Gout affects ~1 to 2% of the U.S. population. With an aging population, the societal burden of gout will likely grow. The role of genetic factors on gout and hyperuricemia among different races/ethnicities and the mechanisms by which treatment of hyperuricemia may impact vascular disease remain poorly understood. While the causes of hyperuricemia are known, and efficacious treatments for gout are available, there are large gaps in the quality of care of gout patients. These care gaps, the societal impact of gout, and rising concerns about deleterious effects of hyperuricemia make these conditions ideal targets for translational research. Our multi-disciplinary UAB CORT includes 4 research projects and an administrative core focused on the theme of """"""""Gout and Hyperuricemia: from Bench to Bedside to Backyard. Gout, hyperuricemia, and vascular disease are more common among African Americans than Caucasians, yet little is known about genetic and environmental factors associated with increased risk of gout in this minority population. Our four projects are thus further united by a sub-theme of racial/ethnic disparities in gout and hyperuricemia. We will analyze the association of gout and hyperuricemia with cardiovascular disease in African-Americans and define genetic variants and environmental and medical factors underlying hyperuricemia and gout in this minority group (Project 1);characterize biomarkers of inflammation (CRP), vascular disease (endothelial function), and blood pressure changes associated with the ULT allopurinol (Project 2);examine factors associated with suboptimal gout care and factors influencing effective and safer dosing of allopurinol and colchicine in African-Americans and Caucasians (Project 3);and compare the effectiveness of a novel pharmacy-based """"""""virtual"""""""" Gout Clinic that includes protocol-driven care to usual care in the treatment of chronic gout (Project 4). The overall goal of our CORT is to improve the health of patients with gout and hyperuricemia by applying scientifically rigorous, state-of-the-art methodology to clinically important questions in translational investigation and to educate clinical investigators through an enrichment program. Drawing on the unique strengths of many UAB Centers, Departments, and Programs, and in collaboration with an experienced team of 20 investigators representing 5 disciplines, our innovative projects hold the promise of significant improvements in our understanding of the pathogenesis of gout, hyperuricemia, and related co-morbid conditions, and may ultimately lead to better ways to predict, treat, or prevent gout and hyperuricemia.
Gout and high serum urate levels are common in the general population, as are associated conditions such as cardiovascular disease. A better understanding of the genetic and environmental influences on gout, and hyperuricemia in different races/ethnicities would ultimately improve public health.
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|England, Bryant R; Thiele, Geoffrey M; Anderson, Daniel R et al. (2018) Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ 361:k1036|
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