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Epidemiology, risk factors, and lifestyle modifications for gout

UAB Center for Education and Research (CERTs) on Therapeutics of Musculoskeletal Disorders, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Arthritis research & therapy (Impact Factor: 4.12). 02/2006; 8 Suppl 1(Suppl 1):S2. DOI: 10.1186/ar1907
Source: PubMed

ABSTRACT Gout affects more than 1% of adults in the USA, and it is the most common form of inflammatory arthritis among men. Accumulating data support an increase in the prevalence of gout that is potentially attributable to recent shifts in diet and lifestyle, improved medical care, and increased longevity. There are both nonmodifiable and modifiable risk factors for hyperuricemia and gout. Nonmodifiable risk factors include age and sex. Gout prevalence increases in direct association with age; the increased longevity of populations in industrialized nations may contribute to a higher prevalence of gout through the disorder's association with aging-related diseases such as metabolic syndrome and hypertension, and treatments for these diseases such as thiazide diuretics for hypertension. Although gout is considered to be primarily a male disease, there is a more equal sex distribution among elderly patients. Modifiable risk factors for gout include obesity, the use of certain medications, high purine intake, and consumption of purine-rich alcoholic beverages. The increasing prevalence of gout worldwide indicates that there is an urgent need for improved efforts to identify patients with hyperuricemia early in the disease process, before the clinical manifestations of gout become apparent.

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    • "Current treatments for gout have two targets: to control the inflammation of a gout attack and to lower serum uric acid levels (Tausche et al. 2009). However, given the disadvantages of drug therapy, modifications to lifestyle and diet, which are relatively inexpensive and safe, are attractive alternatives and, moreover, may result in better control of this disorder (Saag and Choi 2006). Thus, we propose the production of low-purine-content food as a novel solution to the problem of elevated serum urate. "
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    ABSTRACT: Construction of a transgenic Arxula adeninivorans strain that produces a high concentration of adenine deaminase and investigation of the application of the enzyme in the production of food with low purine content. The A. adeninivorans AADA gene, encoding adenine deaminase, was expressed in this yeast under the control of the strong inducible nitrite reductase promoter using the Xplor(®) 2 transformation/expression platform. The recombinant enzyme was biochemically characterized and was found to have a pH range of 5.5-7.5 and temperature range of 34-46 °C with medium thermostability. A beef broth was treated with the purified enzyme resulting in the concentration of adenine decreasing from 70.4 mg l(-1) to 0.4 mg l(-1) . It was shown that the production of adenine deaminase by A. adeninivorans can be increased and that the recombinant adenine deaminase can be used to lower the adenine content in the food. Adenine deaminase is one component of an enzymatic system that can reduce the production of uric acid from food constituents. This study gives details on the expression, characterization and application of the enzyme and thus provides evidence that supports the further development of the system. This article is protected by copyright. All rights reserved.
    Journal of Applied Microbiology 08/2013; 115(5):1134-46. DOI:10.1111/jam.12317 · 2.39 Impact Factor
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    • "to attacks of painful acute arthritis (Pennes and Martel, 1986). Gout is a common biochemical abnormality with an estimated prevalence of 8.4 cases per 1,000 persons (Lawrence et al., 1998; Saag Kenneth and Choi, 2006) and is associated with painful arthritis attacks and the development of metabolic syndromes (Choi and Ford, 2007) and nephropathy (Avram and Krishnan, 2008). Control of hyperurecemia is, most often, achieved by reducing uric acid production with an inhibitor of Xanthine oxidase (XO), the enzyme that catalyzes the production of uric acid, or less frequently, by employing uricosuric agents to increase renal excretion of uric acid. "
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    ABSTRACT: New Xanthine oxidase inhibitors are in development and these need to be evaluated reliably before being introduced into clinical investigations. The presence of valid, easy and reliable in vivo bioassy to evaluate the Xanthine oxidase inhibition is of utmost importance to achieve steady paces in drug discovery attempts to treat gout disease. The objective of the current study was to develop and validate a bioassay procedure that can be employed for in vivo evaluation of drugs investigated as xanthine oxidase inhibitors. Exploiting rats as an animal model to carry out the bioassay is proposed to establish a novel approach to screen and evaluate the xanthine oxidase inhibitory activity of potential agents and/or plant extracts. Allopurinol was used as a reference treatment to inhibit Xanthine oxidase while the degree of enzyme inhibition was indirectly measured by determining the blood levels of 6-mercaptopurine (6-MP) as a surrogate chemical marker. In this model, serum obtained from: untreated rats, rats treated with 6-MP alone and rats treated with 6-MP and different doses of allopurinol were analyzed, for levels of 6-mercaptopurine. An elevated plasma 6-mercaptopurine level in the allopurinol treated rats as compared to untreated rats was an indication of an in vivo inhibition of the enzyme Xanthine oxidase.
    Scientific research and essays 01/2011; 523:3750-3755. · 0.45 Impact Factor
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