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Li D, Dong J, Xiong T, Zhou X, Li Y, Chen C, Li S, Song Z, Xu N, Yang M, Yan X, Liu T, Liu S. Transdermal delivery of iguratimod and colchicine ethosome by dissolving microneedle patch for the treatment of recurrent gout. Colloids Surf B Biointerfaces 2024; 242:114087. [PMID: 39003846 DOI: 10.1016/j.colsurfb.2024.114087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/16/2024]
Abstract
This study introduces a novel approach of repetitive modeling to simulate the pathological process of recurrent gout attacks in humans. This methodology addresses the instability issues present in rat models of gout, providing a more accurate representation of the damage recurrent gout episodes inflict on human skeletal systems. A soluble nanoneedle system encapsulating colchicine and iguratimod ethosomal formulations was developed. This system aims to modulate inflammatory cytokines and inhibit osteoclast activity, thereby treating inflammatory pain and bone damage associated with recurrent gout. Additionally, a comprehensive evaluation of the microneedles' appearance, morphology, mechanical properties, and penetration capability confirmed their effectiveness in penetrating the stratum corneum. Dissolution tests and skin irritation assessments demonstrated that these microneedles dissolve rapidly without irritating the skin. In vitro permeation studies indicated that transdermal drug delivery via these microneedles is more efficient and incurs lower drug loss compared to traditional topical applications. In vivo pharmacodynamic assessments conducted in animal models revealed significant analgesic and anti-inflammatory effects when both types of microneedles were used together. Further analyses, including X-ray imaging, hematoxylin and eosin (H&E) staining, Safranin-O/fast green staining, tartrate-resistant acid phosphatase staining, and quantification of osteoclasts, confirmed the bone-protective effects of the microneedle combination. In conclusion, the findings of this research underscore the potential of this novel therapeutic approach for clinical application in the treatment of recurrent gout.
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Affiliation(s)
- Du Li
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Jindian Dong
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Tong Xiong
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Xingyu Zhou
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Yanhui Li
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Chuncheng Chen
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Shijie Li
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China.
| | - Zhuoyue Song
- Bioengineering Laboratory, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510070, PR China
| | - Nenggui Xu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Mingjing Yang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Xiaoxia Yan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China
| | - Tao Liu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China.
| | - Shihui Liu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China.
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Zhang J, Jiang H, Fu G, Wu Z, Yao Y, Sun J. Relationship between serum vitamin C and serum uric acid in people with different BMIs: results from the NHANES 2017-2018 and Mendelian randomization study. Front Nutr 2024; 11:1429123. [PMID: 39246399 PMCID: PMC11380155 DOI: 10.3389/fnut.2024.1429123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/13/2024] [Indexed: 09/10/2024] Open
Abstract
Objective To examine the association of overweight/obesity and serum vitamin C (serum VC) with serum uric acid (SUA) and to assess causality using Mendelian randomization (MR). Methods 4,772 participants from the National Health and Nutrition Examination Survey (NHANES), 2017-2018 were included in this study. Multivariate linear regression, variance inflation factor and quantile regression were used to analyze the relationships between overweight/obesity and serum VC and SUA levels. Secondly, Mendelian randomization (MR) was utilized to mitigate bias and prevent reverse causality in the observational study. Genetic variants associated with obesity (N = 13,848), vitamin C levels (N = 64,979) and serum uric acid levels (N = 343,836) were sourced from the most extensive genome-wide association studies (GWAS). The primary analytical method employed was inverse variance weighted (IVW). Results Based on the observational study, BMI was positively associated with SUA (β = 0.06, 95% CI: 0.05 to 0.07, p < 0.001) and serum VC was negatively associated with SUA (β = -0.14, 95% CI: -0.23 to -0.04, p = 0.005). In individuals with overweight/obesity (BMI > =25), the negative effects of serum VC on SUA enhanced with increasing serum VC. High serum VC level (Q4 level, above 1.19 mg/dL) reduced SUA (β = -0.30, 95% CI: -0.47 to -0.14, p < 0.001) in individuals with overweight/obesity compared to low serum VC level (Q1 level, below 0.54 mg/dL). IVW-MR analysis revealed a significant association between SUA levels and genetically elevated levels of VC (β = -0.03, 95% CI: -0.06 to -0.00, p = 0.029) and obesity (β = 0.06, 95% CI: 0.04 to 0.07, p < 0.001). Conclusion Cross-sectional observational analysis revealed that BMI exhibited a positive correlation with SUA levels and that serum VC was negatively correlated with SUA levels; moreover, moderate serum VC can reduce SUA, especially in individuals with overweight/obesity. There was evidence indicating a causal effect of VC and obesity on SUA. It highlights the importance of VC in the management of SUA levels, particularly in overweight/obese individuals. The findings might be helpful for the management of high SUA levels.
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Affiliation(s)
- Jiajie Zhang
- Department of Urology, National Children's Medical Center & Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hejun Jiang
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanghui Fu
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zou Wu
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yukai Yao
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Sun
- Department of Urology, National Children's Medical Center & Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Meng F, Lu S, Li Y, Zhang C, Kang T, Qian T, Tan C, Liu X, Hou X. Association between oxidative balance score and risk of gout: The NHANES cross-sectional study, 2007-2018. Int J Rheum Dis 2024; 27:e15255. [PMID: 38982881 DOI: 10.1111/1756-185x.15255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. The association between OBS and gout has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and gout in US adults. METHODS In all, 10 492 participants were included in this study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and gout. RESULTS Compared with the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [C]) for the highest quartile of OBS (Q4) was 0.72 (0.52-1.00) (p = .13 for trend); furthermore, the RCS showed a negative linear relationship between OBS and gout (p-nonlinear = .606). CONCLUSION In conclusion, the risk of gout is higher with high OBS. The prevalence of gout decreased with higher OBS. Diabetes may alter this negative correlation.
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Affiliation(s)
- Fanzhang Meng
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Siyi Lu
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yingzi Li
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Zhang
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tianlun Kang
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tangliang Qian
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chao Tan
- Department of Internal Medicine, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoping Liu
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiujuan Hou
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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Meng S, Lu W, Li Z, Zhou Y, Shi S, Zhao H, Li M, Li Y. The Clinical Significance of Serum Interleukin-36α Levels in Patients with Gout. Immunol Invest 2024; 53:788-799. [PMID: 38638029 DOI: 10.1080/08820139.2024.2341233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND Gout is a chronic inflammatory diseases caused by monosodium urate crystal deposition. However, the role of interleukin (IL)-36 in gout has not dbeen elucidated. METHODS We enrolled 75 subjects, including 20 healthy controls (HC), 30 patients with acute gout attack and 25 patients in remission. Baseline data were obtained through clinical interrogation and laboratory data were obtained through tests of blood samples. Serum levels of IL-36α were detected using enzyme-linked immunosorbent assay. Spearman correlation analysis was used to investigate the correlation of IL-36α with other parameters. The diagnostic value of IL-36α was demonstrated using a receiver operating characteristic curve. RESULTS The serum IL-36α level of gout patients in acute attack and remission stage was significantly higher than that of HC. Serum IL-36α was positively correlated with alanine transaminase (ALT) and aspartate transaminase (AST). Serum amyloid A (SAA) levels positively correlated with C-reactive protein levels and erythrocyte sedimentation rates. Glutamyl transpeptidase levels positively correlated with AST and ALT levels. CONCLUSION In conclusion, serum IL-36α levels were elevated in patients with gout and correlated with the clinical markers of inflammation. Our findings suggest that IL-36α may be a novel inflammatory indicator for gout.
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Affiliation(s)
- Sicen Meng
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Wubing Lu
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Zhi Li
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Yinxin Zhou
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Shanjun Shi
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Hui Zhao
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
- Department of Clinical Laboratory, Ningbo University, Ningbo, China
| | - Mingcai Li
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Yan Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
- School of Basic Medical Sciences and Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
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Xiang G, Yang L, Qin J, Wang S, Zhang Y, Yang S. Revealing the potential bioactive components and mechanism of Qianhua Gout Capsules in the treatment of gouty arthritis through network pharmacology, molecular docking and pharmacodynamic study strategies. Heliyon 2024; 10:e30983. [PMID: 38770346 PMCID: PMC11103544 DOI: 10.1016/j.heliyon.2024.e30983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
Recent clinical studies have confirmed the effectiveness of Qianhua Gout Capsules (QGC) in the treatment of gouty arthritis (GA). However, the specific regulatory targets and mechanisms of action of QGC are still unclear. To address this gap, we utilized network pharmacology, molecular docking, and pharmacodynamic approaches to investigate the bioactive components and associated mechanisms of QGC in the treatment of GA. By employing UPLC-Q Exactive-MS, we identified the compounds present in QGC, with active ingredients defined as those with oral bioavailability ≥30 % and drug similarity ≥0.18. Subsequently, the targets of these active compounds were determined using the TCMSP database, while GA-related targets were identified from DisGeNET, GeneCards, TTD, OMIM, and DrugBank databases. Further analysis including PPI analysis, GO analysis, and KEGG pathway enrichment was conducted on the targets. Validation of the predicted results was performed using a GA rat model, evaluating pathological changes, inflammatory markers, and pathway protein expression. Our results revealed a total of 130 components, 44 active components, 16 potential shared targets, GO-enriched terms, and 47 signaling pathways related to disease targets. Key active ingredients included quercetin, kaempferol, β-sitosterol, luteolin, and wogonin. The PPI analysis highlighted five targets (PPARG, IL-6, MMP-9, IL-1β, CXCL-8) with the highest connectivity, predominantly enriched in the IL-17 signaling pathway. Molecular docking experiments demonstrated strong binding of CXCL8, IL-1β, IL-6, MMP9, and PPARG targets with the top five active compounds. Furthermore, animal experiments confirmed the efficacy of QGC in treating GA in rats, showing reductions in TNF-α, IL-6, and MDA levels, and increases in SOD levels in serum. In synovial tissues, QGC treatment upregulated CXCL8 and PPARG expression, while downregulating IL-1β, MMP9, and IL-6 expression. In conclusion, this study applied a network pharmacology approach to uncover the composition of QGC, predict its pharmacological interactions, and demonstrate its in vivo efficacy, providing insights into the anti-GA mechanisms of QGC. These findings pave the way for future investigations into the therapeutic mechanisms underlying QGC's effectiveness in the treatment of GA.
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Affiliation(s)
- Gelin Xiang
- National Traditional Chinese Medicine Clinical Research Base and Drug Research Center of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Luyin Yang
- National Traditional Chinese Medicine Clinical Research Base and Drug Research Center of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- Institute of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Jing Qin
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shaohui Wang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Meishan Hospital of Chengdu University of Traditional Chinese Medicine, Meishan, China
| | - Yi Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Meishan Hospital of Chengdu University of Traditional Chinese Medicine, Meishan, China
| | - Sijin Yang
- National Traditional Chinese Medicine Clinical Research Base and Drug Research Center of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- Institute of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, China
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Li Y, Xie Y, Li J, Chang Z, Zhang J, Zhou Z, Ren R, Chen Y. Diastolic and systolic blood pressure and gout: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1367621. [PMID: 38841306 PMCID: PMC11150642 DOI: 10.3389/fendo.2024.1367621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Although there is solid epidemiological evidence supporting the connection between hypertension and gout, little has been said about the relationship between diastolic and systolic blood pressure and gout, the causal relationship and direction associated are uncertain, so we aim to research the causal relationship between diastolic and systolic blood pressure and gout. Methods We conducted a two-sample Mendelian randomization (MR) analysis to assess the causal effect between 2 blood pressure phenotypes (including diastolic blood pressure and systolic blood pressure) and 5 gout phenotypes (including gout, drug-induced gout, idiopathic gout, unspecified gout, and strictly defined gout) using genome-wide association study statistics. The inverse variance weighting method was used to generate the main results, while sensitivity analyses using MR-Egger, weighted median, Cochran's Q test, Egger intercept test, and leave-one-out analysis, were performed to assess the stability and reliability of the results. Results After the screening, we found a causal relationship between diastolic blood pressure and gout, idiopathic gout, unspecified gout, and strictly defined gout, and a causal relationship between systolic blood pressure and gout, idiopathic gout, unspecified gout, and strictly defined gout. Conclusion From a genetic predisposition, controlling blood pressure may reduce the risk of gout.
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Affiliation(s)
- Yanfang Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yufeng Xie
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Jun Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhichun Chang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jianmei Zhang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zunming Zhou
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Rong Ren
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Yun Chen
- The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
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Xie W, Wu Y, Yang H, Zhang C. Multiple gouty tophi throughout the body: A rare case report. Asian J Surg 2024; 47:1821-1822. [PMID: 38160144 DOI: 10.1016/j.asjsur.2023.12.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Wendong Xie
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, China
| | - Yunbiao Wu
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, China
| | - Hao Yang
- Orthopedic Cadre Ward, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Chao Zhang
- Orthopedic Cadre Ward, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Yu Y, Yang X, Hu G, Tong K, Yin Y, Yu R. Effect of tea intake on genetic predisposition to gout and uric acid: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 14:1290731. [PMID: 38440060 PMCID: PMC10911082 DOI: 10.3389/fendo.2023.1290731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/26/2023] [Indexed: 03/06/2024] Open
Abstract
Objective The effect of tea on gout and uric acid is still controversial. This study aims to analyze the effect of tea intake on genetic predisposition to gout, idiopathic gout, gout due to impairment of renal function as well as uric acid by Mendelian randomization (MR). Methods Forty independent single nucleotide polymorphisms (SNPs) associated with tea intake were selected from UK Biobank. SNPs for uric acid were obtained from BioBank Japan, SNPs for gout were obtained from UK Biobank, and SNPs for gout due to impairment of renal function and idiopathic gout were derived from FinnGen. The causal relationship of exposure-outcome was tested using inverse variance weighted, MR-Egger and weighted median. MR-Egger intercept was employed to assess horizontal pleiotropy, Cochran's Q test was used to assess heterogeneity, and leave-one-out sensitivity analysis was utilized to analyze the stability of the results. Results The results of MR analysis showed that tea intake was negatively associated with gout due to impairment of renal function (OR 0.997, 95% CI 0.994 to 0.999, P = 0.017), whereas there was no causal association with gout, idiopathic gout, and uric acid (P > 0.05), for which sensitivity analysis suggested that these results were robust. Conclusions There was a genetic predisposition effect of increased tea intake on the reduced risk of gout due to impairment of renal function, whereas there was no such effect on gout, idiopathic gout, and uric acid. Tea intake may become an important option in the dietary treatment of gout due to impairment of renal function.
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Affiliation(s)
- Yunfeng Yu
- Department of Endocrinology, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xinyu Yang
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Gang Hu
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Keke Tong
- Department of Gastroenterology, The Hospital of Hunan University of Traditional Chinese Medicine, Changde, Hunan, China
| | - Yuman Yin
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Yu
- Department of Endocrinology, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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Gao X, Gao H, Zhang L, Zhang L. Comparison of diagnostic efficacy of dual-energy CT and ultrasound in gouty arthritis. Int J Rheum Dis 2023; 26:1697-1703. [PMID: 37421186 DOI: 10.1111/1756-185x.14792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/26/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE To explore the performance and effect of dual-energy computed tomography (CT) and ultrasound in the diagnosis of gouty arthritis and to provide a reference for the clinical diagnosis of gouty arthritis. METHODS A retrospective analysis of 76 patients with gouty arthritis admitted to the hospital from June 2020 to June 2022 was conducted. Patients were diagnosed with gouty arthritis using ultrasound and dual-energy CT technology. The accuracy of diagnosis by different imaging techniques was analyzed along with the imaging findings of ultrasound and dual-energy CT. RESULTS Seventy-six patients, 60 men and 16 women, ranging in age from 20 to 77 years (mean age 50.8 ± 10.92 years), presented with uric acid levels of 254.1-720.05 μmol/L (mean 482.17 ± 105.06 μmol/L) and C-reactive protein levels ranging from 4.25 to 10.3 mg/L. The receiver operating characteristic curve showed that the area under the curve and specificity of serum uric acid were higher by dual-energy CT than those of ultrasound in the diagnosis of gouty arthritis. The dual-energy CT detection rate of tophi was significantly higher than the ultrasound detection rate (p < .05). For inflammatory effusion and synovial thickening, the ultrasound detection rates were significantly higher than the dual-energy CT detection rates (p < .05). Regarding soft-tissue edema, the detection rate of the two methods was not significantly different (p > .05). CONCLUSION Compared with ultrasound, dual-energy CT has increased accuracy in the diagnosis of gouty arthritis.
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Affiliation(s)
- Xiulin Gao
- Department of Clinical Medicine, Fenyang College of Shanxi Medical University, Fenyang, China
| | - Huanling Gao
- Department of Nursing, Fenyang College of Shanxi Medical University, Fenyang, China
| | - Liyun Zhang
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Liqing Zhang
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
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Fu W, Ge M, Li J. Phospholipase A2 regulates autophagy in gouty arthritis: proteomic and metabolomic studies. J Transl Med 2023; 21:261. [PMID: 37069596 PMCID: PMC10108447 DOI: 10.1186/s12967-023-04114-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/09/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Acute gouty arthritis is inflammatory joint arthritis. Gouty arthritis (GA) involves multiple pathological processes. Deposition of joints by monosodium urate (MSU) crystals has been shown to play a critical role in the injury process. Due to the different effects of MSU stimulation on the joints, the exact changes in the synovial fluid are unknown. We want to explore the changes in proteins and metabolites in the joints of gouty arthritis. Regulating various functional substances in the joint can reduce inflammation and pain symptoms. METHODS 10 patients with gouty knee arthritis and 10 normal controls were selected from clinical, surgical cases. The biological function of the metabolome was assessed by co-expression network analysis. A molecular network based on metabolomic and proteomic data was constructed to study critical molecules. The fundamental molecular changes in the relevant pathways were then verified by western blot. RESULTS Proteomic analysis showed that the expressions of proteases Cathepsin B, Cathepsin D, Cathepsin G, and Cathepsin S in synovial fluid patients with gouty arthritis were significantly increased. Enrichment analysis showed a positive correlation between lysosomal and clinical inflammatory cell shape changes. Untargeted metabolomic analysis revealed that lipids and lipoids accumulate, inhibit autophagic flux, and modulate inflammation and immunity in gouty arthritis patients. It was determined that the accumulation of lipid substances such as phospholipase A2 led to the imbalanced state of the autophagy-lysosome complex, and the differentially expressed metabolites of Stearoylcarnitine, Tetradecanoylcarnitine, Palmitoylcarnitine were identified (|log2 fold change|> 1.5, adjusted P value < 0.05 and variable importance in prediction (VIP) > 1.5). The autophagy-lysosomal pathway was found to be associated with gouty knee arthritis. Essential molecular alterations of multi-omics networks in gouty knee arthritis patients compared with normal controls involve acute inflammatory response, exosomes, immune responses, lysosomes, linoleic acid metabolism, and synthesis. CONCLUSIONS Comprehensive analysis of proteomic and untargeted metabolomics revealed protein and characteristic metabolite alterations in gouty arthritis, it mainly involves lipids and lipid like molecules, phospholipase A2 and autophagic lysosomes. This study describes the pathological characteristics, pathways, potential predictors and treatment goals of gouty knee arthritis.
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Affiliation(s)
- Weili Fu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Minghao Ge
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jian Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China
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Wang K, Yang QZ, Wen HN, Hai YX, Gao GD, Song M. Nerve root compression due to lumbar spinal canal tophi: A case report and review of the literature. Medicine (Baltimore) 2022; 101:e31562. [PMID: 36397389 PMCID: PMC9666167 DOI: 10.1097/md.0000000000031562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
RATIONALE Gout in the spine and adnexa is rare in clinical practice and can also be easily misdiagnosed, we reported a patient with nerve root compression due to lumbar gout stones in the lumbar spinal canal. PATIENT CONCERNS A 51-year-old male was admitted to the hospital with lumbar pain with numbness in the left lower limb for more than 6 months. The physical examination showed that tenderness and percussion pain were present at L4-S1 spinous process. Straight leg raise test: 50° on the left side were positive. Laboratory tests showed that the sUA was 669 μmol/L, MRI of the lumbar spine showed that cystic T1WI low signal and T2WI mixed high signal shadows were seen in the spinal canal at the level of L4-L5. DIAGNOSES Combining with lab examinations, imaging examinations, and histopathological results, the patient was diagnosed with lumbar spinal canal tophi. INTERVENTIONS After active improvement of all examinations, the patient underwent surgical treatment with decompression and internal fixation of the L4-L5 segment. OUTCOMES After surgery, the patient's symptoms improved and muscle strength returned to normal. Among the 95 previously reported patients with lumbar gout, the ratio of men to women was 2.96:1, and the peak age group of incidence was 56 to 65 years. The onset of the disease was mainly in a single segment of the lumbar spine, with 34.41% of all cases occurring at the L4-L5 level. 61.05% of the patients had a history of gout attacks or hyperuricemia, and the most frequently involved site was the foot and ankle, followed by the wrist. Sixty-seven patients underwent surgical treatment, and 22 chose conservative treatment, with overall satisfactory results. LESSONS SUBSECTIONS The incidence of lumbar gout is low and relatively rare in the clinic and pathological biopsy is still the gold standard. Vertebral plate incision and decompression are often selected for surgical treatment, and whether to perform fusion should be comprehensively considered for the destruction of vertebral bone by gout and the reasonable selection of the extent of surgical resection. Whether choosing surgical treatment or conservative therapy, the control of uric acid levels should be emphasized.
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Affiliation(s)
- Kai Wang
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
| | - Quan-Zeng Yang
- Department of Orthopedics, The Affiliated hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
| | - Hao-Nan Wen
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
| | - Yun-Xaing Hai
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
| | - Guo-Dong Gao
- Department of Orthopedics, The Affiliated hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
- *Correspondence: Min Song, Clinical College of Chinese Medicine, Gansu University of Chinese Medicine,Lanzhou, Gansu Province, China (e-mail: )
| | - Min Song
- Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
- Department of Orthopedics, The Affiliated hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
- *Correspondence: Min Song, Clinical College of Chinese Medicine, Gansu University of Chinese Medicine,Lanzhou, Gansu Province, China (e-mail: )
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Cao Y, Zhong Q, Tang F, Yao X, Liu Z, Zhang X. Anethole ameliorates inflammation induced by monosodium urate in an acute gouty arthritis model via inhibiting TLRs/MyD88 pathway. Allergol Immunopathol (Madr) 2022; 50:107-114. [PMID: 36335453 DOI: 10.15586/aei.v50i6.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To assess the effects of anethole on monosodium urate (MSU)-induced inflammatory response, investigate its role in acute gouty arthritis (AGA), and verify its molecular mechanism. METHODS Hematoxylin and eosin staining assay and time-dependent detection of degree of ankle swelling were performed to assess the effects of anethole on joint injury in MSU-induced AGA mice. Enzyme-linked-immunosorbent serologic assay was performed to demonstrate the production levels of inflammatory factors (interleukin 1β [IL-1β], interleukin 6 [IL-6], interleukin 8 [IL-8], tumor necrosis factor α [TNF-α], and monocyte chemo-attractant protein-1 [MCP-1]) in MSU-induced AGA mice. Western blot assays were used to confirm the effects of anethole on oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome activity and the activation of toll-like receptors (TLRs)-myeloid differentiation factor 88 (MyD88) pathway in MSU-induced AGA mice. RESULTS We observed that a significant joint injury occurred in MSU-induced AGA mice. Anethole could alleviate the pathological injury of the synovium in MSU-induced AGA mice and suppressed ankle swelling. In addition, we observed that anethole could inhibit MSU-induced inflammatory response and inflammasome activation in MSU-induced AGA mice. Moreover, we discovered that anethole enabled to inhibit the activation of TLRs/MyD88 pathway in MSU-induced AGA mice. Our findings further confirmed that anethole contributed to the inhibitory effects on progression in MSU-induced AGA mice. CONCLUSION It confirmed that anethole ameliorated the MSU-induced inflammatory response in AGA mice in vivo via inhibiting TLRs-MyD88 pathway.
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Affiliation(s)
- Yuepeng Cao
- Department of Rheumatology and Immunology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Qin Zhong
- Department of Rheumatology and Immunology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Fang Tang
- Department of Rheumatology and Immunology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Xueming Yao
- Department of Rheumatology and Immunology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Zhengqi Liu
- Department of Rheumatology and Immunology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China;
| | - Xiaodong Zhang
- Second Clinical School of Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
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Metagenomic Analysis of Gut Microbiome in Gout Patients with Different Chinese Traditional Medicine Treatments. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6466149. [PMID: 36262169 PMCID: PMC9576389 DOI: 10.1155/2022/6466149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022]
Abstract
Introduction Changes in eating habits have made gout a metabolic disease of increasing concern. Previous studies have indicated that there are significant differences in species composition and abundance of gut microbiome in gout patients compared with average. Considering that traditional Chinese medicine has a momentous effect in treating gout, the research study aimed to explore the differences of genomic and metabolomics of gut microbiome before and after traditional Chinese medicine treatment in patients with gout. Method 30 patients with gout and 29 matched controls were recruited of which 16 patients took H treatment and 14 patients took T treatment. Stools were collected twice for patients before and after treatment and only once for controls. A total of 89 samples were annotated with metagenomic species and functions, and the enrichment analysis of differential genes and KO pathway was carried out. Result The results showed a decrease in the diversity of gut microbiome in gout patients and the gene abundance and metabolomics had great differences among study groups. The number of bacterial genera also had significant differences among treatment groups. Moreover, among different groups, the regulation of different species was variously correlated. The correlation between species and clinical laboratory indicators in the rising group was stronger than that in the decreasing group and the upregulation of some strain was related to the content of urea nitrogen. Conclusion After the traditional Chinese medicine treatment, the glutathione pathway was significantly enriched and some pathogenic bacteria were significantly inhibited. The study suggests that traditional Chinese medicine treatment may exert its therapeutic effect by inhibiting relevant pathways.
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Guan X, Zhang S, Liu J, Wu F, Zhou L, Liu Y, Su N. Cardiovascular safety of febuxostat and allopurinol in patients with gout: A meta-analysis. Front Pharmacol 2022; 13:998441. [PMID: 36249825 PMCID: PMC9563376 DOI: 10.3389/fphar.2022.998441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Gout is a common disease and is usually treated with uric acid-lowering drugs (the most commonly used of which are febuxostat and allopurinol). However, the cardiovascular safety of febuxostat and allopurinol is still controversial. The purpose of our study is to evaluate the cardiovascular safety of the two drugs in patients with gout using one-stage and two-stage meta-analysis. Methods: PubMed, Embase, CBM, CNKI, WanFang, Central, and VIP were searched from inception to 30 January 2022. Randomized controlled trials which evaluated the cardiovascular safety of febuxostat or allopurinol for treating patients with gout were included. Based on the Kaplan-Meier curves of the two studies, individual patient data (IPD) were extracted and reconstructed. We used time-varying risk ratios (RRs) to summarize time-to-event outcomes, and the RRs of MACE incidence, cardiovascular mortality, and all-cause mortality were calculated by a multi-level flexible hazard regression model in 1-stage meta-analyses. p values were calculated using a log-rank test. At the same time, using the reconstructed IPD, we performed 2-stage meta-analyses to inform the quantitative estimates of time-specific relative risks at the six time points (1 , 2, 3, 4, 5, and 6 years) based on a random-effects model. Results: Two RCTs with 12,318 participants were included. In the incidence of major adverse cardiovascular events between the two regimens, there was no significant difference [RR = 0.99 (95% CI, 0.89-1.11), p = 0.87]; at the same time, there was no significant difference in cardiovascular mortality [RR = 1.17 (95% CI, 0.98-1.40),p = 0.08] or all-cause mortality [RR = 1.03 (95% CI, 0.91-1.17),p = 0.62]. In terms of 2-stage meta-analyses, there was no significant difference in any outcomes at any time point (moderate-to low-certainty evidence). Conclusion: In patients without atherosclerotic disease, febuxostat likely has a similar cardiovascular profile to allopurinol. However, in patients with a history of cardiovascular disease, allopurinol treatment is associated with less cardiovascular mortality as compared with febuxostat. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#loginpage, identifier PROSPERO, CRD42022325656.
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Affiliation(s)
- Xudong Guan
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Shengzhao Zhang
- Department of Pharmacy, Karamay Central Hospital, Xinjiang, China
| | - Jiayan Liu
- Department of Dermatology and Venereal Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Fengbo Wu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Lingyan Zhou
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Liu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Na Su
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
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Simple Application and Adherence to Gout Guidelines Enables Disease Control: An Observational Study in French Referral Centres. J Clin Med 2022; 11:jcm11195742. [PMID: 36233609 PMCID: PMC9570816 DOI: 10.3390/jcm11195742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In a context of therapeutic inertia, the French Society of Rheumatology (SFR) published its first recommendations on gout in 2020, which were deliberately simple and concise. The objectives of the study were to determine the profile of patients referred to French gout-expert centres, and to examine the results of their management and the factors leading to those results. Methods: Three hundred patients attending a first visit for gout management in three French referral centres were retrospectively and randomly included in this multicentre observational study. Visits were performed at baseline (M0) and scheduled for month 6 (M6), month 12 (M12), and month 24 (M24). Results: Patients were 81% male and had a mean age 62.2 ± 15.2 years. Management followed French recommendations after the baseline visit in 94.9% of cases. SU levels were below 6.0 mg/dL in 59.4% of patients at M6, 67.9% at M12, and 78.6% at M24, with increasing clinical improvement (i.e., flare decrease) over 2 years of follow-up. At M24, 50% of patients were treated with allopurinol (313 ± 105 mg/d), which exceeded renal restrictions of doses in 61.5% of them, and 48.2% received febuxostat (84 ± 36 mg/d). The need for a sufficient dosage of ULT was the only predictive factor found for successful achievement of SU levels < 6.0 mg/dL at a given visit. Conclusions: Simple application of gout-management guidelines is feasible in clinical practice and is efficient, with a majority of patients achieving SU targets and clinical improvement.
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Hegaze AH, Hamdi AS, Alqrache AT, Hegazy M. Unusual Case of Gouty Arthritis of the Second Distal Interphalangeal Joint (Second Toe). Cureus 2020; 12:e11405. [PMID: 33312803 PMCID: PMC7725467 DOI: 10.7759/cureus.11405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Gout is one of the most common diseases affecting men globally due to the spread of unhealthy dietary habits, kidney disease, and the use of diuretics. It is characterized as having monosodium crystals depositions in the synovial fluid, which causes an inflammatory response and painful joints. Most of the time, it can be found affecting the first metatarsophalangeal joint or other large joints in concurrence with other disorders. Non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, and steroids have been known to suppress such events in most cases without the need for any surgical intervention. We present a case of a 44-years-old medically free healthy male who presented with a case of gouty arthritis in the second distal interphalangeal joint. Initially, colchicine treatment was given along with NSAIDs, but symptoms failed to subside. After a persistent increase of swelling and pain, the surgical evacuation was sought to reduce the pain and exclude any other causes of arthritis. Histopathology report confirmed the presence of monosodium urate crystals without any signs of infection. In conclusion, surgical intervention of gouty arthritis can be beneficial in cases of persistent pain and increasing rate of swelling despite the medicinal trial, especially in unusual cases of gouty arthritis such as gout of the second metatarsophalangeal joint.
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Affiliation(s)
- Adel H Hegaze
- Orthopedics Department, King Abdulaziz University, Faculty of Medicine, Jeddah, SAU
| | - Amre S Hamdi
- Orthopedics Department, King Abdulaziz University, Faculty of Medicine, Jeddah, SAU
| | | | - Mohamed Hegazy
- Trauma and Orthopedics, Independent Researcher, Private Sector, Berlin, DEU
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