My father had gout. Both of my brothers had gout. So, I wasn’t surprised to read about a new study that put genetics at the top of the list of causes for this condition.
Gout is the most common type of inflammatory arthritis. “Normally, blood moves uric acid to the kidneys, and the uric acid exits the body in urine,” University of Colorado Health explains. “In people with gout, their bodies either make too much uric acid, or they eat foods and drinks that cause excess acid levels, or their kidneys can’t remove uric acid properly.”
If you’ve ever known someone with gout, you know that the crystals that uric acid produces can produce extreme pain. Most often starting in the big toe, the crystals can form in any joint. When a gout attack occurs, it’s because the crystals have become inflamed.
Typically, a long list of food items head the list of risk, but a study reported in the Sept. 9 edition of Science Alert says that they “know where gout comes from, and it’s not what we thought.”
The article written by journalist David Nield said, “Gout is often blamed on overindulgence in alcohol or unhealthy eating, but research suggests genetics plays a much bigger role in the painful arthritic condition than previously thought.”
This was a big study. Nield reported that genetic data was collected from 2.6 million people across 13 different cohorts of DNA data, of which 120,295 were people with “prevalent gout.”
There is a caveat, he said the limitations to the study included the fact that the majority of the data was obtained from people of European ancestry, and that some of information was gained from self-reporting.
Nield said, “While lifestyle and environmental factors are certainly still in play, the findings suggest genetics is a major driver of gout risk – and the researchers think there may be more undiscovered genetic links still to be found, too.”
Quoted in the article is epidemiologist Tony Merriman from the University of Otago in New Zealand where the study was conducted. He said, “Gout is a chronic disease with a genetic basis and is not the fault of the sufferer – the myth that gout is caused by lifestyle or diet needs to be busted.”
Merriman said that researchers are aware of a reluctance to seek treatment because of misconceptions as to the condition’s cause. “This widespread myth causes shame in people with gout, making some people more likely to suffer in silence and not go to see the doctor to get a preventive drug that lowers urate in the blood and will prevent their pain.”
Having better understanding of the causes will help scientists explore more options for treatments. Nield said that would be particularly helpful “in terms of managing the body’s immune response to the buildup of uric acid. In fact, existing drugs could be repurposed for this job.”
Merriman said that he hopes the study will lead to better and more accessible treatments. He thinks that more resources and higher priority should be afforded to gout.
In a different article published last month by Georgia State University, journalist Andre Walker talked about a study where researchers are using CRISPR gene editing to bring back a gene that humans lost millions of years ago that breaks down uric acid.
The missing piece is uricase which is an enzyme that animals still have, but humans don’t. Uricase breaks down uric acid which, as we know, is the culprit for gout.
My impression is that this research has a long way to go, and there will always be ethical concerns about gene editing. But scientists think it could be a game-changer for treatment for not only gout but related metabolic diseases.
For now, gout medications are available in two types which focus on two different problems. Mayo Clinic explains, “The first type helps reduce the inflammation and pain associated with gout attacks. The second type works to prevent gout complications by lowering the amount of uric acid in your blood. Which type of medication is right for you depends on the frequency and severity of your symptoms, along with any other health problems you may have.”
A visit with your primary care provider will help you figure out a successful treatment plan.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at [email protected].