Calcium-containing crystals, such as calcium pyrophosphate dihydrate and basic calcium phosphate, have profound in vitro biologic effects. They promote synovial hyperplasia and synthesis of metalloproteases able to degrade cartilage matrix. Clinical observations support the thesis that these in vitro effects also occur in vivo. Prospects for successful interventions in the crystal deposition diseases depend upon better understanding of the mechanisms of crystal formation and activation pathways that lead to their biologic effects.
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