Publications by authors named "Alexander So"

Article Synopsis
  • * Managing gout involves treating acute flare-ups and lowering serum urate (sUA) levels while considering these related health issues.
  • * Recent advances in gout treatment highlight both new and existing therapies that significantly impact clinical practice, which will be discussed in the article.
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Article Synopsis
  • - Gout is a chronic condition caused by the immune system's reaction to monosodium urate crystals due to high uric acid levels, and recent research sheds light on its inflammatory mechanisms.
  • - A large genome-wide association study (GWAS) involving 2.6 million people identified 377 genetic locations linked to gout, with a focus on 149 new loci related to urate and gout inflammation.
  • - The study also pinpointed candidate genes influencing the inflammatory response in gout, including those affecting NLRP3 inflammasome activity, and suggests a potential causal role of specific genetic factors in developing the disease.
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Article Synopsis
  • The study aimed to analyze the disease, demographic, and imaging characteristics linked to different types of calcium pyrophosphate deposition (CPPD) disease, focusing on recurrent acute CPP crystal arthritis, chronic CPP crystal inflammatory arthritis, and crowned dens syndrome (CDS).
  • Researchers utilized data from an international cohort of 618 individuals to investigate the phenotypic traits of each type of CPPD and performed multivariable logistic regression to assess associations between risk factors and inflammatory phenotypes.
  • Key findings indicated that longer disease duration correlated with recurrent acute arthritis, while chronic arthritis was linked to specific joint issues and less associated with metabolic risks, and CDS was more common in males with greater joint involvement. *
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Article Synopsis
  • The study investigates how integrin CD11b affects inflammasome activation in macrophages when triggered by monosodium urate (MSU) crystals, which are related to gout.
  • Researchers used bone marrow-derived macrophages from both wild-type and CD11b knock-out mice to analyze inflammation and metabolic changes caused by MSU.
  • Results showed that CD11b-deficient mice experienced more severe symptoms of gouty arthritis, higher levels of inflammatory cytokine IL-1β, and altered macrophage metabolism, suggesting CD11b as a target for potential gout treatments.
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Lysyl oxidases (LOX(L)) are enzymes that catalyze the formation of cross-links in collagen and elastin fibers during physiologic calcification of bone. However, it remains unknown whether they may promote pathologic calcification of articular cartilage, an important hallmark of debilitating arthropathies. Here, we have studied the possible roles of LOX(L) in cartilage calcification, related and not related to their cross-linking activity.

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Article Synopsis
  • Calcium pyrophosphate deposition (CPPD) disease is common but previously lacked validated classification criteria, which have now been developed by the American College of Rheumatology (ACR) and EULAR.
  • A multinational group established these criteria by generating lists of candidate items, refining definitions, and validating the framework through patient profiles and statistical analysis.
  • The new criteria allow for CPPD classification based on specific symptoms, testing results, and a scoring system, demonstrating high sensitivity and specificity in identifying the disease.
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Article Synopsis
  • Calcium pyrophosphate deposition (CPPD) disease lacks established classification criteria, prompting the American College of Rheumatology (ACR) and EULAR to create the first validated criteria for symptomatic cases.
  • A multinational team developed these criteria by analyzing patient profiles, defining candidate items, and employing decision-making methods to establish a scoring system for classification.
  • The new criteria showed high sensitivity (92.2% in one cohort; 99.2% in another) and specificity (87.9% and 92.5%, respectively), making them effective tools for diagnosing CPPD disease and advancing research.
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Pathological calcification of cartilage is a hallmark of osteoarthritis (OA). Calcification can be observed both at the cartilage surface and in its deeper layers. The formation of calcium-containing crystals, typically basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPP) crystals, is an active, highly regulated and complex biological process that is initiated by chondrocytes and modified by genetic factors, dysregulated mitophagy or apoptosis, inflammation and the activation of specific cellular-signalling pathways.

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Objective: To determine whether a gout polygenic risk score (PRS) is associated with age at gout onset and tophaceous disease in European, East Polynesian, and West Polynesian men and women with gout.

Methods: A 19-variant gout PRS was produced in 7 European gout cohorts (N = 4,016), 2 East Polynesian gout cohorts (N = 682), and 1 West Polynesian gout cohort (N = 490). Sex-stratified regression models were used to estimate the relationship between the PRS and age at gout onset and tophaceous disease.

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Background: Cartilage damage in inflammatory arthritis is attributed to inflammatory cytokines and pannus infiltration. Activation of the coagulation system is a well known feature of arthritis, especially in rheumatoid arthritis (RA). Here we describe mechanisms by which fibrin directly mediates cartilage degeneration.

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Hyperuricemia is often encountered as glomerular filtration rate decreased. It is associated with a more rapid decline of the renal function, but causality has not been demonstrated. Recent studies showed that treatment of hyperuricemia did not affect the progression in chronic kidney disease (CKD) patients.

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Pathologic calcification (PC) is a painful and disabling condition whereby calcium-containing crystals deposit in tissues that do not physiologically calcify: cartilage, tendons, muscle, vessels and skin. In cartilage, compression and inflammation triggered by PC leads to cartilage degradation typical of osteoarthritis (OA). The PC process is poorly understood and treatments able to target the underlying mechanisms of the disease are lacking.

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Objective: Classification criteria for calcium pyrophosphate deposition (CPPD) disease will facilitate clinical research on this common crystalline arthritis. Our objective was to report on the first 2 phases of a 4-phase process for developing CPPD classification criteria.

Methods: CPPD classification criteria development is overseen by a 12-member steering committee.

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Pathologic calcification of cartilage consists of the formation of basic calcium phosphate (BCP) and/or calcium pyrophosphate dihydrate (CPPD) containing calcium crystals in mature hyaline or articular cartilage and is associated with aging, cartilage injury and likely plays a role in accelerating the pathology of osteoarthritis (OA). The pathways regulating joint calcification, in particular cartilage calcification, are not completely understood, but inflammation and the formation of reactive oxygen species (ROS) are contributory factors. The xanthine oxidase (XO) form of xanthine oxidoreductase (XOR), the key enzyme in xanthine and uric acid metabolism, is a major cellular source of superoxide.

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Objective: To evaluate the efficacy and safety of anakinra compared to triamcinolone in the treatment of gout flares.

Methods: Patients for whom nonsteroidal antiinflammatory drugs and colchicine were not suitable treatments were enrolled in this multicenter, randomized, double-blind study with follow-up for up to 2 years. The study was designed to assess superiority of anakinra (100 or 200 mg/day for 5 days) over triamcinolone (40 mg in a single injection) for the primary end point of changed patient-assessed pain intensity in the most affected joint (scored on a visual analog scale of 0-100) from baseline to 24-72 hours.

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Osteoarthritis (OA) is a progressive joint disease that is strongly associated with calcium-containing crystal formation (mineralization) by chondrocytes leading ultimately to cartilage calcification. However, this calcification process is poorly understood and treatments targeting the underlying disease mechanisms are lacking. The CD11b/CD18 integrin (Mac-1 or αMβ2), a member of the beta 2 integrin family of adhesion receptors, is critically involved in the development of several inflammatory diseases, including rheumatoid arthritis and systemic lupus erythematosus.

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Background: Osteoarthritis (OA) is characterized by the formation and deposition of calcium-containing crystals in joint tissues, but the underlying mechanisms are poorly understood. The gasotransmitter hydrogen sulfide (HS) has been implicated in mineralization but has never been studied in OA. Here, we investigated the role of the HS-producing enzyme 3-mercaptopyruvate sulfurtransferase (3-MST) in cartilage calcification and OA development.

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Article Synopsis
  • The ABCG2 Q141K and rs10011796 genetic variants are linked to hyperuricaemia (HU) and may influence the progression from HU to gout.
  • A study involving over 16,000 participants, including Europeans and Polynesians, revealed that the ABCG2 141K allele is strongly associated with an increased risk of gout, especially when considering individuals with HU.
  • Additionally, the presence of the ABCG2 141K allele, in combination with the rs10011796 genotype, significantly amplifies gout risk in both European and Western Polynesian populations.
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Objective: The aim of this study was to examine whether serum urate-associated genetic variants are associated with early-onset gout.

Methods: Participants with gout in the Genetics of Gout in Aotearoa study with available genotyping were included (n = 1648). Early-onset gout was defined as the first presentation of gout <40 years of age.

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