Gout,a metabolic disorder characterized by dysregulated uric acid metabolism,has emerged as a major global public health concern owing to its steadily increasing prevalence.This study systematically examined the disti...Gout,a metabolic disorder characterized by dysregulated uric acid metabolism,has emerged as a major global public health concern owing to its steadily increasing prevalence.This study systematically examined the distinctive diagnostic and therapeutic principles of Miao medicine theory in the prevention and treatment of gout.Our findings indicated that Miao medicine conceptualized gout management through a unique“disease stage-functional framework-body domain”system,grounded in a regulatory model that integrates energy,matter,and structural dynamics.This holistic and dynamically balanced perspective offered novel theoretical insights and complementary practical strategies that might enrich contemporary approaches to gout management.展开更多
[Objectives]To analyze the clinical characteristics,distribution of traditional Chinese medicine(TCM)syndrome types,spectrum of comorbidities,and complications among inpatients with gout.[Methods]Data from 592 gout pa...[Objectives]To analyze the clinical characteristics,distribution of traditional Chinese medicine(TCM)syndrome types,spectrum of comorbidities,and complications among inpatients with gout.[Methods]Data from 592 gout patients admitted in the Department of Rheumatology at Wuxi Traditional Chinese Medicine Hospital between January 2018 and December 2024 were retrospectively collected.The data collected encompassed patient gender,age,TCM syndrome types,underlying comorbidities,infection status,and major complications,including renal insufficiency,interstitial lung disease,and osteoporosis.Descriptive statistical analyses were subsequently performed.[Results]Among the 592 inpatients,80.75%were male and 19.25%were female.A total of 94.76%patients had at least one underlying condition,with hypertension(80.74%),cerebral infarction(29.59%),heart disease(24.24%),and diabetes(21.56%)being the most prevalent.The primary TCM syndrome types identified were damp-heat obstruction syndrome(63.51%)and phlegm-stasis obstruction syndrome(21.11%).During hospitalization,20.94%of patients experienced concurrent infections,predominantly pulmonary infections(38.10%).The principal complications observed included renal insufficiency(32.09%),interstitial lung disease(18.75%),and osteoporosis(9.29%).[Conclusions]Inpatients diagnosed with gout often present with complex conditions and a high burden of comorbidities,predominantly cardiovascular and cerebrovascular diseases,as well as metabolic disorders.Additionally,there is a high incidence of infections and renal insufficiency within this population.TCM syndrome types in these patients are primarily characterized by damp-heat obstruction.In clinical practice,a comprehensive management approach that incorporates multidisciplinary collaboration is recommended.Alongside the control of uric acid levels and joint inflammation,proactive screening and management of comorbidities and related complications are essential.展开更多
Currently, glucocorticoids are the only treatment option for acute gout attacks in patients with chronic kidney disease (CKD) and progressive renal dysfunction. Management becomes particularly challenging when steroid...Currently, glucocorticoids are the only treatment option for acute gout attacks in patients with chronic kidney disease (CKD) and progressive renal dysfunction. Management becomes particularly challenging when steroid therapy is contraindicated, poorly tolerated, or ineffective. IL-1β monoclonal antibodies offer potent, targeted anti-inflammatory effects and have been approved for the treatment of gout, providing new therapeutic hope for this population. Here, we report a case of a patient with CKD and progressively worsening renal function who experienced an acute gout attack requiring dialysis. Treatment with the IL-1β monoclonal antibody Firsekibart produced rapid and remarkable anti-inflammatory and analgesic effects, effectively controlling the gout attack, improving renal function, and allowing discontinuation of dialysis.展开更多
Background:Tophi ulceration with infection and refractory wound healing remains a clinical challenge,particularly in patients with concurrent diabetes.Interleukin-1β(IL-1β)is a central mediator of gouty inflammation...Background:Tophi ulceration with infection and refractory wound healing remains a clinical challenge,particularly in patients with concurrent diabetes.Interleukin-1β(IL-1β)is a central mediator of gouty inflammation;targeted IL-1 inhibition may rapidly suppress inflammation and facilitate tissue repair.Case Presentation:This study reported the case of a 27-year-old male with a 6-year history of gouty arthritis,multiple tophi,infected left foot ulceration,and type 2 diabetes.Despite conventional anti-infective therapy,glycemic control,and local wound care,the ulcer showed limited improvement.Following a single subcutaneous injection of firsekibart(200 mg),wound exudate decreased rapidly,granulation tissue developed satisfactorily,and the ulcer healed progressively.At the 4-month followup,complete wound closure was achieved without recurrence or adverse events.Conclusion:Firsekibart demonstrated favorable anti-inflammatory and wound-healing effects in a patient with tophi ulceration complicated by diabetes,suggesting its potential as a therapeutic option for refractory cases.Prospective studies are warranted to confirm these findings.展开更多
Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout...Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout and associated renal dysfunction in a mouse model.The results show that curcumin treatment alleviates ankle joint swelling,reduces inflammatory cytokines IL-1βand TNF-α,and lowers serum uric acid concentrations.High-dose curcumin notably inhibits xanthine oxidase(XOD)activity,a key enzyme in uric acid production,while it enhances the renal expression of the urate transporter ABCG2,thereby promoting uric acid excretion.Furthermore,curcumin effectively mitigates renal injury as evidenced by reduced serum creatinineand blood urea nitrogen levels and suppresses renal inflammation.At the molecular level,curcumin exerts potent antioxidant effects by lowering reactive oxygen species(ROS)levels in both cultured HK-2 human renal tubular epithelial cells and RAW264.7 mouse macrophages.The curcumin-mediated effects are associated with the disruption of NEK7-NLRP3 complex formation,leading to the suppression of the ROS/NEK7-NLRP3 inflammasome pathway.This,in turn,inhibits pyroptosis and the subsequent release of mature IL-1β.These findings suggest that curcumin not only reduces uric acid production but also modulates inflammation through ROSscavenging properties and its ability to inhibit the NLRP3 inflammasome.展开更多
Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the so...Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the society.UA metabolism is a complex physiological process involving the kidney,intestine,and other organs.A number of factors together regulate UA metabolism,including genetics,diet,hormones,and the gut microbiota.This review summaries the gut microbiota features in subjects with HUA and gout,and the therapeutic effects of implementing microecological therapies(probiotics,prebiotics,or fecal microbiota transplant)that target modulate the gut microbiota and its downstream metabolism on the disease.Current evidence shows that these strategies are safe and promising in alleviate inflammation,reduce UA,and restoring a healthy gut microbiota in subjects with UA metabolism-related diseases.However,most clinical data are generated by animal studies.Therefore,we propose that vigorous human intervention trials should be conducted in the future to evaluate the therapeutic effects of microecological therapies in managing HUA and gout.展开更多
To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmac...To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmacology and molecular docking methods.Disease-associated targets for gout and hyperuricemia were identified from the GeneCards,OMIM,Disgenet,and TTD databases,while the key active components and their corresponding targets for Smilax Glabra and Semen Coicis were obtained from the TCSMP database.The intersection of these targets enabled the construction of a protein-protein interaction(PPI)network,which was subsequently visualized and analyzed.Core targets were further subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses to elucidate the biological processes and pathways involved.Molecular docking was then employed to validate the reliability of the interactions between the active components and the identified targets.The analysis revealed that Smilax Glabra and Semen Coicis contained 15 bioactive components that interacted with 393 potential targets,while gout and hyperuricemia were associated with 660 targets in total.The primary active compounds implicated in treating these conditions included diosgenin,quercetin,and naringenin,which were found to interact with crucial hub targets such as BCL2,CASP3,and MAPK3.These interactions suggested that the herbal medicine pair modulated several biological processes,including gland development and the regulation of body fluid levels,through pathways involving membrane rafts,membrane microdomains,and nuclear receptor activities.Enrichment analyses highlighted their involvement in multiple signaling pathways,such as EGFR tyrosine kinase inhibitor resistance,phospholipase D signaling,and platelet activation.Molecular docking confirmed the strong binding affinities between the hub genes and the major active components,supporting their potential role in therapeutic efficacy.This study demonstrated that Smilax Glabra and Semen Coicis might offer a promising therapeutic strategy for gout and hyperuricemia by targeting multiple molecular components,biological functions,and pathways.The findings underscored the unique potential of traditional Chinese medicine(TCM)in managing complex diseases by leveraging synergistic effects across diverse biological mechanisms.展开更多
The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlig...The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlights dapagliflo-zin’s efficacy in lowering serum uric acid levels,enhancing cardiac function,and reducing cardiovascular events.This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid.Furthermore,this review examines the potential role of SGLT2 inhibitor in the context of gout,evaluating its mechanisms and clinical application prospects in the management of hyperuricemia,thereby further enriching the medical community’s understanding of SGLT2 inhibitor.展开更多
Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict...Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict its target points through the database,and then construct the gout-related protein-protein interaction network(PPI),and then construct the"Weiling,"the"Xian,Guizhi"drug pair"active ingredient-predicted target"network,the construction of the gout-related"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network,based on the Kyoto Encyclopedia of Genes and Genomes(KEGG)biological pathway enrichment analysis and gene ontology(GO)functional enrichment analysis,to study the mechanism of action of the two drugs"Weilingxian-Guizhi"in the treatment of gout.Results:The goutrelated"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network contains 14 targets.KEGG pathway enrichment analysis yields 32 pathways,and GO functional enrichment analysis yields 517 GO entries.Among them,there are 468 items related to biological processes,21 items related to molecular functions,and 28 items related to cell composition.Conclusion:The results of this study initially verified and predicted the mechanism of the"Weilingxian-Cinnamon Stick"medicine on the treatment of gout,and laid a good foundation for further revealing its mechanism of action.展开更多
In order to implement the requirements of the document Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovation of Traditional Chinese Medicin...In order to implement the requirements of the document Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovation of Traditional Chinese Medicine,accelerate the promotion of the construction of a healthy China,adhere to the equal importance of Chinese and Western medicines,promote the mutual complementarity of traditional Chinese medicine and Western medicine and coordinated development,strengthen the academic exchanges and cooperation of Chinese and Western medicine in the field of preventing and controlling gout,and cultivate the high-caliber young clinical talents,the China Association of Chinese Medicine(CACM)organized the 48th Salon on Clinical Advantageous Diseases in Beijing on 21 March 2025,focusing on the combined Chinese and Western medicine diagnosis and treatment strategy of gout,bringing together experts in Chinese and Western medicine and interdisciplinary fields,and reaching specific recommendations and consensus on the combined Chinese and Western medicine diagnosis and treatment of gout through in-depth discussion.On this basis,under the leadership of the CACM,gout diagnosis and treatment problems were analyzed from the perspective of gout occurrence and development law,focusing on the advantages and characteristics of Chinese medicine and combined Chinese and Western medicine in gout diagnosis and treatment,and proposing scientific research and technological layout of gout in the following aspects:(1)Improvement of gout staging and identification system,(2)optimization of Chinese medicine to prevent and treat gout and drug research and development,(3)improvement of indicators for post-treatment assessment of gout,(4)research on early warning system of Chinese and Western medicine,(5)construction of gout co-morbidities spectrum and Chinese medicine theoretical system,(6)research on co-morbidities mechanism of gout,(7)chronic disease grassroots health management,and at the same time,it also puts forward the proposed layout and direction of the research,the expected goal and value and the priority of the proposed funding.Therefore,this article is based on the gout Chinese medicine advantageous disease series salon,proposed gout scientific and technological research paradigm,in order to help the high-quality development of traditional Chinese medicine.展开更多
Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focuse...Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focused on immune inflammation,gene polymorphism and related studies.Uric acid deposition or crystal precipitation activates phagocytes,fibroblasts and mast cells in synovium,produces IL-1β,TNF and chemokine IL-8(CXCL8),thereby activating neutrophils,urate crystal polyanion surface can be coated with immunoglobulins and other serum proteins as substrates for complement activation,complement substitution pathways and classical complement pathways to activate complements.Uric acid crystals activate inflammation-related signal transduction pathways including the activation of inflammation-related signal transduction pathway by uric acid crystals and TLRS/MyD88 signal transduction pathways.Gene polymorphism is related to inflammation and signaling pathway,EGF gene is closely related to gout inflammation,which may be involved in the regulation of gout inflammation,among which NLRP3 inflammatory signaling pathway and gene polymorphism have been deeply studied in the pathogenesis of gout,which is the main therapeutic target of anti-inflammatory and uric acid lowering.展开更多
BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMM...BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMMARY We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels.The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years,which was aggravated for 3 d.The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years.Resection of the nasal masses was performed.Cartilage from the right ear cavity was used to repair the nasal defects.The pathological report confirmed a nasal gouty tophus.No recurrence or deformity was found after a 1 year follow-up.CONCLUSION Normal SUA cannot completely negate the diagnosis of gouty tophus,especially in some rare regions.展开更多
Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used...Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used uric acid-lowering treatment,febuxostat on gut microbiota in gout.16S ribosomal RNA sequencing and metagenomic shotgun sequencing was performed on fecal DNA isolated from 38 untreated gout patients,38 gout patients treated with febuxostat,and 26 healthy controls.A restriction of gut microbiota biodiversity was detected in the untreated gout patients,and the alteration was partly restored by febuxostat.Biochemical metabolic indexes involved in liver and kidney metabolism were significantly associated with the gut microbiota composition in gout patients.Functional analysis revealed that the gut microbiome of gout patients had an enriched function on carbohydrate metabolism but a lower potential for purine metabolism,which was comparatively enhanced in the febuxostat treated gout patients.A classification microbial model obtained a high mean area under the curve up to 0.973.Therefore,gut dysbiosis characterizings gout could potentially serve as a noninvasive diagnostic tool for gout and may be a promising target of future preventive interventions.展开更多
Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicin...Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicinal herbs(MEMH), and its modulatory effects on inflammatory mediators associated with gouty arthritis. Both in vitro and in vivo studies were carried out to assess the anti-inflammatory efficacy of MEMH on monosodium urate(MSU) crystals-induced gouty inflammation. MSU crystals stimulated human chondrosarcoma cell line, SW1353, and human primary chondrocytes were treated with MEMH in vitro. The expression levels of pro-inflammatory mediators and metalloproteases were analyzed. The effect of MEMH on NFκB signaling pathway in SW1353 cells was examined. Effect of MEMH on the mR NA expression level of pro-inflammatory mediators and chemotactic factor from human monocytic cell line, THP-1, was also analyzed. The probable role of MEMH in the differentiation process of osteoblast like cells, SaO S-2, after MSU treatment was also observed. To investigate the effects of MEMH in vivo, MSU crystals-induced ankle arthritic model was established. Histopathological changes in affected joints and plasma levels of pro-inflammatory mediators(IL-1β and TNFα) were recorded. MEMH inhibited NFκB signaling pathway and COX-2 protein expression in chondrocytes. MSU-induced mR NA expressions of pro-inflammatory mediators and chemotactic cytokines were suppressed by MEMH. In MSU crystals-induced ankle arthritic mouse model, administration of MEMH relieved inflammatory symptoms and decreased the plasma levels of IL-1β and TNFα. The results indicated that MEMH can effectively inhibit the expression of inflammatory mediators in gouty arthritis, demonstrating its potential for treating gouty arthritis.展开更多
OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,doub...OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,double-blind,controlled trial included 165 AGA patients with the damp-heat symptom pattern who were randomly divided into an RBX CHT group and an RBX CFG group and treated for 7 d at three centers.The total effective rates of the joint symptom score,Traditional Chinese Medicine(TCM)symptoms score,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)were used to evaluate the clinical efficacy.Safety assessments were also performed.RESULTS:Of the 165 enrolled patients,147 completed the clinical observation.There was no difference in baseline between the two groups.The total effective rates of the joint symptom score were 94.36%and 97.36%,and the total effective rates of the TCM symptoms score were 95.77%and 97.36%in the CFG group and CHT group,respectively.No statistical difference was found between the two groups(P>0.05).Additionally,ESR and CRP were similar in both groups(P>0.05).Furthermore,treatment efficacy regarding TCM and joint symptoms,the ESR,and CRP were consistent within each center and among the different centers(P>0.05).In addition,the incidence of adverse events was 4.22%and 2.63%in the CFG group and CHT group,respectively,and no difference was observed between the two groups(P>0.05).CONCLUSION:RBX CFG and CHT have significant and similar efficacy in the treatment of AGA,and CFG did not increase adverse side effects.展开更多
·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 201...·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (【5 years), B (5 -10 years) and C (】10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant( 【0.01, 【0.01).Transparent vesicles with metal -like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant ( 【0.05, 【0.01, 【0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascular changes. These features have important clinical significance in early detection of the gout and prevention of eye injury. ·展开更多
Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly ...Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly altered compared to that of healthy people.This article focused on the complex interconnection between alterations in the gut microbiota and the development of this disorder.Some studies have suggested that changes in the composition,diversity,and activity of microbes play a key role in establishing and progressing HUA and gout pathogenesis.Therefore,we discussed how the gut microbiota contributes to HUA through purine metabolism,UA excretion,and intestinal inflammatory responses.We examined specific changes in the composition of the gut microbiota associated with gout and HUA,highlighting key bacterial taxa and the metabolic pathways involved.Additionally,we discussed the effect of conventional gout treatments on the gut microbiota composition,along with emerging therapeutic approaches that target the gut microbiome,such as the use of probiotics and prebiotics.We also provided insights into a study regarding the gut microbiota as a possible novel therapeutic intervention for gout treatment and dysbiosis-related diagnosis.展开更多
Gout is a common of inflammatory arthritis and is caused by the deposition of monosodium urate(MSU)crystals as a result of hyperuricemia(HUA).Although HUA is considered to be the main risk factor for gout,only approxi...Gout is a common of inflammatory arthritis and is caused by the deposition of monosodium urate(MSU)crystals as a result of hyperuricemia(HUA).Although HUA is considered to be the main risk factor for gout,only approximately 10%of the individuals with HUA will eventually experience a gout attack.In this review,we first briefly introduce the development of gout and then summarize several possible reasons for its development.Genetic factors play a more prominent role in gout than in other diseases;functional mutations related to urate control and innate immunity components have been found to be associated with gout.Here,we list some of the most prominent genes involved in the pathogenesis of gout.In joints with MSU deposition,mature macrophages may uptake MSU crystals without causing inflammation,and this helps to maintain joints in an asymptomatic state.As an auxiliary inflammation pathway,the ATP-P2X7R-NLRP3 axis may contribute to the amplification of MSU-induced inflammation to affect the development of gout.Finally,this review summarizes the research progress on natural products that can be used in the treatment of HUA and gout.展开更多
The aim of this work was to evaluate the ability of 33 herbal extracts in inhibiting the acute inflammation and xanthine oxidase (XOD) activity. The anti-inflammation effects of the herbal extracts were detected by ...The aim of this work was to evaluate the ability of 33 herbal extracts in inhibiting the acute inflammation and xanthine oxidase (XOD) activity. The anti-inflammation effects of the herbal extracts were detected by an in vitro cell model, which was established by stimulating human umbilical vein endothelial cells (HUVEC) using sodium urate (MSU). In this model, the intercellular adhesion molecule-1 (ICAM-1) and interleukin-1 beta (IL-1β) were expressed, and the anti-inflammation effects of herbal extracts were evaluated by detecting the content changes of ICAM-1 and IL-1β in cell lysates and cell culture supernates using an enzyme-linked immunosorbent assay (ELISA). Moreover, an ultrahigh performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS) method was used for the detection of XOD activity and the screening of XOD inhibitors in this research. The amount of uric acid from each analyte was directly detected using the multiple reaction monitoring mode and the uric acid level could be reduced via the addition of an inhibitor. Results indicated that Salviae Miltiorrhizae Radix et Rhizome, Rhei Radix et Rhizoma, Polygoni Cuspidati Rhizoma et Radix, Selaginellae Herba, Paeoniae Radix Rubra, especially Ginkgo Folium seemed to be more effective in anti-inflammation and inhibiting XOD activity. The anti-inflammation and enzyme inhibitory activities of the herbal extracts may be correlated with their bioactive components. And the differences between the herbal extracts were correlated with the amount of flavonoid and anthraquinone components. In our study, we have investigated the potential anti-inflammation bioactivity of 33 herbal extracts in vitro, which could provide a reference for further in vivo research in the orevention and treatment of gout.展开更多
BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases.However,large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome(A...BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases.However,large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome(ACS)-related hospitalizations and post-revascularization is inadequate.AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations,subsequent healthcare burden and predictors of post-revascularization inpatient mortality.METHODS We used the national inpatient sample(2010-2014)to identify the ACS and goutrelated hospitalizations,relevant comorbidities,revascularization and postrevascularization outcomes using the ICD-9 CM codes.A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality.RESULTS We identified 3144744 ACS-related hospitalizations,of which 105198(3.35%)also had gout.The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities.Coronary artery bypass grafting was required more often in the ACS-gout cohort.Post-revascularization complications including cardiac(3.2%vs 2.9%),respiratory(3.5%vs 2.9%),and hemorrhage(3.1%vs 2.7%)were higher whereas all-cause mortality was lower(2.2%vs 3.0%)in the ACSgout cohort(P<0.001).An older age(OR 15.63,CI:5.51-44.39),non-elective admissions(OR 2.00,CI:1.44-2.79),lower household income(OR 1.44,CI:1.17-1.78),and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization(P<0.001).Odds of post-revascularization inhospital mortality were lower in Hispanics(OR 0.45,CI:0.31-0.67)and Asians(OR 0.65,CI:0.45-0.94)as compared to white(P<0.001).However,postoperative complications significantly raised mortality odds.Mean length of stay,transfer to other facilities,and hospital charges were higher in the ACS-gout cohort.CONCLUSION Although gout was not independently associated with an increased risk of postrevascularization in-hospital mortality in ACS,it did increase postrevascularization complications.展开更多
基金Yunnan Clinical Research Center for rheumatism in Traditional Chinese Medicine(Grant No.202405AJ310004)Key Research and Development Project of the Science and Technology Department of Yunnan Province+2 种基金Social Development Special Project(Grant No.202403AC100019)The Expert Workstation of Zhangxuan in Yunnan Province(Grant No.202305AF150175)Joint Research Fund Project of the University and the College of Yunnan University of Traditional Chinese Medicine(Grant No.XYLH2024042,XYLH2024030)。
摘要Gout,a metabolic disorder characterized by dysregulated uric acid metabolism,has emerged as a major global public health concern owing to its steadily increasing prevalence.This study systematically examined the distinctive diagnostic and therapeutic principles of Miao medicine theory in the prevention and treatment of gout.Our findings indicated that Miao medicine conceptualized gout management through a unique“disease stage-functional framework-body domain”system,grounded in a regulatory model that integrates energy,matter,and structural dynamics.This holistic and dynamically balanced perspective offered novel theoretical insights and complementary practical strategies that might enrich contemporary approaches to gout management.
基金Supported by Wuxi Taihu Talent Program(202101)Project of Wu Jieping Medical Foundation(320.6750.2023-03-33).
摘要[Objectives]To analyze the clinical characteristics,distribution of traditional Chinese medicine(TCM)syndrome types,spectrum of comorbidities,and complications among inpatients with gout.[Methods]Data from 592 gout patients admitted in the Department of Rheumatology at Wuxi Traditional Chinese Medicine Hospital between January 2018 and December 2024 were retrospectively collected.The data collected encompassed patient gender,age,TCM syndrome types,underlying comorbidities,infection status,and major complications,including renal insufficiency,interstitial lung disease,and osteoporosis.Descriptive statistical analyses were subsequently performed.[Results]Among the 592 inpatients,80.75%were male and 19.25%were female.A total of 94.76%patients had at least one underlying condition,with hypertension(80.74%),cerebral infarction(29.59%),heart disease(24.24%),and diabetes(21.56%)being the most prevalent.The primary TCM syndrome types identified were damp-heat obstruction syndrome(63.51%)and phlegm-stasis obstruction syndrome(21.11%).During hospitalization,20.94%of patients experienced concurrent infections,predominantly pulmonary infections(38.10%).The principal complications observed included renal insufficiency(32.09%),interstitial lung disease(18.75%),and osteoporosis(9.29%).[Conclusions]Inpatients diagnosed with gout often present with complex conditions and a high burden of comorbidities,predominantly cardiovascular and cerebrovascular diseases,as well as metabolic disorders.Additionally,there is a high incidence of infections and renal insufficiency within this population.TCM syndrome types in these patients are primarily characterized by damp-heat obstruction.In clinical practice,a comprehensive management approach that incorporates multidisciplinary collaboration is recommended.Alongside the control of uric acid levels and joint inflammation,proactive screening and management of comorbidities and related complications are essential.
摘要Currently, glucocorticoids are the only treatment option for acute gout attacks in patients with chronic kidney disease (CKD) and progressive renal dysfunction. Management becomes particularly challenging when steroid therapy is contraindicated, poorly tolerated, or ineffective. IL-1β monoclonal antibodies offer potent, targeted anti-inflammatory effects and have been approved for the treatment of gout, providing new therapeutic hope for this population. Here, we report a case of a patient with CKD and progressively worsening renal function who experienced an acute gout attack requiring dialysis. Treatment with the IL-1β monoclonal antibody Firsekibart produced rapid and remarkable anti-inflammatory and analgesic effects, effectively controlling the gout attack, improving renal function, and allowing discontinuation of dialysis.
摘要Background:Tophi ulceration with infection and refractory wound healing remains a clinical challenge,particularly in patients with concurrent diabetes.Interleukin-1β(IL-1β)is a central mediator of gouty inflammation;targeted IL-1 inhibition may rapidly suppress inflammation and facilitate tissue repair.Case Presentation:This study reported the case of a 27-year-old male with a 6-year history of gouty arthritis,multiple tophi,infected left foot ulceration,and type 2 diabetes.Despite conventional anti-infective therapy,glycemic control,and local wound care,the ulcer showed limited improvement.Following a single subcutaneous injection of firsekibart(200 mg),wound exudate decreased rapidly,granulation tissue developed satisfactorily,and the ulcer healed progressively.At the 4-month followup,complete wound closure was achieved without recurrence or adverse events.Conclusion:Firsekibart demonstrated favorable anti-inflammatory and wound-healing effects in a patient with tophi ulceration complicated by diabetes,suggesting its potential as a therapeutic option for refractory cases.Prospective studies are warranted to confirm these findings.
基金supported by the Fundamental Research Funds for the Central Universities(DUT24YG142).
摘要Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout and associated renal dysfunction in a mouse model.The results show that curcumin treatment alleviates ankle joint swelling,reduces inflammatory cytokines IL-1βand TNF-α,and lowers serum uric acid concentrations.High-dose curcumin notably inhibits xanthine oxidase(XOD)activity,a key enzyme in uric acid production,while it enhances the renal expression of the urate transporter ABCG2,thereby promoting uric acid excretion.Furthermore,curcumin effectively mitigates renal injury as evidenced by reduced serum creatinineand blood urea nitrogen levels and suppresses renal inflammation.At the molecular level,curcumin exerts potent antioxidant effects by lowering reactive oxygen species(ROS)levels in both cultured HK-2 human renal tubular epithelial cells and RAW264.7 mouse macrophages.The curcumin-mediated effects are associated with the disruption of NEK7-NLRP3 complex formation,leading to the suppression of the ROS/NEK7-NLRP3 inflammasome pathway.This,in turn,inhibits pyroptosis and the subsequent release of mature IL-1β.These findings suggest that curcumin not only reduces uric acid production but also modulates inflammation through ROSscavenging properties and its ability to inhibit the NLRP3 inflammasome.
基金the National Natural Science Foundation of China(32325040)the Research Fund for the National Key R&D Program of China(2022YFD2100700).
摘要Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the society.UA metabolism is a complex physiological process involving the kidney,intestine,and other organs.A number of factors together regulate UA metabolism,including genetics,diet,hormones,and the gut microbiota.This review summaries the gut microbiota features in subjects with HUA and gout,and the therapeutic effects of implementing microecological therapies(probiotics,prebiotics,or fecal microbiota transplant)that target modulate the gut microbiota and its downstream metabolism on the disease.Current evidence shows that these strategies are safe and promising in alleviate inflammation,reduce UA,and restoring a healthy gut microbiota in subjects with UA metabolism-related diseases.However,most clinical data are generated by animal studies.Therefore,we propose that vigorous human intervention trials should be conducted in the future to evaluate the therapeutic effects of microecological therapies in managing HUA and gout.
摘要To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmacology and molecular docking methods.Disease-associated targets for gout and hyperuricemia were identified from the GeneCards,OMIM,Disgenet,and TTD databases,while the key active components and their corresponding targets for Smilax Glabra and Semen Coicis were obtained from the TCSMP database.The intersection of these targets enabled the construction of a protein-protein interaction(PPI)network,which was subsequently visualized and analyzed.Core targets were further subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses to elucidate the biological processes and pathways involved.Molecular docking was then employed to validate the reliability of the interactions between the active components and the identified targets.The analysis revealed that Smilax Glabra and Semen Coicis contained 15 bioactive components that interacted with 393 potential targets,while gout and hyperuricemia were associated with 660 targets in total.The primary active compounds implicated in treating these conditions included diosgenin,quercetin,and naringenin,which were found to interact with crucial hub targets such as BCL2,CASP3,and MAPK3.These interactions suggested that the herbal medicine pair modulated several biological processes,including gland development and the regulation of body fluid levels,through pathways involving membrane rafts,membrane microdomains,and nuclear receptor activities.Enrichment analyses highlighted their involvement in multiple signaling pathways,such as EGFR tyrosine kinase inhibitor resistance,phospholipase D signaling,and platelet activation.Molecular docking confirmed the strong binding affinities between the hub genes and the major active components,supporting their potential role in therapeutic efficacy.This study demonstrated that Smilax Glabra and Semen Coicis might offer a promising therapeutic strategy for gout and hyperuricemia by targeting multiple molecular components,biological functions,and pathways.The findings underscored the unique potential of traditional Chinese medicine(TCM)in managing complex diseases by leveraging synergistic effects across diverse biological mechanisms.
摘要The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlights dapagliflo-zin’s efficacy in lowering serum uric acid levels,enhancing cardiac function,and reducing cardiovascular events.This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid.Furthermore,this review examines the potential role of SGLT2 inhibitor in the context of gout,evaluating its mechanisms and clinical application prospects in the management of hyperuricemia,thereby further enriching the medical community’s understanding of SGLT2 inhibitor.
摘要Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict its target points through the database,and then construct the gout-related protein-protein interaction network(PPI),and then construct the"Weiling,"the"Xian,Guizhi"drug pair"active ingredient-predicted target"network,the construction of the gout-related"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network,based on the Kyoto Encyclopedia of Genes and Genomes(KEGG)biological pathway enrichment analysis and gene ontology(GO)functional enrichment analysis,to study the mechanism of action of the two drugs"Weilingxian-Guizhi"in the treatment of gout.Results:The goutrelated"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network contains 14 targets.KEGG pathway enrichment analysis yields 32 pathways,and GO functional enrichment analysis yields 517 GO entries.Among them,there are 468 items related to biological processes,21 items related to molecular functions,and 28 items related to cell composition.Conclusion:The results of this study initially verified and predicted the mechanism of the"Weilingxian-Cinnamon Stick"medicine on the treatment of gout,and laid a good foundation for further revealing its mechanism of action.
基金supported by the National Key Research and Development Program of China(Nos.2022YFC3501200 and 2022YFC3501203)the National Natural Science Foundation of China(No.8217152586).
摘要In order to implement the requirements of the document Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovation of Traditional Chinese Medicine,accelerate the promotion of the construction of a healthy China,adhere to the equal importance of Chinese and Western medicines,promote the mutual complementarity of traditional Chinese medicine and Western medicine and coordinated development,strengthen the academic exchanges and cooperation of Chinese and Western medicine in the field of preventing and controlling gout,and cultivate the high-caliber young clinical talents,the China Association of Chinese Medicine(CACM)organized the 48th Salon on Clinical Advantageous Diseases in Beijing on 21 March 2025,focusing on the combined Chinese and Western medicine diagnosis and treatment strategy of gout,bringing together experts in Chinese and Western medicine and interdisciplinary fields,and reaching specific recommendations and consensus on the combined Chinese and Western medicine diagnosis and treatment of gout through in-depth discussion.On this basis,under the leadership of the CACM,gout diagnosis and treatment problems were analyzed from the perspective of gout occurrence and development law,focusing on the advantages and characteristics of Chinese medicine and combined Chinese and Western medicine in gout diagnosis and treatment,and proposing scientific research and technological layout of gout in the following aspects:(1)Improvement of gout staging and identification system,(2)optimization of Chinese medicine to prevent and treat gout and drug research and development,(3)improvement of indicators for post-treatment assessment of gout,(4)research on early warning system of Chinese and Western medicine,(5)construction of gout co-morbidities spectrum and Chinese medicine theoretical system,(6)research on co-morbidities mechanism of gout,(7)chronic disease grassroots health management,and at the same time,it also puts forward the proposed layout and direction of the research,the expected goal and value and the priority of the proposed funding.Therefore,this article is based on the gout Chinese medicine advantageous disease series salon,proposed gout scientific and technological research paradigm,in order to help the high-quality development of traditional Chinese medicine.
基金Supported by Six Peak Talents Projects in Jiangsu Province on Clinical Application of HuRAT1 Combined with ABCG2 Gene Detection in Predicting Hyperuricemia/Gout Susceptibility(2015-WSN-089)Research Projects of Traditional Chinese Medicine of Wuxi Municipal Health Commission on Mechanisms of Bixie Drink on Neutrophils and Inflammatory Signal Transduction Pathway of NLRP3 in Gout Model Rats(ZYZL201803).
摘要Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focused on immune inflammation,gene polymorphism and related studies.Uric acid deposition or crystal precipitation activates phagocytes,fibroblasts and mast cells in synovium,produces IL-1β,TNF and chemokine IL-8(CXCL8),thereby activating neutrophils,urate crystal polyanion surface can be coated with immunoglobulins and other serum proteins as substrates for complement activation,complement substitution pathways and classical complement pathways to activate complements.Uric acid crystals activate inflammation-related signal transduction pathways including the activation of inflammation-related signal transduction pathway by uric acid crystals and TLRS/MyD88 signal transduction pathways.Gene polymorphism is related to inflammation and signaling pathway,EGF gene is closely related to gout inflammation,which may be involved in the regulation of gout inflammation,among which NLRP3 inflammatory signaling pathway and gene polymorphism have been deeply studied in the pathogenesis of gout,which is the main therapeutic target of anti-inflammatory and uric acid lowering.
摘要BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMMARY We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels.The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years,which was aggravated for 3 d.The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years.Resection of the nasal masses was performed.Cartilage from the right ear cavity was used to repair the nasal defects.The pathological report confirmed a nasal gouty tophus.No recurrence or deformity was found after a 1 year follow-up.CONCLUSION Normal SUA cannot completely negate the diagnosis of gouty tophus,especially in some rare regions.
基金the Project of Zhejiang Provincial Department of Education,China(Y202045471)the Project of Wenzhou Science and Technology,China(NO.Y2020205)。
摘要Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used uric acid-lowering treatment,febuxostat on gut microbiota in gout.16S ribosomal RNA sequencing and metagenomic shotgun sequencing was performed on fecal DNA isolated from 38 untreated gout patients,38 gout patients treated with febuxostat,and 26 healthy controls.A restriction of gut microbiota biodiversity was detected in the untreated gout patients,and the alteration was partly restored by febuxostat.Biochemical metabolic indexes involved in liver and kidney metabolism were significantly associated with the gut microbiota composition in gout patients.Functional analysis revealed that the gut microbiome of gout patients had an enriched function on carbohydrate metabolism but a lower potential for purine metabolism,which was comparatively enhanced in the febuxostat treated gout patients.A classification microbial model obtained a high mean area under the curve up to 0.973.Therefore,gut dysbiosis characterizings gout could potentially serve as a noninvasive diagnostic tool for gout and may be a promising target of future preventive interventions.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(Nos.2014R1A1A4A03009388&2014R1A1A2055560)a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)+2 种基金funded by the Ministry of Health&Welfare,Republic of Korea(No.HI12C1265)Hallym University Research Fund
摘要Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicinal herbs(MEMH), and its modulatory effects on inflammatory mediators associated with gouty arthritis. Both in vitro and in vivo studies were carried out to assess the anti-inflammatory efficacy of MEMH on monosodium urate(MSU) crystals-induced gouty inflammation. MSU crystals stimulated human chondrosarcoma cell line, SW1353, and human primary chondrocytes were treated with MEMH in vitro. The expression levels of pro-inflammatory mediators and metalloproteases were analyzed. The effect of MEMH on NFκB signaling pathway in SW1353 cells was examined. Effect of MEMH on the mR NA expression level of pro-inflammatory mediators and chemotactic factor from human monocytic cell line, THP-1, was also analyzed. The probable role of MEMH in the differentiation process of osteoblast like cells, SaO S-2, after MSU treatment was also observed. To investigate the effects of MEMH in vivo, MSU crystals-induced ankle arthritic model was established. Histopathological changes in affected joints and plasma levels of pro-inflammatory mediators(IL-1β and TNFα) were recorded. MEMH inhibited NFκB signaling pathway and COX-2 protein expression in chondrocytes. MSU-induced mR NA expressions of pro-inflammatory mediators and chemotactic cytokines were suppressed by MEMH. In MSU crystals-induced ankle arthritic mouse model, administration of MEMH relieved inflammatory symptoms and decreased the plasma levels of IL-1β and TNFα. The results indicated that MEMH can effectively inhibit the expression of inflammatory mediators in gouty arthritis, demonstrating its potential for treating gouty arthritis.
基金grants from the Traditional Chinese Medicine Department of Chongqing Municipal Health and Family Planning commission(No.2012-1-16)National Natural Science Foundation of China(Grant no.81673724)+1 种基金Chongqing Science and Technology Commission(cstc2018jxj1130084 and cstc2017jxjl130033)Chongqing Hospital of Traditional Chinese Medicine Advantageous Diseases Special Fund(No.cqszyyysbz2018004)。
摘要OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,double-blind,controlled trial included 165 AGA patients with the damp-heat symptom pattern who were randomly divided into an RBX CHT group and an RBX CFG group and treated for 7 d at three centers.The total effective rates of the joint symptom score,Traditional Chinese Medicine(TCM)symptoms score,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)were used to evaluate the clinical efficacy.Safety assessments were also performed.RESULTS:Of the 165 enrolled patients,147 completed the clinical observation.There was no difference in baseline between the two groups.The total effective rates of the joint symptom score were 94.36%and 97.36%,and the total effective rates of the TCM symptoms score were 95.77%and 97.36%in the CFG group and CHT group,respectively.No statistical difference was found between the two groups(P>0.05).Additionally,ESR and CRP were similar in both groups(P>0.05).Furthermore,treatment efficacy regarding TCM and joint symptoms,the ESR,and CRP were consistent within each center and among the different centers(P>0.05).In addition,the incidence of adverse events was 4.22%and 2.63%in the CFG group and CHT group,respectively,and no difference was observed between the two groups(P>0.05).CONCLUSION:RBX CFG and CHT have significant and similar efficacy in the treatment of AGA,and CFG did not increase adverse side effects.
摘要·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (【5 years), B (5 -10 years) and C (】10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant( 【0.01, 【0.01).Transparent vesicles with metal -like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant ( 【0.05, 【0.01, 【0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascular changes. These features have important clinical significance in early detection of the gout and prevention of eye injury. ·
摘要Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly altered compared to that of healthy people.This article focused on the complex interconnection between alterations in the gut microbiota and the development of this disorder.Some studies have suggested that changes in the composition,diversity,and activity of microbes play a key role in establishing and progressing HUA and gout pathogenesis.Therefore,we discussed how the gut microbiota contributes to HUA through purine metabolism,UA excretion,and intestinal inflammatory responses.We examined specific changes in the composition of the gut microbiota associated with gout and HUA,highlighting key bacterial taxa and the metabolic pathways involved.Additionally,we discussed the effect of conventional gout treatments on the gut microbiota composition,along with emerging therapeutic approaches that target the gut microbiome,such as the use of probiotics and prebiotics.We also provided insights into a study regarding the gut microbiota as a possible novel therapeutic intervention for gout treatment and dysbiosis-related diagnosis.
基金Important Drug Development Fund,Ministry of Science and Technology of China(2018ZX09735-002)National Natural Science Foundation of China(81173524,81673688)。
摘要Gout is a common of inflammatory arthritis and is caused by the deposition of monosodium urate(MSU)crystals as a result of hyperuricemia(HUA).Although HUA is considered to be the main risk factor for gout,only approximately 10%of the individuals with HUA will eventually experience a gout attack.In this review,we first briefly introduce the development of gout and then summarize several possible reasons for its development.Genetic factors play a more prominent role in gout than in other diseases;functional mutations related to urate control and innate immunity components have been found to be associated with gout.Here,we list some of the most prominent genes involved in the pathogenesis of gout.In joints with MSU deposition,mature macrophages may uptake MSU crystals without causing inflammation,and this helps to maintain joints in an asymptomatic state.As an auxiliary inflammation pathway,the ATP-P2X7R-NLRP3 axis may contribute to the amplification of MSU-induced inflammation to affect the development of gout.Finally,this review summarizes the research progress on natural products that can be used in the treatment of HUA and gout.
基金the National Natural Science Foundation of China(Nos.21175128,81303280,81573574)
摘要The aim of this work was to evaluate the ability of 33 herbal extracts in inhibiting the acute inflammation and xanthine oxidase (XOD) activity. The anti-inflammation effects of the herbal extracts were detected by an in vitro cell model, which was established by stimulating human umbilical vein endothelial cells (HUVEC) using sodium urate (MSU). In this model, the intercellular adhesion molecule-1 (ICAM-1) and interleukin-1 beta (IL-1β) were expressed, and the anti-inflammation effects of herbal extracts were evaluated by detecting the content changes of ICAM-1 and IL-1β in cell lysates and cell culture supernates using an enzyme-linked immunosorbent assay (ELISA). Moreover, an ultrahigh performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS) method was used for the detection of XOD activity and the screening of XOD inhibitors in this research. The amount of uric acid from each analyte was directly detected using the multiple reaction monitoring mode and the uric acid level could be reduced via the addition of an inhibitor. Results indicated that Salviae Miltiorrhizae Radix et Rhizome, Rhei Radix et Rhizoma, Polygoni Cuspidati Rhizoma et Radix, Selaginellae Herba, Paeoniae Radix Rubra, especially Ginkgo Folium seemed to be more effective in anti-inflammation and inhibiting XOD activity. The anti-inflammation and enzyme inhibitory activities of the herbal extracts may be correlated with their bioactive components. And the differences between the herbal extracts were correlated with the amount of flavonoid and anthraquinone components. In our study, we have investigated the potential anti-inflammation bioactivity of 33 herbal extracts in vitro, which could provide a reference for further in vivo research in the orevention and treatment of gout.
摘要BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases.However,large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome(ACS)-related hospitalizations and post-revascularization is inadequate.AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations,subsequent healthcare burden and predictors of post-revascularization inpatient mortality.METHODS We used the national inpatient sample(2010-2014)to identify the ACS and goutrelated hospitalizations,relevant comorbidities,revascularization and postrevascularization outcomes using the ICD-9 CM codes.A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality.RESULTS We identified 3144744 ACS-related hospitalizations,of which 105198(3.35%)also had gout.The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities.Coronary artery bypass grafting was required more often in the ACS-gout cohort.Post-revascularization complications including cardiac(3.2%vs 2.9%),respiratory(3.5%vs 2.9%),and hemorrhage(3.1%vs 2.7%)were higher whereas all-cause mortality was lower(2.2%vs 3.0%)in the ACSgout cohort(P<0.001).An older age(OR 15.63,CI:5.51-44.39),non-elective admissions(OR 2.00,CI:1.44-2.79),lower household income(OR 1.44,CI:1.17-1.78),and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization(P<0.001).Odds of post-revascularization inhospital mortality were lower in Hispanics(OR 0.45,CI:0.31-0.67)and Asians(OR 0.65,CI:0.45-0.94)as compared to white(P<0.001).However,postoperative complications significantly raised mortality odds.Mean length of stay,transfer to other facilities,and hospital charges were higher in the ACS-gout cohort.CONCLUSION Although gout was not independently associated with an increased risk of postrevascularization in-hospital mortality in ACS,it did increase postrevascularization complications.