Pain from too much uric acid: Researchers identify 28 gout risk genes
An increased uric acid concentration in the organism can cause gout. In a genome-wide association study, scientists led by Anna Köttgen from Freiburg University Hospital have now identified 28 gene variants that are related to uric acid levels and are therefore rated as risk factors for gout disease.
The deposition of the urinary tract crystals in the joints leads to swelling, redness, overheating, deformity and pain in the joints in gout patients. It was already known from previous studies that the disease is largely determined by hereditary components. The international team of researchers led by Anna Köttgen from the Freiburg University Medical Center started here and, as part of the Global Urate Genetics Consortium (GUGC), evaluated the genome of more than 140,000 people of European descent in order to find out the genetic causes of the disease.
Genetics of 140,000 patients evaluated The 28 identified risk genes have a direct influence on the uric acid concentration and therefore form risk factors in relation to the development of a gout disease, the scientists report in the journal Nature Genetics. "The findings provide a basis for the development of new treatment methods and medications for the common gout disease," the scientists hope. Over 220 scientists from 14 countries were involved in the study. The data from 140,000 patients from more than 70 individual studies in Australia, Europe, Japan and the USA were evaluated. Using the data, the researchers were able to “identify 28 genome-wide significant loci” that are related to serum uric acid levels, including 18 new gene variants, write Anna Köttgen and colleagues in the current article. The gene variants are "related to an increased uric acid level" and therefore have "influence on the development of gout".
Interaction of the risk genes and nutrition as a trigger of gout? According to the researchers, the identified risk genes will also significantly improve the treatment and prevention of gout in the future. The current study contributes to a significantly better understanding of the disease. As a metabolic disease, gout primarily affects urea metabolism, which is permanently impaired in the course of the disease and can no longer guarantee the breakdown or excretion of uric acid to the required extent. A significant influence is also attributed to nutrition in this context, whereby the intake of high uric acid concentrations, such as meat consumption at Christmas, can lead to acute gout attacks. Typical symptoms of an acute attack of gout include sudden joint pain with the recognizable external changes in the joints described above, as well as accompanying symptoms such as fever or, in rare cases, headache. Without treatment, the acute gout attack lasts up to three weeks before the symptoms go away. If the disease has already progressed into the chronic course, those affected may no longer have any symptom-free periods at all. They suffer from constant pain and their joints are significantly deformed. Over time, the kidney is also increasingly damaged by the disease and there is a long-term risk of fatal renal failure.
Appropriate nutrition helps against gout In order to minimize the risk of gout, medical practitioners recommend using foods that contain little or no uric acid, such as apples, eggs, yogurt, pumpkin, potatoes, milk, whole grain bread or cheese. A dietitian can provide gout patients with useful tips on how to lower uric acid levels in the long term. Those who already have problems with their uric acid levels should better exercise caution at Christmas dinner and the accompanying alcohol consumption in order not to risk an acute gout attack. How many people are actually affected by the common gout disease can be seen from the information in the German Gout League, according to which 2.8 percent of men and 0.4 percent of women between the ages of 30 and 59 in Germany suffer from gout. The prospect of improvements in gout treatment and prevention based on the current study results is therefore of considerable social importance. (fp)
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