Weinberger A
Beilinson Medical Center, Felsenstein Medical Research Center, Petah Tiqva, Israel.
Curr Opin Rheumatol. 1995 Jul;7(4):359-63. doi: 10.1097/00002281-199507000-00017.
Serum triglyceride levels are significantly higher and serum high-density lipoprotein cholesterol levels are lower in patients with gout compared with healthy individuals. Whereas increased serum triglyceride levels exist intrinsically in gout, serum uric acid concentration correlates inversely with insulin sensitivity and positively with serum triglycerides. Interaction of monosodium urate crystals with granulocyte-macrophage colony-stimulating factor and with tumor necrosis factor-activated neutrophils favored the production of interleukin-1 over that of interleukin-1-Ra, resulting in a proinflammatory imbalance. Interaction of the crystals with iron or tyrosine kinase may modify their inflammatory response and can be an important modulating mechanism in gouty arthritis. E-selectin is a specific marker for synovial fluid soluble endothelial activity and is increased in the synovial fluid of patients with gouty arthritis, as well as in that of patients with other inflammatory arthritides. Similarly, E-selectin was found to be high in joints with monosodium urate crystal-induced synovitis. In addition, synovial fluid levels of interleukin-8 were found to be high in gout, rheumatoid arthritis, and osteoarthritis.
与健康个体相比，痛风患者的血清甘油三酯水平显著更高，血清高密度脂蛋白胆固醇水平更低。虽然痛风患者体内血清甘油三酯水平本就升高，但血清尿酸浓度与胰岛素敏感性呈负相关，与血清甘油三酯呈正相关。尿酸钠晶体与粒细胞-巨噬细胞集落刺激因子以及肿瘤坏死因子激活的中性粒细胞相互作用，相较于白细胞介素-1受体拮抗剂，更有利于白细胞介素-1的产生，从而导致促炎失衡。晶体与铁或酪氨酸激酶的相互作用可能会改变其炎症反应，并且可能是痛风性关节炎的一种重要调节机制。E-选择素是滑膜液可溶性内皮细胞活性的特异性标志物，在痛风性关节炎患者的滑膜液中升高，在其他炎性关节炎患者的滑膜液中也升高。同样，在尿酸钠晶体诱导滑膜炎的关节中发现E-选择素水平较高。此外，在痛风、类风湿性关节炎和骨关节炎中，滑膜液白细胞介素-8水平也较高。
