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New insights in an Ancient disease - Gout

Gout was recognised already by the Egyptians 4,600 years ago. It was described later by Hippocrates and colchicine has been used by treatment since at least the ninth century. Antoni van Leeuwenhoek (1632–1723), one of the pioneers of microscopy, described the uric acid crystals which we know are central to the condition. You’d be forgiven for thinking that this is one condition we understand fully.

We are still learning though. Over the last year there have been new insights. In an article published in July 2019, Norwegian researchers showed that higher levels of uric acid do not cause inflammation, whereas the uric acid crystals themselves are a strong trigger for inflammation. A French and German study just published found that C-Reactive Protein (CRP) directly binds to the uric acid crystals and triggers the acute inflammatory reaction.

MSU - CRP in human serum: rabbit anti-CRP
MSU - CRP in human serum: rabbit anti-CRP

We have been using CRP as a blood test to show the levels of inflammation. This new insight indicates that CRP is itself a direct player, directly linking the crystals to inflammation. We know that gout is associated with increased mortality and it is clearly important as an indicator of risks of other conditions, besides acute arthritis it can cause in joints.

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