title: Hyperuricaemia and gout.
abstract: Gout is increasing in prevalence throughout the world, particularly in developed countries. The causes are dietary--purine-rich foods, high saturated fats, fructose-containing drinks and alcohol. Gout is also drug-related and associated with increased obesity, hypertension, insulin resistance and metabolic syndrome. Although very readily treated, there is evidence that physicians fail to optimise the treatment and achieve low enough serum urate levels, while patients fail to comply with the treatment and dietary advice. Standard treatment of acute attacks is with non-steroidal anti-inflammatory drugs, colchicine or steroids. The standard urate-lowering agents are allopurinol and uricosuric agents. Newer urate lowering agents are now available for refractory gout. Increased understanding of the membrane transporters involved in urate excretion in the kidney and the genes that control them and of the way that sodium urate crystals cause inflammation via the innate immune system and the inflammasome offers hope for new therapeutic approaches.
authors.affiliation: Centre for Rheumatology, University College Hospital, London, UK. Mike.Shipley@uclh.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Shipley
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D004032:Diet; D006073:Gout / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007113:Immunity, Innate; D007249:Inflammation / Q000209:etiology*; D007668:Kidney / Q000378:metabolism; D026901:Membrane Transport Proteins / Q000378:metabolism; D059039:Standard of Care; D013256:Steroids / Q000627:therapeutic use; D014527:Uric Acid / Q000009:adverse effects / Q000097:blood / Q000378:metabolism*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D026901:Membrane Transport Proteins; D013256:Steroids; D014527:Uric Acid; D000493:Allopurinol; D003078:Colchicine