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Developments in the scientific and clinical understanding of gout
Arthritis Research & Therapy, 10/16/08

So A - A review to summarize recent progress in our understanding of uric acid metabolism in particular the role of renal transporters in regulating urate levels. The mechanisms through which monosodium urate (MSU) crystals cause inflammation have also been intensively studied and these insights would likely affect the therapy of hyperuricemia and gout in the future.

Within the joint, MSU crystals trigger a local inflammatory reaction, neutrophil recruitment, and the production of proinflammatory and other inflammatory mediators
Uptake of MSU crystals by monocytes involves interactions with components of the innate immune system
Intracellularly, MSU crystals activate multiple processes that lead to the formation of the NALP-3 inflammasome complex that in turn processes IL-1 to IL-1β
Inflammatory effects of MSU are IL-1-dependent and can be blocked by IL-1 inhibitors

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