Gout: new therapeutic strategies

DOI: https://doi.org/10.29296/25877305-2021-06-04
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N. Kunitskaya, MD I.I. Mechnikov North-Western State Medical University, Ministry of Health of
Russia, Saint Petersburg

Long-term urate deposition is now known to require treatment that is not limited to acute episodes, but is also aimed at modulating the activity of key enzymes involved in the metabolism and excretion of urates, including xanthine oxidoreductase (XOR) and URAT1. This review presents the latest data on the efficacy of XOR inhibitors and uricosuric compounds in reducing the level of uric acid (UA) in both the systemic circulation and peripheral tissues. Emphasis is placed on the effect of novel XOR inhibitors on UA metabolism. The decrease of UA levels via XOR inhibition is associated with the reduction of oxidative stress that leads to endothelial dysfunction, thereby contributing to the development of diabetes, hypertension, atherosclerosis, and chronic heart failure. Thus, prevention of the accumulation of oxygen radicals generated by XOR is becoming a new area in the treatment of both hyperuricemia and gout.

oxidative stress
xanthine oxidase inhibitors

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