What makes gouty inflammation so variable?

BMC Medicine

Minireview

Robert Terkeltaub¹ 

[1] VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, 92161, San Diego, CA, USA;Department of Medicine, University of California San Diego, San Diego, CA, USA;

关键词: Gout flare;    NLRP3 inflammasome;    AMPK;    PPAR-γ;    PGC1B;    Short-chain fatty acids;    β-hydroxybutyrate;    miR-146a;    miR-155;    IL-37;   

DOI  :  10.1186/s12916-017-0922-5

 received in 2017-06-07, accepted in 2017-08-02,  发布年份 2017

来源: Springer

【 摘 要 】

Acute gout arthritis flares contribute dominantly to gout-specific impaired health-related quality of life, representing a progressively increasing public health problem. Flares can be complex and expensive to treat, partly due to the frequent comorbidities. Unmet needs in gout management are more pressing given the markedly increasing gout flare hospital admission rates. In addition, chronic gouty arthritis can cause joint damage and functional impairment. This review addresses new knowledge on the basis for the marked, inherent variability of responses to deposited urate crystals, including the unpredictable and self-limited aspects of many gout flares. Specific topics reviewed include how innate immunity and two-signal inflammasome activation intersect with diet, metabolism, nutritional biosensing, the microbiome, and the phagocyte cytoskeleton and cell fate. The paper discusses the roles of endogenous constitutive regulators of inflammation, including certain nutritional biosensors, and emerging genetic and epigenetic factors. Recent advances in the basis of variability in responses to urate crystals in gout provide information about inflammatory arthritis, and have identified potential new targets and strategies for anti-inflammatory prevention and treatment of gouty arthritis.

【 授权许可】

CC BY   
© The Author(s). 2017