Uric acid crystals trigger complex human chemistry.
Battles rage through our immune system, and we cry with pain as our joints swell and burn.
Then comes relief from pain-killing drugs, or through simply waiting.
Doctors are relieved to see a pain-free patient after a few colchicine tablets or a better combination. We are relieved the pain has gone, and thankful of our health care.
But who cares for our tendons and their dead babies?
Gout crystals form when uric acid is too concentrated to remain soluble. Either crystals of pure uric acid , or more commonly, salts of sodium and other elements, form tiny solids in and around our joints. We can call them uric acid crystals or gout crystals. The name is not important. What matters is, they should not be there.
Our immune system cannot accept these invaders, and so gout crystals are attacked like invading viruses and bacteria. But inanimate crystals cannot be killed, and so the white blood cells of our immune system surround them. Lumps and bumps and tophi form in a mix of gout crystals and dead cells. This is a process that I describe often. If you understand the process, you can understand why different gout treatments are necessary for different aspects of gout. You can understand why pain continues during early months of uric acid lowering treatment. So you understand that you have to persevere, and not give up the allopurinol just because a few gout attacks still occur.
I understood all that, but I never truly understood how this could lead to permanent joint damage.
I reported on new research about the affects of gout crystals on tendons. Now I understand where our joints go, and it is not nice.
The report introduced me to some cells called tenocytes. These are specialist cells that grow into collagen that is used to build tendons. I am aware of similar cells, osteoblasts, that form bone. I am fascinated by the fact that baby cells are destined to grow into structures that keep us growing, and keep us alive.
Since I learned the process of gout pain being an immune response, I’ve had great respect for our white blood cells, waging war on gout crystals. Today, I realized it is not just the immune cell heroes that die in battle. Baby tendon cells get caught in the fight too.
There may be other processes involved that add to joint destruction, but this seems basic to me. If gout crystals are stopping tenocytes from building tendons, I must assume that the bone and cartilage destruction revealed by advanced imaging techniques is all part of the same cell death.
It’s time to remember the dead babies, and get rid of gout crystals.
If you have been affected by the issues raised in this article, free counseling and support is available in the gout forum. If you would like to support dead baby tendon cells, please respond to the tenocytes helpline.
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