Gout-associated uric acid crystals induce tophi ulcerations and impair wound healing in a novel gouty ulcer model

Total Hip Arthroplasty Outcomes in Patients with Gout: A Retrospective Analysis of Matched Large Cohorts

Background

Gout is the most prevalent form of inflammatory arthritis in the world. Total hip arthroplasty (THA) has emerged as a widely sought-after and highly effective surgical procedure for advanced hip diseases. However, there is a lack of research on the impact of gout on primary THA outcomes in large cohorts. This study aimed to address this gap by primarily investigating complications following THA in patients with or without gout.

Methods

Patients with records of gout in the 2 years leading up to their primary THA and who also have at least 2 years of follow-up were identified using a national insurance database and compared to a 5:1 matched control. A total of 32,466 patients with gout and 161,514 patients without gout undergoing THA were identified. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. In addition, 90-day emergency department (ED) visits and inpatient readmission were also documented.

Results

Patients with gout demonstrated higher rates of medical complications including deep vein thrombosis, transfusion, acute kidney injury, and urinary tract infection than non-gout patients (p < 0.001). Gout patients also showed higher rates of pulmonary embolism (p = 0.017). Increased incidences of surgical complications were identified in gout patients, specifically wound complications and periprosthetic joint infection (p < 0.001). There was an increased risk of revision for gout patients up to 90 days (p = 0.003), 1 year (p = 0.027), and 2 years (p = 0.039). There was also an increased risk of dislocation for gout patients up to 90 days (p = 0.022) and 1 year (p = 0.047), but not at 2 years. No significant difference was observed in aseptic loosening or periprosthetic fracture. Additionally, gout patients also demonstrated a higher likelihood of 90-day ED visits and readmission (p < 0.001).

Conclusions

Primary THA in gout patients is associated with increased risks of multiple medical and surgical complications. Our findings provide insights into the planning and expectation of THA for patients with gout. These insights have the potential to benefit the decision-making process for gout patients considering THA.

Anti-gouty arthritis and anti-inflammatory effects of curcumin nanoparticles in monosodium urate crystals induced Balb/C mice

Gout is a metabolic condition characterized by the accumulation of urate crystals in the synovial joints. These crystal depositions result in joint swelling and increased concentration of serum uric acid in blood. The commercially available drugs lower serum uric acid levels and reduce inflammation, but these standard therapies have many side effects. This study aimed to investigate anti-gout and anti-inflammatory properties of curcumin nanoparticles (CNPs). For this purpose, CNPs were prepared by dissolving curcumin into dichloromethane. Then, gout was induced by injecting monosodium urate crystals (MSU) in the ankle joint and in the intra-peritoneal cavity which caused ankle swelling and increased blood uric acid levels. CNPs in different concentrations (5, 10, and 20 ppm) and allopurinol were orally administered. The MSU crystals increased the xanthine oxidase levels both in serum and the liver. Moreover, MSU crystals increased the serum levels of interleukin 1β, interleukin-6, tumor necrosis factor-alpha, liver function tests markers, renal function tests markers, and lipid profiles. However, the administration of CNPs decreased the levels of all these variables. CNPs increased the serum high-density lipoprotein and interleukin-10 levels. Moreover, CNPs also reduced ankle swelling significantly. Hence, the levels of xanthine oxidase, uric acid and ankle swelling were reduced significantly by oral administration of CNPs. Our findings indicate that CNPs through their anti-inflammatory properties significantly alleviate gouty arthritis. Thus, the study concluded that CNPs can be developed as an efficient anti-gout agent with minimal side effects.

Gouty Arthritis Across Ages: Understanding Disease Patterns and Predictors

Introduction Gout, a chronic inflammatory joint disease, is increasingly prevalent worldwide, mainly affecting men, young females, and post-menopausal women. This study aims to investigate gout epidemiology in Al-Baha, Saudi Arabia, addressing the dearth of localized data on prevalence, risk factors, and management practices. Methods A cross-sectional analysis was conducted at King Fahad Hospital, Al-Baha, Saudi Arabia, covering 116 patients from March 2016 to November 2017. Data encompassed demographics, clinical presentations, and biochemical markers relevant to gout. Results Among 116 patients, 41 (35.3%) were diagnosed with gout, with males exhibiting a significantly higher prevalence than females (43.9% vs. 24%). Significant associations were found between gout prevalence and residency, occupational status, education level, clinical presentations (podagra, arthralgia/arthritis), and biochemical markers. Conclusion This study enriches global knowledge by providing localized insights into gout's epidemiology and highlighting demographic influences and clinical presentations specific to the Saudi context. The findings underscore the importance of tailored approaches in gout management, considering regional variations in prevalence, risk factors, and clinical manifestations.

Gout therapeutics and drug delivery

Gout is a common inflammatory arthritis caused by persistently elevated uric acid levels. With the improvement of people's living standards, the consumption of processed food and the widespread use of drugs that induce elevated uric acid, gout rates are increasing, seriously affecting the human quality of life, and becoming a burden to health systems worldwide. Since the pathological mechanism of gout has been elucidated, there are relatively effective drug treatments in clinical practice. However, due to (bio)pharmaceutical shortcomings of these drugs, such as poor chemical stability and limited ability to target the pathophysiological pathways, traditional drug treatment strategies show low efficacy and safety. In this scenario, drug delivery systems (DDS) design that overcome these drawbacks is urgently called for. In this review, we initially describe the pathological features, the therapeutic targets, and the drugs currently in clinical use and under investigation to treat gout. We also comprehensively summarize recent research efforts utilizing lipid, polymeric and inorganic carriers to develop advanced DDS for improved gout management and therapy.

Knowledge and attitudes of gout patients and their perspectives about diagnosis and management: A cross-sectional study in Saudi Arabia

BACKGROUND

Gout is a chronic noncommunicable disease that might lead to multiple systemic complications if it is left untreated. The knowledge, attitudes, and perceptives among patients toward the diagnosis and management of gout are important indicators in determining the prognosis and predicting sequelae of the disease. This cross-sectional survey aimed to assess the knowledge, attitudes, and perspectives of patients diagnosed with gout toward the disease diagnosis and treatment.

METHODOLOGY

An observational cross-sectional study was conducted at university clinics and local health facilities in central Riyadh, Saudi Arabia, for the duration between April and August 2022. Pearson χ2 test was used to determine the difference in the proportion of patients who adapt different attitudes and perspectives in terms of their demographic variables. Statistical significance was defined as a p value less than .05.

RESULTS

Two-hundred thirteen patients were involved in this study. The majority of the patients (84.0%) were diagnosed for more than 1 year. The majority of the patients (76.5%) were aged 25-60 years when they were diagnosed with gout. The most common complaint at the time of the diagnosis was joint pain (73.7%). The most commonly reported gout medication treatment being used was allopurinol accounting for 23.0%. The majority of the patients (83.6%) were satisfied regarding the effects of gout management on their job performance, work life, and careers. The vast majority (97.5%) reported that they are satisfied with the health service provided.

CONCLUSION

The patients diagnosed with gout in Saudi Arabia exhibited a satisfactory level of information, attitude, and perspectives regarding their condition. The participants expressed a significant degree of satisfaction with the impact of gout management on their occupational performance, work-life balance, and professional plans. Additional research is necessary to ascertain the risk factors associated with gout and provide suitable preventative interventions.

Fabrication of Curcumin-Loaded Silk Fibroin and Polyvinyl Alcohol Composite Hydrogel Films for Skin Wound Healing

Skin regeneration of full-thickness wounds remains a challenge, requiring a well-regulated interplay of cell-cell and cell-matrix signaling. Herein, the composite hydrogel films composed of silk fibroin (SF) and polyvinyl alcohol (PVA) as scaffolds loaded with curcumin nanoparticles (Cur NPs) were developed for skin wound healing. The structure and physicochemical properties of hydrogel films were first evaluated by scanning electron microscopy (SEM), water contact angle, and chemical and mechanical measurements. In addition, the as-fabricated composite hydrogel films have a unique 3D structure and excellent biocompatibility that facilitates the adhesion and growth of cells. Antimicrobial tests in vitro showed that they could inhibit the growth of bacteria due to the incorporation of Cur NPs into composite hydrogel films. The efficacy of the curcumin-loaded SF/PVA composite hydrogel films for skin wound healing was investigated on the skin defect model in vivo. Immunological analysis showed that the as-fabricated Cur NP-loaded SF/PVA composite hydrogel films inhibited inflammation at the wound sites, while promoting angiogenesis during the wound healing process.