A modern view of the pathogenetic aspects of gout (review)
Summary. Gout is an important socio-economic problem in the world, which causes a decrease and disability, restriction of professional activity, deterioration in the quality of life of patients. Increasing urate levels in the blood is the leading laboratory marker for gout. The homeostasis of urate metabolism is determined by the balance between the complex of the processes of secretion, excretion of uric acid (UA) by the renal tubules and its elimination by the extrarenal pathways. The dominant number of UC (65–75%) is excreted by the kidneys, a smaller part (25–35%) — through the gastrointestinal tract. The presented article highlights the main pathogenetic aspects of gout, including a cascade of immunological changes, options for violation of urate equilibrium; the latest information on the role of the renal, intestinal and bacterial transporters of UA in supporting urate human homeostasis is presented. The current tendency to study gout is to focus the attention of researchers on the extrarenal ways of removing UA in conjunction with changes in the immunological status, which will expand our knowledge about the features of the pathogenesis of the disease.
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