Article Text

Annexin 5 overexpression increased articular chondrocyte apoptosis induced by basic calcium phosphate crystals
  1. H K Ea1,2,3,
  2. V Monceau4,
  3. E Camors4,
  4. M Cohen-Solal1,2,3,
  5. D Charlemagne4,
  6. F Lioté1,2,3
  1. 1
    INSERM U606, IFR 139, Hôpital Lariboisière, Paris, France
  2. 2
    Fédération de rhumatologie, centre Viggo Petersen, Hôpital Lariboisière, Paris, France
  3. 3
    Faculté de médecine Denis Diderot, Université Paris VII, Paris, France
  4. 4
    INSERM U 572, IFR 139, Hôpital Lariboisière, Paris, France
  1. Professor Frédéric Lioté, INSERM U606 (IFR 139), centre Viggo Petersen, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France; frederic.liote{at}


Objectives: Basic calcium phosphate (BCP) crystals (octacalcium phosphate (OCP), carbapatite (CA) and hydroxyapatite (HA)) are associated with severe forms of osteoarthritis. In advanced osteoarthritis, cartilage shows chondrocyte apoptosis, overexpression of annexin 5 (A5) and BCP crystal deposition within matrix vesicles. We assessed in vitro whether BCP crystals and overexpression of A5 increased chondrocyte apoptosis.

Methods: Apoptosis was induced by BCP crystals, tumour necrosis factor (TNF)-α (20 ng/ml) and Fas ligand (20 ng/ml) in normal articular chondrocytes (control) and in A5 overexpressed chondrocytes, performed by adenovirus infection. Apoptosis was assessed by caspase 3 (Cas3) activity, and DNA fragmentation.

Results: All BCP crystals, TNF-α and Fas ligand induced chondrocyte apoptosis as demonstrated by decreased cell viability and increased Cas3 activity and DNA fragmentation. TUNEL (terminal deoxyribonucleotide transferase-mediated dUTP nick end-labelling)-positive staining chondrocytes were increased by OCP (12.4 (5.2)%), CA (9.6 (2.6)%) and HA (9.2 (3.0)%) crystals and TNF-α (9.6 (2.4)%) stimulation compared with control (3.1 (1.9)%). BCP crystals increased Cas3 activity in a dose-dependent fashion. BCP-crystal-induced chondrocyte apoptosis was independent from TNF-α and interleukin-1β pathways but required cell-crystal contact and intralysosomal crystal dissolution. Indeed, preincubation with ammonium chloride, a lysosomal inhibitor of BCP crystal dissolution, significantly decreased BCP-crystal-induced Cas3 activity. Finally, overexpression of A5 enhanced BCP crystal- and TNF-α-induced chondrocyte apoptosis.

Conclusions: Overexpression of A5 and the presence of BCP crystals observed in advanced osteoarthritis contributed to chondrocyte apoptosis. Our results suggest a new pathophysiological mechanism for calcium-containing crystal arthropathies.

Statistics from


  • Funding: This work was funded by grants from four non-profit organisations: the Société Française de Rhumatologie (French Society for Rheumatology, Grant 2005), the Association Rhumatisme et Travail, the Association pour la Recherche en Pathologie Synoviale and the Fonds d’Etude et de Recherche des Hôpitaux de Paris et Assistance-Publique. H-K E was supported by the last three organisations.

  • Competing interests: None.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.