Update on gout: pathophysiology and potential treatments.
After several decades of senescence, the twin fields of hyperuricemia and gout have again regained attention in both the scientific and clinical spheres, and this review highlights several recent advancements. Specifically, we review newly discovered mechanisms of uric acid-induced inflammation, uric acid's putative role as a "danger signal" in innate immunity, the possible link between hyperuricemia and cardiovascular disease, and evolutionary evidence suggesting that hyperuricemia conferred a survival advantage in primates (when the gene for uricase was lost) several million years ago. Finally, we provide an overview of the current approach to gout, as well as what treatments are on the horizon.
Abeles
Aryeh M
AM
Division of Rheumatology, Medical Arts and Research Building, 263 Farmington Avenue, Farmington, CT 06030, USA. aabeles@uchs.edu
Park
Jean Y
JY
Pillinger
Michael H
MH
Cronstein
Bruce N
BN
D000818:Animals; D002318:Cardiovascular Diseases / Q000150:complications; D006073:Gout / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D006074:Gout Suppressants / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications; D033461:Hyperuricemia / Q000150:complications; D007113:Immunity, Innate / Q000502:physiology; D007249:Inflammation / Q000503:physiopathology; D011323:Primates / Q000378:metabolism; D014527:Uric Acid / Q000378:metabolism
D006074:Gout Suppressants; D014527:Uric Acid