Gout is hereditary rather than down to lifestyle, suggests a new study. Once regarded as an illness of the wealthy and believed to have been suffered by Henry VIII, the painful condition is the most common form of arthritis in men and affects around one in 40 adults.
Gout has seen a resurgence in recent years with an almost 1,000% rise in cases in just four years in some parts of England. Symptoms include sudden severe pain in a joint, often the big toe, as well as hot, swollen, red skin over the affected joint.
Now a new study, led by researchers at the University of Otago in New Zealand, suggests the cause may be down to our genes. The team analysed genetic information from 2.6 million people from around the world.
The findings, published in the journal Nature Genetics, showed that inherited genetics is an important part of why some people get gout and most others don’t. Senior author Professor Tony Merriman hopes the study will remove some of the stigma around gout.
He said: “Gout is a chronic disease with a genetic basis and is not the fault of the sufferer the myth that gout is caused by lifestyle or diet needs to be busted. This widespread myth causes shame in people with gout, making some people more likely to suffer in silence and not go and see the doctor to get a preventive drug that lowers urate in the blood and will prevent their pain.”
“People need to understand that while specific dietary factors, such as eating red meat, can trigger gout attacks, the fundamental cause is high urate levels, crystals in the joints, and an immune system primed to ‘attack’ the crystals genetics plays an important role in all of these processes.”
The research identified a large number of immune genes and immune pathways that provide new targets and approaches for preventing gout attacks. Prof Merriman hopes the findings will lead to improved treatment for sufferers.
Attacks of gout are usually treated with a non-steroidal anti-inflammatory, such as ibuprofen, but steroids may also be administered if required. Prof Merriman said: “We hope that, in time, better and more accessible treatments will become available with the new targets we identified.”
He says one option could be the repurposing of a drug used to treat other immune-related diseases, including rheumatoid arthritis. Tocilizumab targets a receptor for an immune signaller, interleukin-6, which the research identified as a new gene for gout.
Prof Merriman added: “Gout deserves more health spend resource and greater prioritisation in the health system.”