Determination of urate crystal formation using flow cytometry and microarea X-ray diffractometry

Gout is known to be induced by monosodium urate (MSU) crystals. The formation of MSU crystals is the first step of gouty inflammation. Detecting the early stage of crystallization accurately is considered to be important in understanding the mechanism of gouty arthritis. In this study, we employed flow cytometry (FCM) to detect small amounts of crystals produced in a supersaturated solution of uric acid. FCM was sensitive and crystals were determined at 2 h after the beginning of reaction. Gamma-globulin accelerated the formation rate time-dependently and dose-dependently. Low levels of lactic acid (less than 1.0 mg/ml) did not affect the formation rate but lactic acid of 2.0 mg/ml enhanced the formation of urate crystals. The crystals obtained with 2.0 mg/ml of lactic acid were analyzed with a microarea X-ray diffractometer and were shown to be a mixture of MSU and uric acid. FCM is a very useful method to determine the formation of crystals. Furthermore, analysis with a microarea X-ray diffractometer can provide detailed information about crystal composition.