Gout: Disease of Kings now a 21st Century Epidemic gout disease epidemic arthritis
Transformation of gout from the disease of kings to a common 21st century disease Around 3 million Americans have gout, an extremely painful arthritic condition. Historically, gout was called the “disease of kings” because it was thought to manifest due to overindulgence in food and alcohol. Scientists discovered that although some food products can exacerbate the condition, it occurs due to a higher concentration of uric acid in the blood, i.e., hyperuricemia.
Naturally, uric acid is produced in the blood. It is also a breakdown product of purines, a chemical in many food products. Typically, uric acids are removed from the body via urine. Gout occurs due to two conditions, i.e., when too much uric acid is synthesized in the body or when the removal capacity of the kidney is compromised. Patients suffering from gout for a prolonged period form nodules of uric acid around the joints, which are known as tophi.
Although gout was considered a disease of the past, a recent significant rise in cases in the United States has been observed. Scientists stated part of the reason why gout is increasing in America is the obesity epidemic. Gout mainly affects middle-aged and older men. Due to the lack of protective effect of estrogen, postmenopausal women are also susceptible to the disease.
To test this hypothesis, William Guggino and his team at Johns Hopkins University’s School of Medicine used the Xenopus egg system. Interestingly, they observed that ABCG2 pumps urate out of the cell. Mutation of the ABCG2 gene results in the synthesis of protein that decreases the normal pumping strength by half.
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