Abstract
Calcium Pyrophosphate Crystal Deposition (CPPD) disease is characterized by the deposition of calcium pyrophosphate crystals in the cartilage. In most cases, it can manifest as a subclinical condition named chondrocalcinosis, often revealed by joint x-ray examination. In other cases, deposition can cause flares of arthritis, known as acute CPP crystal arthritis. In the last few years, many pathogenic pathways have been discovered. Interleukin-1 (IL-1) plays a key role in the pathogenesis of CPPD disease, both as a mediator of inflammatory response to crystals and as a promoter of damage to articular cartilage. In this review, we investigated the role of IL-1R inhibitor, such as Anakinra, as an alternative to the various therapeutic strategies for CPPD disease, especially among patients resistant to traditional treatment with NSAIDs, corticosteroids and colchicine.
Highlights
Calcium Pyrophosphate Crystal Deposition (CPPD) Disease is characterized by the deposition of Calcium Pyrophosphate crystals in the cartilage [1]
IL-1 is produced by activated macrophages and monocytes; it can induce and orchestrate a proinflammatory response resulting from the activation of various enzymes that mediate the production of further proinflammatory cytokines, such as PGE2, or proinflammatory mediators like nitric oxide (NO)
This response is synergized by the suppression of other factors that have an antagonist effect compared to IL-1, such as peroxisome proliferator-activated receptor γ (PPARγ)
Summary
Calcium Pyrophosphate Crystal Deposition (CPPD) Disease is characterized by the deposition of Calcium Pyrophosphate crystals in the cartilage [1]. Moltò et al reported a small case series of five patients with CPP-induced arthritis, with a flare lasting, on average, 45 ± 15 days. Similar results are shown by Ottaviani et al In their case series, 16 patients with CCP induced arthritis, with a mean age of 80.2 years and mean duration of flare of 10.7 days, showed at baseline mean VAS pain of 78.7, mean tender joint count (TJC) of 6.9 and mean swollen joint count (SJC) of 6.3.
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