Zhao Jianan, Guo Shicheng, Schrodi Steven J, He Dongyi
Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai, China.
Front Cell Dev Biol. 2022 Jun 23;10:937855. doi: 10.3389/fcell.2022.937855. eCollection 2022.
Hyperuricemia and gout are complex diseases mediated by genetic, epigenetic, and environmental exposure interactions. The incidence and medical burden of gout, an inflammatory arthritis caused by hyperuricemia, increase every year, significantly increasing the disease burden. Genetic factors play an essential role in the development of hyperuricemia and gout. Currently, the search on disease-associated genetic variants through large-scale genome-wide scans has primarily improved our understanding of this disease. However, most genome-wide association studies (GWASs) still focus on the basic level, whereas the biological mechanisms underlying the association between genetic variants and the disease are still far from well understood. Therefore, we summarized the latest hyperuricemia- and gout-associated genetic loci identified in the Global Biobank Meta-analysis Initiative (GBMI) and elucidated the comprehensive potential molecular mechanisms underlying the effects of these gene variants in hyperuricemia and gout based on genetic perspectives, in terms of mechanisms affecting uric acid excretion and reabsorption, lipid metabolism, glucose metabolism, and nod-like receptor pyrin domain 3 (NLRP3) inflammasome and inflammatory pathways. Finally, we summarized the potential effect of genetic variants on disease prognosis and drug efficacy. In conclusion, we expect that this summary will increase our understanding of the pathogenesis of hyperuricemia and gout, provide a theoretical basis for the innovative development of new clinical treatment options, and enhance the capabilities of precision medicine for hyperuricemia and gout treatment.
高尿酸血症和痛风是由遗传、表观遗传和环境暴露相互作用介导的复杂疾病。痛风是一种由高尿酸血症引起的炎症性关节炎,其发病率和医疗负担逐年增加,疾病负担显著加重。遗传因素在高尿酸血症和痛风的发生发展中起着至关重要的作用。目前,通过大规模全基因组扫描寻找与疾病相关的基因变异,主要提高了我们对这种疾病的认识。然而,大多数全基因组关联研究(GWAS)仍集中在基础层面,而基因变异与疾病之间关联的生物学机制仍远未被充分理解。因此,我们总结了全球生物银行荟萃分析计划(GBMI)中确定的最新高尿酸血症和痛风相关基因位点,并从遗传角度,就影响尿酸排泄和重吸收、脂质代谢、葡萄糖代谢以及NOD样受体吡啉结构域3(NLRP3)炎性小体和炎症途径的机制,阐明了这些基因变异在高尿酸血症和痛风中作用的潜在分子机制。最后,我们总结了基因变异对疾病预后和药物疗效的潜在影响。总之,我们期望本综述将增进我们对高尿酸血症和痛风发病机制的理解,为新的临床治疗方案的创新发展提供理论依据,并提高高尿酸血症和痛风精准治疗的能力。