Tuesday, 4 October 2016

Sophisticate Mechanisms and Unsolved Problems in the Resolution of Acute Gouty Arthritis

Different from allantoin in avian species, the end-product of purine metabolism in human being is uric acid due to 2 non-sense mutations at codons 33 and 187 of urate oxidase during hominoid evolution.

Acute Gouty Arthritis
The solubility of uric acid in the fluid milieu reaches a maximum of 6.8 mg/dl and becomes hyper-saturation status in plasma when over its solubility capacity. Many factors including [Na+], pH, temperature, oncostatic pressure, and in presence of nucleating factors/growth promoting factors may accelerate crystal formation in the joints, periarticular soft tissues, renal tubules or subcutaneous locations.

Thus, acute inflammation elicited by monosodium urate monohydrate (MSU) crystal deposition occurs usually in the low-temperature joints especially in the lower limbs. Usually, the acute inflammation in the joint of patients with acute attack may last a few days from 7-10 days.

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