Short-Term Drug Control of Crystal-Induced Inflammation

  • D. J. McCarty
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 50 / 2)


The constant presence of microcrystalline monosodium urate monohydrate (MSU) in joint fluid from acute gout was first documented in 1961 (McCarty and Hollander, 1961). MSU needles can be seen by ordinary light microscopy, but the strongly negative birefringence with axial extinction by compensated polarized light microscopy is a much more sensitive test that is quite specific. Van Leeuwenhoek (b. 1633) was the first to describe urate crystals, having obtained them from a draining tophus (McCarty, 1970a). He was unaware of their chemical composition, as uric (lithic) acid was not discovered until a century later (Scheele, 1776). It is of historic interest that A. B. Garrod had used polarized light microscopic inspection of fresh tissue sections cut by hand with a razor blade to identify urate crystals (Garrod, 1876). He wrote that “... in the constancy of such deposition lies the clue that has long been wanting; the occurrence of the deposit is at once pathognomonic and separates gout from every other disease which at first sight may appear allied to it.” Phagocytosis of MSU crystals by both polymorphonuclear and mononuclear cells was first described in recently erupted human skin tophi by the Viennese dermatologist Gustav Riehl (Riehl, 1897), a phenomenon re-discovered later in gouty joint fluid (McCarty, 1962).


Chemotactic Factor Acute Gout Urate Crystal Calcium Pyrophosphate CPPD Crystal 
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© Springer-Verlag Berlin Heidelberg 1979

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  • D. J. McCarty

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