Skip to main content
SpringerLink
Log in

Role of Local Factors in the Precipitation of Urate Crystals

  • Chapter
Uric Acid

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 51))

Abstract

Over the past 15 years, the urate crystal has become accepted as the fundamental local factor in the pathogenesis of gout (McCarty and Hollander, 1961; McCarty, 1977). In this concept, formation of crystals is the primary event underlying all gout, with acute arthritis or the growth of tophi invariably being secondary crystal-induced responses. Clearly, the conditions leading to urate precipitation are of paramount importance to an understanding of the syndrome of gout. Crystallization in vitro is a phenomenon well understood by physical chemists, who are thus able to determine precise solubility limits for any solute in a given solvent under defined conditions of temperature and pH. Formation of urate crystals in vivo, however, is not well understood by physicians, who have found that the incidence of gout correlates poorly with the concentration of urate in human serum, and that crystals, when present, are not randomly distributed but occur preferentially at well-recognized peripheral sites.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Bennett, R. M., Lehr, J. R., McCarty, D. J.: Crystal shedding and acute pseudogout. Arthr. And Rheum. 19, 93–97 (1976)

    Article  CAS  Google Scholar 

  • Brochner-Mortensen, K.: One-hundred gouty patients. Acta med. scand. 106, 81–107 (1941)

    Article  CAS  Google Scholar 

  • Brogsitter, A.M.: Histopathology of Gout. Leipzig: Vogel 1927

    Google Scholar 

  • Dagnall, J. C.: Naming the profession. Brit. J. Chiropody 28, 69–76 (1963)

    Google Scholar 

  • De Séze, S., Ryckewaert, A., Levernieux, J., Marteau, R.: Physiopathology, clinical manifestations, and treatment of gout. Part 2. Clinical and therapeutic studies. Ann. rheum. Dis. 17, 15–21 (1958)

    Article  Google Scholar 

  • Dieppe, P. A., Crocker, P., Huskisson, E.C., Willoughby, D.A.: Apatite deposition disease: A new arthropathy. Lancet 1976 I, 266–269

    Article  Google Scholar 

  • Falchuk, K. H., Goetzl, E.J., Kulka, J.P.: Respiratory gasses of synovial fluids. An approach to synovial tissue circulatory-metabolic imbalance in rheumatoid arthritis. Amer. J. Med. 49, 223–231 (1970)

    Article  PubMed  CAS  Google Scholar 

  • Garrod, A.B.: The Nature and Treatment of Gout and Rheumatic Gout. London: Walton and Maberly 1859

    Google Scholar 

  • Grahame, R., Scott, J.T.: Clinical survey of 354 patients with gout. Ann. rheum. Dis. 29, 461–468 (1970)

    Article  PubMed  CAS  Google Scholar 

  • Hall, A.P., Barry, P.E., Dawber, T.R., McNamara, P.M.: Epidemiologie of gout and hyperuricemia. A long-term population study. Amer. J. Med. 42, 27–37 (1967)

    Article  PubMed  CAS  Google Scholar 

  • Hench, P.S.: Diagnosis and treatment of gout and gouty arthritis. J. Amer. med. Ass. 116, 453–459 (1941)

    Google Scholar 

  • Hench, P.S., Darnall, C.M.: A clinic on acute, old-fashioned gout; with special reference to its inciting factors. Med. Clin. N. Amer. 16, 1371–1393 (1933)

    Google Scholar 

  • Hollander, J. L., Horvath, S. M.: The influence of physical therapy procedures on the intra-articular temperature of normal and arthritis subjects. Amer. J. med. Sci. 218, 543–548 (1949)

    Article  PubMed  CAS  Google Scholar 

  • Horvath, S. M., Hollander, J. L.: Intra-articular temperature as a measure of joint reaction. J. clin. Invest. 28, 469–473 (1949)

    Article  Google Scholar 

  • Hunt, J.D., Jackson, K.A.: Nucleation of solid in an undercooled liquid by cavitation. J. appl. Physiol. 37, 254 (1966)

    Article  CAS  Google Scholar 

  • Kellgren, J.H., Lawrence, J. S.: Osteo-arthrosis and disc degeneration in an urban population. Ann. rheum. Dis. 17, 388–397 (1958)

    Article  PubMed  CAS  Google Scholar 

  • Kippen, I, Klinenberg, J.R., Weinberger, A., Wilcox, W.R.: Factors affecting urate solubility in vitro. Ann. rheum. Dis. 33, 313–317 (1974)

    Article  PubMed  CAS  Google Scholar 

  • Loeb, J.N.: The influence of temperature on the solubility of monosodium urate. Arthr. And Rheum. 15, 189–192(1972)

    Article  CAS  Google Scholar 

  • Martel, W.: Acute and chronic arthritis of the foot. Semin. Roentgenol. 5, 391–406 (1970)

    Article  Google Scholar 

  • McCarty, D.J., Jr.: The inflammatory reaction to microcrystalline sodium urate. Arthr. And Rheum. 8, 726–735 (1965)

    Article  Google Scholar 

  • McCarty, D. J.: The gouty toe—a multifactorial condition. Ann. intern. Med. 86, 234–236 (1977)

    Google Scholar 

  • McCarty, D.J., Hollander, J. L.: Identification of urate crystals in gouty synovial fluid. Ann. intern. Med. 54, 452–460 (1961)

    PubMed  CAS  Google Scholar 

  • Mikkelsen, W.M., Dodge, H. J., Valkenburg, H.: The distribution of serum uric acid values in a population unselected as to gout or hyperuricemia. Tecumseh, Michigan 1959–1960. Amer. J. Med. 39, 242–251(1965)

    Article  PubMed  CAS  Google Scholar 

  • Mullin, J.W.: Crystallisation, 2nd Ed. London-Cleveland: Butterworth 1972

    Google Scholar 

  • Peter, J.B., Pearson, C.M., Marmor, L.: Erosive osteoarthritis of the hands. Arthr. and Rheum. 9, 365–388 (1966)

    Article  CAS  Google Scholar 

  • Reeves, B.: Significance of joint fluid uric acid levels in gout. Ann. rheum. Dis. 24, 569–571 (1965)

    Article  PubMed  CAS  Google Scholar 

  • Ropes, M. W., Bauer, W.: Synovial Fluid Changes in Joint Disease. Cambridge: Harvard University Press 1953

    Google Scholar 

  • Scudamore, C.: A Treatise of the Nature and Course of Gout, 4th Ed. London: Mallett 1823

    Google Scholar 

  • Seegmiller, J.E., Howell, R.R.: The old and new concepts of acute gouty arthritis. Arthr. and Rheum. 5, 616–623 (1962)

    Article  CAS  Google Scholar 

  • Simkin, P.A.: Local concentration of urate in the pathogenesis of gout. Lancet 1973 II, 1295–1298

    Article  Google Scholar 

  • Simkin, P.A.: The pathogenesis of podagra. Ann. Intern. Med. 86, 230–233 (1977)

    PubMed  CAS  Google Scholar 

  • Simkin, P.A., Pizzorno, J.E.: Transynovial exchange of small molecules in normal human subjects. J. appl. Phys. 36, 581–587 (1974)

    CAS  Google Scholar 

  • Sokoloff, L.: The pathology of gout. Metabolism 6, 230–243 (1957)

    PubMed  CAS  Google Scholar 

  • Talbott, J.H.: Gout. New York-London: Grune & Stratton 1964

    Google Scholar 

  • Talbott, J.H., Yü, T.-F.: Gout and Uric Acid Metabolism. New York: Stratton Intercontinental Medical 1976

    Google Scholar 

  • Treuhaft, P.S., McCarty, D.J.: Synovial fluid pH, lactate, oxygen, and carbon dioxide partial pressure in various joint diseases. Arthr. and Rheum. 14, 475–484 (1971)

    Article  CAS  Google Scholar 

  • Unsworth, A., Dowson, D., Wright, V.: Cracking joints. A bioengineering study of cavitation in the metacarpophalangeal joint. Ann. rheum. Dis. 30, 348–358 (1971)

    Article  PubMed  CAS  Google Scholar 

  • Wilcox, W.R., Khalaf, A.A.: Nucleation of monosodium urate crystals. Ann. rheum. Dis. 34, 332–339 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Wynngaarden, J.B., Kelley, W.N.: Gout and Hyperuricemia. New York-San Francisco-London: Grune & Stratton 1976

    Google Scholar 

Download references

Authors
  1. P. A. Simkin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Internal Medicine, Medical School, University of Michigan, Ann Arbor, MI, 48109, USA

    William N. Kelley MD (Professor and Chairman) (Professor and Chairman)

  2. Department of Pathology, Upstate Medical Center, Syracuse, NY, 13210, USA

    Irwin M. Weiner MD (Professor and Chairman) (Professor and Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 1978 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Simkin, P.A. (1978). Role of Local Factors in the Precipitation of Urate Crystals. In: Kelley, W.N., Weiner, I.M. (eds) Uric Acid. Handbook of Experimental Pharmacology, vol 51. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66867-8_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-66867-8_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-66869-2

  • Online ISBN: 978-3-642-66867-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation