Therapeutic drugs of gout: The progress in target selection

Abstract

Therapeutic drugs of gout: The progress in target selectionGout is a chronic, inflammatory, and metabolic disease caused by the deposition of monosodium urate (MSU) crystals. It presents clinically with gout flares, chronic gouty arthritis, and tophi. 1 Gout attacks are often accompanied by various serious complications, such as cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease, and premature death. 2 With the improvement of living standards and intake of more and more purine-containing foods, gout incidence is increasing yearly. Presently, the incidence rate is 0.58-2.89 per 1000 person-years. 3 Gout has become a severe public health problem, causing great suffering and a heavy financial burden to patients.Gout is caused by purine metabolism disorder and MSU crystals deposition around joints and other tissues. As shown in Figure 1, purine nucleotides are converted to hypoxanthine by purine nucleoside phosphorylase (PNP). Subsequently, hypoxanthine is oxidized to form xanthine by xanthine oxidase (XO). Finally, xanthine is oxidized by XO to produce uric acid. 4 When the level of serum uric acid (SUA) exceeds its solubility point of 6.8 mg/dL, it is defined as