Gicht

Honokiol alleviates monosodium urate-induced gouty pain by inhibiting voltage-gated proton channels in mice

OBJECTIVE

To investigate whether honokiol (HNK) acted as an analgesic in connection with inhibiting the voltage-gated proton channel (Hv1).

METHODS

The model of gouty arthritis was induced by injecting monosodium urate (MSU) crystals into the hind ankle joint of mice. HNK was given by intragastric administration. Ankle swelling degree and mechanical allodynia were evaluated using ankle joint circumference measurement and von Frey filaments, respectively. Hv1 current, tail current, and action potential in dorsal root ganglion (DRG) neurons were recorded with patch-clamp techniques.

RESULTS

HNK (10, 20, 40 mg/kg) alleviated inflammatory response and mechanical allodynia in a dose-dependent manner. In normal DRG neurons, 50 µM Zn2+ or 2-GBI significantly inhibited the Hv1 current and the current density of Hv1 increased with increasing pH gradient. The amplitude of Hv1 current significantly increased on the 3rd after MSU treatment, and HNK dose-dependently reversed the upregulation of Hv1 current. Compared with MSU group, 40 mg/kg HNK shifted the activation curve to the direction of more positive voltage and increased reversal potential to the normal level. In addition, 40 mg/kg HNK reversed the down-regulation of tail current deactivation time constant (τtail) but did not alter the neuronal excitability of DRG neurons in gouty mice.

CONCLUSION

HNK may be a potential analgesic by inhibiting Hv1 current.

Assessment of oral toxicity of Moringa oleifera Lam aqueous extract and its effect on gout induced in a murine model

Background and Aim

Although widely employed in traditional remedies globally, the safety and efficacy of Moringa oleifera remain inadequately documented through scientific research. This study evaluated the oral toxicity of M. oleifera leaf aqueous extract (MoAE) and its impact on gout-induced rats.

Materials and Methods

2000 mg/kg was given in a single dose during the acute oral toxicity test, while 100 mg/kg, 250 mg/kg, and 500 mg/kg were given daily for 28 days in the repeated dose toxicity test. 100 mg/kg, 250 mg/kg, and 500 mg/kg MoAE doses were administered during the assessment of its impact on gout caused by monosodium urate. In the hyperuricemia model induced by oxonic acid, serum uric acid levels were assessed and pain response was measured through acetic acid-induced writhing.

Results

In acute oral and 28-day repeated dose tests, no indications of toxicity were detected, while MoAE alleviated ankle joint swelling and reduced serum uric acid concentrations in arthritic rats, causing a significant reduction in acetic acid-induced contortions.

Conclusion

No acute oral toxicity or toxicity in 28-day repeated doses was found for MoAE, while it exhibited antiarthritic, antihyperuricemic, and pain-relieving effects in the murine model.

Sepsis complicated with secondary hemophagocytic syndrome induced by giant gouty tophi rupture: A case report

BACKGROUND

Gouty tophi are a chronic granulomatous caused by a deposition of monosodium urate crystal deposition in the body. Once broken, it may easily induce severe infection. Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting, and no such serious complications have been reported in literature.

CASE SUMMARY

This is a 52-year-old Chinese male patient with a 20-year history of gouty arthritis. At admission, the gout stone in the patient’s right ankle was broken and it secreted a white mucoid substance. During the course of treatment, the patient suffered from systemic inflammatory response syndrome multiple times. His condition gradually deteriorated, further complicated by hemophagocytic syndrome. After thorough removal of gout lesions and active anti-infection treatment and control of blood uric acid level, combined with multidisciplinary cooperation, the patient was finally cured.

CONCLUSION

Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting. Timely and accurate diagnosis is very important to save patients' lives.

Simiaosan alleviates the symptoms of gouty arthritis via the NALP3/IL‑1β pathway

Previous studies have suggested that the herbal medicine simiaosan has beneficial effects on gouty arthritis (GA), for which conventional Western medicines are insufficient (particularly in cases of multiple episodes). The objective of the present study was to investigate the mechanism by which simiaosan alleviated the symptoms of GA. Sprague-Dawley rat models of acute GA were successfully established, as verified by pathological analyses. Additionally, an NLR family pyrin domain containing 3 (NLRP3) overexpression vector was constructed and a high transfection efficiency was confirmed by reverse transcription PCR. The following five treatment groups were established: i) Normal control; ii) model + saline; iii) model + simiaosan; iv) model + NALP3-overexpressing adenovirus + simiaosan; and v) model + empty vector adenovirus + simiaosan. The samples from mice in each group were subjected to hematoxylin and eosin (H&E) staining for assessing the histopathological changes, enzyme-linked immunosorbent assays for determining IL-1β and TGF-β1 levels and western blotting for evaluating NALP3 expression. H&E staining indicated that simiaosan could reduce the infiltration of inflammatory cells, while NALP3 overexpression aggravated the inflammatory response in tissues. Expression levels of IL-1β, TGF-β1 and NALP3 were significantly higher in the model and the model + NALP3-overexpressing adenovirus + simiaosan groups compared with the normal control group. Levels of IL-1β, TGF-β1 and NALP3 were significantly lower in the model + simiaosan and model + empty vector adenovirus + simiaosan groups compared with the model group. These results indicated that the effects of simiaosan were mediated through NALP3 inhibition. Therefore, the herbal medicine simiaosan was revealed to possess an ability to alleviate the symptoms of GA by regulating the NALP3/IL-1β signaling pathway.

Gicht – auch eine Frage des Lebensstiles

Mit steigenden Harnsäurewerten steigt das Risiko einer Gicht. Da die Harnsäure-Homöostase von zahlreichen Lebensstilfaktoren beeinflusst wird, ist das Auftreten einer Gicht fast immer auch mit der Lebensweise assoziiert. Lange schon ist bekannt, dass die Zufuhr purinreicher Lebensmittel (z. B. Fleisch, Meeresfrüchte) über vermehrte Harnsäurebildung aus exogen zugeführten Purinen zu Gichtanfällen führen kann. Auch Fruktose-haltige Getränke haben über einen vermehrten Abbau von ATP bei der Verstoffwechslung von Fruktose eine Hyperurikämie zur Folge, wogegen bei vermehrter Alkoholzufuhr und Adipositas eine verminderte renale Harnsäureausscheidung für die Hyperurikämie ursächlich ist. Einige Lebensmittel (z. B. Milch, Kaffee) scheinen einen harnsäuresenkenden Effekt zu haben und können Patienten explizit empfohlen werden. Mit Blick auf den Lebensstil spielen jedoch nicht nur Ernährungsfaktoren (Lebensmittel) eine wichtige Rolle. So kommt es beim aktuell sehr populären Heilfasten durch die entstehende Ketose und häufig gleichzeitig zu geringer Flüssigkeitszufuhr zu einer verminderten Harnsäureausscheidung über die Niere und konsekutiv Harnsäureanstieg. Auch Extremsport wie Marathon stellt aufgrund der katabolen Stoffwechsellage (Ketose) und hohen mechanischen Belastung (Mikrotraumata) bereits arthrotisch vorgeschädigter Gelenke einen Risikofaktor für das gehäufte Auftreten von Gichtanfällen dar. Patienten mit einer Hyperurikämie sollten als Basismaßnahme immer über eine mögliche Ernährungsumstellung beraten werden, zumal die Hyperurikämie eng mit dem metabolischen Syndrom assoziiert ist, häufigen Stoffwechselkrankheiten wie Diabetes mellitus, Hyperlipidämien und Adipositas, die ebenfalls durch eine Lebensstilmodifikation günstig zu beeinflussen sind. Eine manifeste (langjährige) Gicht kann allerdings durch eine alleinige Ernährungsumstellung nur selten erfolgreich behandelt werden. Der Zusammenhang zwischen Lebensstil und Gicht ist seit Jahrhunderten bekannt. Leider beschränken sich die wenigen Studien zu diesem Thema meist auf epidemiologische Erhebungen, über die in dieser Arbeit eine Übersicht gegeben werden soll.

Icariin alleviates MSU-induced rat GA models through NF-κB/NALP3 pathway

Icariin (ICA) has anti-inflammatory effects in some diseases, but its role in gouty arthritis (GA) is not clear. This study investigated the effects of ICA in monosodium urate (MSU)-induced GA rat models. GA rat models were induced by MSU, and co-treated with ICA of low-dose (20 mg/kg), medium-dose (40 mg/kg), and high-dose (80 mg/kg), respectively. The ankle swelling rates, haematoxylin-eosin (HE) staining changes, inflammatory factors (interleukin (IL)-1β, IL-6, tumour necrosis factor-α (TNF-α)) and prostaglandin E2 (PGE₂ ) levels in synovial tissues were detected. The antioxidants levels in rat serum, and NF-κB pathway-related proteins and NALP3 inflammasome expressions in synovial tissues were also analysed. In cell experiments, chondrocytes were co-treated with different concentrations of ICA (1, 5, 10 μmol/L) on the basis of MSU. The activities and inflammatory cytokines, hydroxyproline (Hyp) and glycosaminogly (GAG) expressions in chondrocytes were measured. In rat experiments, MUS increased the ankle swelling rates, promoted inflammatory cells infiltration, and increased IL-1β, IL-6, TNF-α, PGE₂ levels in synovial tissues, which were all alleviated by ICA. Moreover, ICA also suppressed nuclear translocation of NF-κB pathway-related proteins and reduced the expression of NALP3 inflammasome in rat models. As for cell experiments, ICA decreased the activity, inflammatory cytokines and GAG levels, and suppressed nuclear translocation of NF-κB pathway-related proteins of MSU-treated chondrocytes. In general, medium and high concentrations of ICA showed good effects. ICA has an inhibitory effect in MSU-induced rat GA models through NF-κB/NALP3 pathway, which may provide a direction for the treatment of GA. SIGNIFICANCE: Icariin (ICA) has anti-inflammatory effects in some diseases, but its role in gouty arthritis (GA) is not clear. This study excogitated that monosodium urate (MSU) increased the ankle swelling rates of rats, promoted inflammatory cells infiltration, and increased cytokines levels in synovial tissues, which were all alleviated by ICA. In related mechanism, we found that ICA might exert the catabatic functions through the NF-κB/NALP3 pathway. The findings of this study clarified that ICA may provide a direction for the treatment of patients with GA and illustrated the relevant underlying mechanism of its role.

Study on the Multitarget Mechanism of Sanmiao Pill on Gouty Arthritis Based on Network Pharmacology

Sanmiao pill (SMP), a Chinese traditional formula, had been used to treat gouty arthritis (GA). However, the active compounds and underlying mechanism remained unclear. Hence, network pharmacology and molecular docking were utilized to explore bioactive compounds and potential mechanism of action of SMP in treating GA. In the study, the compounds of SMP, corresponding targets, and GA-related targets were mined from various pharmacological databases. Then, herb-compound-target, compound-target, PPI, and target-pathway networks were constructed. Ultimately, molecular docking was carried out to verify the predicted results. The results indicated that 47 active compounds, 338 targets, and 144 disease targets were collected. Network analysis implied that Phellodendron chinense Schneid. played a vital role in the whole formula. Moreover, 7 compounds (quercetin, kaempferol, wogonin, rutaecarpine, baicalein, beta-sitosterol, and stigmasterol) and 4 targets (NFKB1, RELA, MAPK1, and TNF) might be the kernel compounds and targets of SMP against GA. According to GOBP and KEGG pathway enrichment analysis and target-pathway network, SMP might exert a therapeutic role in GA by regulating numerous biological processes and pathways, including lipopolysaccharide-mediated signaling pathway, positive regulation of transcription, Toll-like receptor signaling pathway, JAK-STAT signaling pathway, NOD-like receptor signaling pathway, and MAPK signaling pathway. The results of molecular docking showcased that 11 pairs of compound with targets had tight binding strength. Thereinto, 4 compounds of MAPK1 and 5 compounds of NFKB1 possessed a better combination, suggesting that MAPK1 and NFKB1 might be considered as therapeutic targets in treatment of GA. This study verified that SMP had synergistic effect on GA by multicomponents, multitargets, and multipathways.