Kalziumkristalle im Gelenk

ZUSAMMENFASSUNG

Es gibt im Wesentlichen 2 Arten von Kalziumkristallen im Gelenk. Zum einen gibt es Kalziumphosphatkristalle (BCP) und zum anderen gibt es Kalziumpyrophosphatkristalle (CPPD). BCP-Kristalle sind mit der Arthrose assoziiert und entstehen durch die hypertrophe Differenzierung von Chondrozyten. CPPD-Kristalle sind mit der Chondrokalzinose assoziiert. Hier ist die Entstehung noch nicht vollständig verstanden. Die Kalziumkristalle lösen eine entzündliche Reaktion im Gelenk aus und induzieren die Sekretion von proinflammatorischen Zytokinen. Unterschiedliche direkte oder indirekte Signalwege sind hierfür bereits beschrieben worden und werden im Text näher erläutert. Die bisherigen Therapien greifen hauptsächlich in das Entzündungsgeschehen ein. Es gibt bisher wenige Ansätze einer gezielten Kristall-abhängigen oder insbesondere Kristall-auflösenden Therapie. Durch besseres Verständnis der zu Grunde liegenden Signalwege wird in Zukunft eventuell eine derartige Therapie zur Verfügung stehen, sodass gezielt die Kalziumkristalle aufgelöst oder die spezifischen Signalwege inhibiert werden können.

ABSTRACT

There are 2 main types of calcium crystals in the joint. On the one hand there are calcium phosphate crystals (BCP) and on the other hand there are calcium pyrophosphate crystals (CPPD). BCP crystals are associated with osteoarthritis and occur due to the hypertrophic differentiation of chondrocytes. CPPD crystals are associated with chondrocalcinosis. The origin of these crystals is not yet fully understood. The calcium crystals trigger an inflammatory reaction in the joint and induce the secretion of pro-inflammatory cytokines. Different direct or indirect signaling pathways have already been established and are explained in more detail in the following paragraphs. Current therapies for calcium crystal induced arthropathies mainly interrupt the inflammatory cascades. So far there have been few approaches to directly target crystal-dependent signaling pathways, or to dissolve the crystal themselves. With a better understanding of the underlying signaling pathways, such a therapy might be available in the future, giving the possibility to dissolve the calcium crystals or specifically inhibit the signaling pathways.

Schlüsselwörter

BCP - CPPD - Chondrozyt - Arthrose - Chondrokalzinose - Entzündung

Keywords

BCP - CPPD - chondrocyte - osteoarthritis - chondrocalcinosis - inflammation

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