The genetics of gout: towards personalised medicine?
Over the last decade, there have been major advances in the understanding of the genetic basis of hyperuricaemia and gout as well as of the pharmacogenetics of urate-lowering therapy. Key findings include the reporting of 28 urate-associated loci, the discovery that ABCG2 plays a central role on extra-renal uric acid excretion, the identification of genes associated with development of gout in the context of hyperuricaemia, recognition that ABCG2 variants influence allopurinol response, and the impact of HLA-B*5801 testing in reducing the prevalence of allopurinol hypersensitivity in high-risk populations. These advances, together with the reducing cost of whole genome sequencing, mean that integrated personalised medicine approaches may soon be possible in clinical practice. Genetic data may inform assessment of disease prognosis in individuals with hyperuricaemia or established gout, personalised lifestyle advice, selection and dosing of urate-lowering therapy, and prevention of serious medication adverse effects. In this article, we summarise the discoveries from genome-wide association studies and discuss the potential for translation of these findings into clinical practice.
['Dalbeth|Nicola|N|', 'Stamp|Lisa K|LK|', 'Merriman|Tony R|TR|']
D000493:Allopurinol D055106:Genome-Wide Association Study D006073:Gout D006074:Gout Suppressants D006801:Humans D033461:Hyperuricemia D008019:Life Style D057285:Precision Medicine D011379:Prognosis D014527:Uric Acid
Genetics Gout Personalised medicine Genome-wide association study Urate