinase in monosodium urate monohydrate (MSUM) and calcium pyrophosphate dihydrate (CPPD) crystal-induced neutrophil activation using the tyrosine kinase inhibitor lavendustin C (LVC). Human neutrophils pretreated with LVC at concentrations between 10 and 150 microM or control neutrophils were stimulated by plasma-coated CPPD or uncoated MSUM, and chemiluminescence, superoxide generation, intracellular calcium concentration, and degranulation (myeloperoxidase and lysozyme release) were monitored with time. LVC strongly inhibited chemiluminescence, superoxide anion generation, myeloperoxidase and lysozyme release, and calcium mobilization. After 1-min crystal-neutrophil incubations, neutrophil cytosolic fractions showed extensive inhibition of tyrosine kinase activity by LVC. We conclude that the inhibition of neutrophil responses to crystal stimulation, by the protein tyrosine kinase inhibitor LVC, provides evidence that supports the involvement of tyrosine kinases in crystal-induced neutrophil activation.

Calcium↗

Mixed crystal deposition in an osteoarthritic joint.

The case of a 72-yr-old woman with osteoarthritis of the shoulder, is described. A mixture of crystals of hydroxyapatite and calcium pyrophosphate dihydrate was identified in the joint tissues using analytical electron microscopy and infra-red spectroscopy.

Aged↗

Crystal-induced protein tyrosine phosphorylation in neutrophils and the effect of a tyrosine kinase inhibitor on neutrophil responses.

A specific tyrosine kinase inhibitor, methyl 2,5-dihydroxycinnamate (mDHC), has been used to investigate the role of tyrosine kinases in monosodium urate monohydrate and calcium pyrophosphate dihydrate (CPPD) crystal-induced neutrophil activation. Both uncoated and plasma protein-coated CPPD crystals increased protein tyrosine phosphorylation in human neutrophils. Neutrophils pretreated with mDHC or control neutrophils were stimulated by plasma-opsonized CPPD, uncoated CPPD, or uncoated monosodium urate monohydrate, and chemiluminescence, superoxide generation, intracellular calcium concentration, degranulation (myeloperoxidase and lysozyme release), and protein tyrosine phosphorylation were monitored. mDHC strongly inhibited all neutrophil responses and tyrosine phosphorylation was reduced to the basal levels seen in control unstimulated neutrophils. The possible role of tyrosine kinases in the regulation of crystal-induced neutrophil activation is discussed.

Calcium↗

Psoriatic arthropathy and crystal-induced synovitis.

We demonstrated the simultaneous occurrence of psoriatic arthropathy and the 2 major types of crystalline arthritis--pseudogout and gout. The crystals found within aspirated synovial fluid and exudative leukocytes were unequivocally identified using the compensating polarizing microscope as calcium pyrophosphate dihydrate in one case and sodium monourate in the other. The surface topography of the intracellular sodium monourate crystals were also displayed.

Aged↗

The association of amyloid deposits and osteoarthritis.

Ten of eighteen consecutive patients who underwent total knee or hip arthroplasty for osteoarthritis had amyloid present in the surgically removed articular tissues. It was found in 6 of 13 cartilage specimens, 4 of 18 articular capsules, and 2 of 16 synovial membranes. In 3 of the cartilage specimens, the amyloid was adjacent to focal deposits of calcium pyrophosphate dihydrate crystals. Therefore, deposits of amyloid are not uncommon in osteoarthritis and may be more than incidental findings.

Age Factors↗

Cervical myelopathy attributable to pseudogout. Case report with radiologic, histologic, and crystallographic observations.

A 77-year-old woman complained of numbness in her hands and feet, progressive unsteadiness, weakness, and loss of proprioception of six months' duration. A myelogram revealed stenosis of the spinal canal at the levels of C2-3, T6-7, L2-3, and L3-4. On computerized tomography scan, a large dorsal, epidural, soft tissue mass and focal calcification of the ligamentum flavum were seen at C3. Laboratory studies ruled out gout, collagen disease, vitamin B12 deficiency, syphilis, parathyroid, and thyroid disease. At decompressive laminectomy, a nodular mass in the ligamentum flavum (C2-4) was found and removed. Three months after operation, the neurologic symptoms had improved. Histologic examination of the elastic ligament revealed deposits of birefringent crystals, which were identified by X-ray diffraction as calcium pyrophosphate dihydrate (CCPD). Only about six cases of myelopathy attributable to deposits of CPPD appear to have been previously reported.

Aged↗

Relationships between inhibition of rat polymorphonuclear chemotaxis and various inflammatory reactions.

An extension has been made of previous studies which linked the induction of inflammatory responses by carrageenan with the production or release of a factor which could be detected in the serum and which was capable of inhibiting leucocyte chemotaxis. Thus an inhibition of chemotaxis has been shown to be related also to inflammatory reactions provoked by calcium pyrophosphate and complete Freund's adjuvant and in the latter case the chemotaxis inhibition showed some correlation with the progress of the inflammatory reaction.

Animals↗

[Histological changes of the lumbar ligamentum flavum with age].

The present author investigated morphometrically the changes associated with age in 137 ligamenta flava of the lumbar spine obtained from 79 patients with lumbar diseases and obtained the following results. The predominant changes were decrease of elastic fibers and increase of collagen fibers. The area of type II collagen fibers increased with age in the dorsal and central portions. Those were followed by proliferation of cartilage cells and calcification. The proliferation of cartilage cells was marked in the cranial and caudal insertion portions, and the layer of cartilage cells widened with age. Two types of calcification, deposition of calcium pyrophosphate dihydrate (CPPD) and deposition of hydroxyapatite (HAP), were observed. HAP deposits were small and frequently found in the dorsal portion, while CPPD deposits were larger and widely distributed.

Adolescent↗

One of two chondrocyte-expressed isoforms of cartilage intermediate-layer protein functions as an insulin-like growth factor 1 antagonist.

OBJECTIVE: Aging and osteoarthritic (OA) cartilage commonly demonstrate enhanced expression of the large, transforming growth factor beta (TGFbeta)-inducible glycoprotein cartilage intermediate-layer protein (CILP) as well as enhanced extracellular inorganic pyrophosphate (PPi) that promotes the deposition of calcium pyrophosphate dihydrate crystals. In normal chondrocytes, TGFbeta induces elevated chondrocyte extracellular PPi. Insulin-like growth factor 1 (IGF-1) normally blocks this response and reduces extracellular PPi. However, chondrocyte resistance to IGF-1 is observed in OA and aging. Because CILP was reported to chromatographically fractionate with PPi-generating nucleotide pyrophosphatase phosphodiesterase (NPP) activity, it has been broadly assumed that CILP itself has NPP activity. Our objective was to directly define CILP functions and their relationship to IGF-1 in chondrocytes. METHODS: Using primary cultures of articular chondrocytes from the knee, we defined the function of the previously described CILP (CILP-1) and of a recently described 50.6% identical protein that we designated the CILP-2 isoform. RESULTS: Both CILP isoforms were constitutively expressed by primary cultured articular chondrocytes, but only CILP-1 expression was detectable in cultured knee meniscal cartilage cells. Neither CILP isoform had intrinsic NPP activity. But CILP-1 blocked the ability of IGF-1 to decrease extracellular PPi, an activity specific for the CILP-1 N-terminal domain. The CILP-1 N-terminal domain also suppressed IGF-1-induced (but not TGFbeta-induced) proliferation and sulfated proteoglycan synthesis, and it inhibited ligand-induced IGF-1 receptor autophosphorylation. CONCLUSION: Two CILP isoforms are differentially expressed by chondrocytes. Neither CILP isoform exhibits PPi-generating NPP activity. But, increased expression of CILP-1, via N-terminal domain-mediated inhibitory effects of CILP-1 on chondrocyte IGF-1 responsiveness, could impair chondrocyte growth and matrix repair and indirectly promote PPi supersaturation in aging and OA cartilage.

Alkaline Phosphatase↗

Variations in site and levels of expression of chondrocyte nucleotide pyrophosphohydrolase with aging.

The aim of this study was to identify changes in cartilage intermediate layer protein/nucleotide pyrophosphohydrolase (CILP/NTPPH) expression in articular cartilage during aging. Adult (3-4 years old) and young (7-10 days old) porcine articular hyaline cartilage and fibrocartilage were studied by Northern blot analysis, in situ hybridization, and immunohistochemistry using a complementary DNA (cDNA) probe encoding porcine CILP/NTPPH and antibody to a synthetic peptide corresponding to a CILP/NTPPH sequence. Northern blot analysis of chondrocytes showed lower expression of CILP/NTPPH messenger RNA (mRNA) in young cartilage than in adult cartilage. In adult cartilage, extracellular matrix from the surface to the middeep zone was immunoreactive for CILP/NTPPH, especially in the pericellular matrix surrounding the middeep zone chondrocytes. In young cartilage, chondrocytes were moderately immunoreactive for CILP/NTPPH throughout all zones except the calcified zone. The matrix of young cartilage was negative except in the superficial zone. In young cartilage, CILP/NTPPH mRNA expression was undetectable. In adult cartilage, chondrocytes showed strong mRNA expression for CILP/NTPPH throughout middeep zones. Protein and mRNA signals were not detectable below the tidemark. CILP/NTPPH secretion into matrix around chondrocytes increases with aging. In this extracellular site it may generate inorganic pyrophosphate and contribute to age-related calcium pyrophosphate dihydrate crystal deposition disease.

Aging↗

Treatment of refractory crystal-associated arthritis.

Crystal-associated arthritis includes gout, calcium pyrophosphate deposition (CPPD) disease, and the basic calcium phosphate (BCP)-related syndromes. In this article, the authors discuss the use of drug combinations and steroids for refractory gout patients and recommend management strategies for gout in the organ transplant recipient. Difficult cases of CPPD disease can be treated with colchicine and intra-articular steroids. The BCP-associated syndromes are best managed with NSAIDs and intraarticular measures. Experimental therapies for all forms of crystal-related arthritis are also discussed.

Acute Disease↗

[Pathomechanism of calcium phosphate arthropathy based on a case].

Authors describe the case of a 43 years old male patient with complaints and restriction of motions since years, localized on the talocrural joint. In the background of the disease, responding inadequately to the therapy, calcium pyrophosphate depositions were found in the joint tissues. As the pathomechanism of the disease is even presently not cleared authors summarize our present knowledge referring to this problem.

Adult↗