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Gout discovery offers hope for arthritis

The discovery could help patients suffering from arthritis Keystone

Researchers in Lausanne claim to have made a breakthrough towards better treatment of gout and potentially other inflammatory diseases.

They say they have identified the mechanism that triggers gout and claim it can be successfully blocked using inhibitor drugs already available on the market.

It has long been known that patients suffering from gout have a high level of uric acid in the blood. This over time crystallises and settles in the joints, causing swelling, inflammation, stiffness, and pain.

But the Lausanne research team, led by Professor Jürg Tschopp, say they have now pinpointed the entire sequence of events that leads to gout. Their findings are published in this month’s edition of Nature magazine.

They say the uric acid crystals trigger a molecular complex called inflammasome, which in turn activates and generates the inflammatory molecule interleukin 1.

“What was not known in the past was what triggers inflammation after the build-up of uric acid crystals. We can now make that link,” Tschopp, co-director of the university’s biochemistry department, told swissinfo.

Inhibitor drugs

By using inhibitor drugs to block this chain of events, the Lausanne team believe the development of gout can be prevented.

One inhibitor already exists for interleukin 1, and drug companies, including Basel-based Novartis, are currently developing a new generation of much more potent inhibitors.

Tschopp said the treatment had achieved “spectacular results” three years ago with patients at Lausanne University Hospital suffering from the rare inflammatory disease, Muckle Wells Syndrome.

He said clinical trials with gout patients would begin shortly in Lausanne, adding that he was confident the development would lead into other areas.

“There are 60,000 gout patients in Switzerland who are treated with classical anti-inflammatory drugs, which have side effects,” he said. “This discovery means a complete change in the way gout will be treated – and probably not only gout but other inflammatory conditions.

“We have preliminary evidence that many inflammatory diseases of unknown origin are basically due to an activation of this inflammasome. It can’t be excluded that all diseases where patients suffer from arthritis are due to excess activation of the inflammasome.”

swissinfo, Adam Beaumont

Gout is a metabolic disease stemming from the build-up of uric acid in the blood. Over time the acid crystallises and settles in the joints, causing swelling and inflammation.

Regularly drinking alcohol and a diet of rich food interfere with the removal of uric acid from the body and can increase the risk of developing gout.

Jürg Tschopp received his PhD in biophysics at Basel University in 1979.
In 1982 he was appointed assistant professor at the department of biochemistry at Lausanne University and promoted to full professor seven years later.
Since 2003 he has been co-director of the department.
His current research focuses on signaling pathways that control apoptosis and inflammation.

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