Open Access Highly Accessed Research article

Enhanced interleukin-1β production of PBMCs from patients with gout after stimulation with Toll-like receptor-2 ligands and urate crystals

Eleni E Mylona1*, Maria Mouktaroudi1, Tania O Crisan23, Stamatoula Makri1, Aikaterini Pistiki1, Marianna Georgitsi1, Athina Savva1, Mihai G Netea23, Jos WM van der Meer23, Evangelos J Giamarellos-Bourboulis123 and Leo AB Joosten23

Author affiliations

1 4th Department of Internal Medicine, Attikon University Hospital, 1 Rimini Str., Athens 12462, Greece

2 Department of Medicine, Radboud University Nijmegen Medical Centre, Geert Grooteplein zuid 8, 6525 GA Nijmegen, The Netherlands

3 Nijmegen Institute for Infection, Inflammation and Immunity (N4i), 6525 GA Nijmegen, The Netherlands

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Citation and License

Arthritis Research & Therapy 2012, 14:R158  doi:10.1186/ar3898

Published: 4 July 2012

Abstract

Introduction

Monosodium urate monohydrate (MSU) crystals synergize with various toll-like receptor (TLR) ligands to induce cytokine production via activation of the NOD-like receptor (NLR) family, pyrin domain-containing 3 (NLPR3) inflammasome. This has been demonstrated in vitro using human cell lines or monocytes of healthy volunteers. In the present study, we have investigated the effect of MSU crystals and of their combination with TLR ligands in peripheral blood mononuclear cells (PBMC) of patients with gout.

Methods

PBMCs from 18 patients with primary gout and 12 healthy donors were exposed to MSU crystals in the presence or absence of saturated fatty acid C18:0 (free fatty acid, TLR2 ligand), palmitoyl-3-cystein (Pam3Cys, TLR1/2 ligand) and fibroblast stimulating factor-1 (FSL-1, TLR 2/6 ligand). Production of IL-1β, IL-6, IL-8, IL-17 and tumor necrosis factor alpha (TNFα) was determined by ELISA. mRNA transcripts of IL-1β were measured by real-time PCR.

Results

MSU crystals alone failed to induce IL-1β, IL-6 or TNFα in both patients and control groups, but a stronger synergy between MSU/Pam3Cys and MSU/C18:0 for the induction of IL-1β was found in patients with gout compared to healthy controls. IL-6, but not IL-8, followed the kinetics of IL-1β. No production of the neutrophil-recruiting IL-17 was detectable after stimulation of the patients' PBMCs with MSU in both the presence or absence of TLR ligands. No change of gene transcripts of IL-1β after stimulation with MSU and Pam3Cys or with MSU and C18:0 was found. A positive correlation was found between synergy in IL-1β production from PBMCs of patients between C18:0 and MSU crystals, as well as the annual number of attacks of acute gouty arthritis (rs: +0.649, P: 0.022).

Conclusions

The synergy between MSU crystals and TLR-2 ligands is more prominent in patients with gout than in controls. This is likely mediated by the enhanced maturation of pro-IL-1β into IL-1β.