DOI: https://doi.org/10.22141/1608-1706.3.20.2019.172088

Osteoarthritis and gout: evidence of relationship and possible therapeutic interventions

I.Yu. Golovach, Ye.D. Yehudina

Abstract


The review article presents new data on the potential relationship between the two most common rheumatic diseases and the possible role of uric acid in the pathogenesis of osteoarthritis (OA). OA is a degenerative joint disease that leads to pain, reduced quality of life and negative social and economic consequences. Gout is the most common form of inflammatory arthritis and is the result of persistently elevated levels of urates and deposition of pro-inflammatory crystals of sodium monourate in the joints. Similar localization, predisposing and genetic factors for both diseases has long been established. However, the relationship between these two nosologies has not yet been fully clarified, in particular, the effect of OA on the development of gout and the effect of gout on the development of OA. Traditional risk factors for OA lead to the initiation of cartilage damage and the production of pro-inflammatory mediators that contribute to inflammation. At the same time, the death of chondrocytes leads to the formation of urates, and if their concentrations are high enough, this may contribute to the deposition of crystals on cartilage at a macroscopic level, which can potentially lead to secondary mechanical damage to articular cartilage and contribute to the additional progression of OA. In conditions of hyperuricemia, synovial fluid with OA will have higher background levels of urates that can directly affect the local urate-mediated OA processes, increasing the likelihood of crystallization. The result will be a vicious cycle in which the progression of OA leads to the formation of urates, and the formation of urates contributes to the further progression of OA. Evidence of the relationship between gout and OA is given, with particular emphasis on the role of hyperuricemia in the presence or absence of gout. Studies that clarify the possible biochemical, mechanical and immunological relationships of these states are analyzed. The therapeutic options in the treatment of OA with the use of traditional urate-lowering drugs and colchicine are considered.


Keywords


osteoarthritis; gout; hyperuricemia; uric acid; pathogenesis; relationship; review

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