Gout treatment uric acid production

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Treatment with metabolic inhibitors. For example allopiuinol which inhibits xanthine oxidase, an enzyme responsible for the oxidation of purines, has been used to regulate uric acid production in gout. 

A drug used in the treatment of gout. Because of its structural similarity to hypoxanthine, it acts as a competitive inhibitor of the enzyme xanthine oxidase, thereby reducing uric acid production. 

Xanthine oxidases occur in the liver and kidneys of humans and animals, and cow s milk is a good source of the enzyme (16, 17, 37). These enzymes catalyze the final step in purine metabolism in primates, the production of uric acid. An excess of uric acid crystallizes in joints producing inflammation (i.e., gout) this condition can be relieved by treatment with allopurinol, an inhibitor of xanthine oxidase. 

Some mammals have urate oxidase, which metabolizes uric acid to a much more soluble product, allantoin. Administration of the enzyme to humans could be useful in the treatment of gout. This assay was designed to measure the activity of urate oxidase bound to polyethylene glycol. 

B-5) Allopurinal in the treatment of gout. Xanthine oxidase facilitates steps that lead to the production of urate. Allopurinal, which looks like hypoxanthine (fig. 10.S), is a competitive inhibitor of xanthine oxidase and thereby reduces urate production. (Xanthine oxidase normally functions at steps between hypoxanthine and xanthine, and between xanthine and uric acid). Allopurinal also interacts with PRPP so titat less PRPP is available to form uric acid. 

Gout is an inflammatory joint disease caused by deposition of uric acid crystals in the joints. Treatment of gout aims to control acute attacks with analgesics and colchicine and in the longer term to reduce circulating uric acid levels either by inhibiting its production with allopurinol or by encouraging its excretion by the kidneys with probenecid or sulfinpyrazone. 

In the therapeutic treatment of gout and urate nephrolithiasis with allopurinol, xanthine and hypoxanthine are eliminated instead of uric acid as end-products of purine metabolism. A good separation of these compounds from each other and from uric acid is possible using TLC [21] their increase in urine is proof that the therapy is being observed. 

Treatment for gout involves diet changes and drugs. Depending on the levels of uric acid, a medication such as probenecid is used, which helps the kidneys eliminate uric acid, or allopurinol can be administered to block the production of uric acid by the body. 

Uric acid stones are a product of purine metabolism and a diagnosis of gout should be considered. Chronic renal infections and urinary retention syndromes are other major causes. It is easy to see the importance of obtaining a comprehensive history and the chemical definition of any stone that is passed. Dietary advice and strenuous treatment of infections can prevent reoccurrence of the calculi. 

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