Madin-Darby canine kidney (MDCK) cells exhibit many of the characteristics of cells of the cortical collecting tubule. Since hypotheses concerning the development of gouty and uric acid nephropathy involve a reaction between such cells and crystals, either of monosodium urate monohydrate (MSUM) or uric acid, the reaction between MDCK cells in culture and the above crystals was studied, both morphologically and functionally. In monolayer cultures, reaction sites developed within four hours of exposure to urate crystals. These increased in number for up to 72 hours and subsided gradually after removal of the crystals. At these reaction sites, crystals were observed to have passed beneath the cell surface and could be demonstrated both within intra-cellular lysosomes as well as within the inter-cellular spaces. When the MDCK cells were maintained as single cells in suspension, phagocytosis of crystals by the majority of the cells could be observed, but the response was much more rapid than in monolayers. During the cell/crystal reaction, significant amounts of lysosomal enzymes and prostaglandin E2 were released and, to a less significant degree, cytosolic enzymes, presumably due to cell lysis. This enzyme release did not occur in MDCK cells grown in protein-free medium, and protein coating of the crystals was necessary for reactivity with cells. In this regard, coating with IgG or lysozyme was more effective than albumin. The reaction with uric acid crystals revealed a reactivity which was lesser in degree but qualitatively similar to that of urate crystals.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypotheses concerning the development of uric acid and gouty nephropathy suggest that the initiating disease mechanism involves an interaction between uric acid or monosodium urate monohydrate (MSUM) crystals and renal tubular epithelial cells. We have studied the interaction of these crystals with Madin-Darby canine kidney (MDCK) cells, which exhibit many of the characteristics of cells of the collecting duct epithelium. Addition of MSUM crystals to monolayer cultures of MDCK cells leads to the formation of reaction sites, localised areas which are raised above the monolayer forming a 3-dimensional structure. These reaction sites are evident within 4–8 h and appear to be initiated by the interaction of a single crystal or small number of crystals with a single cell. With time, both cells and crystals accumulate at the site. By 24 h most reaction sites involve 6–12 cells and numerous crystals. Interaction of MSUM crystals and MDCK cells not only involves the attachment of crystals to cells but, by 8 h, some crystals appear to be completely or partially covered by the cell membrane, and MDCK cells appear to react by growing around the crystals. Transmission electron microscopy shows that crystals are found not only within cells, but also within the intercellular spaces. Within the cells, crystals have been shown in vacuoles containing lysosomal enzymes, indicating the formation of a phagolysosome. Ultimately, enzyme release occurs. These studies support the hypothesis that some interstitial deposits of urate and uric acid in the kidney may be derived from intratubular deposits that react with the tubular epithelium and pass into the interstitium; loss of tubular integrity may not be a prerequisite for crystal migration.
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