The gouty tophus: a review

Current Rheumatology Reports
Ashika Chhana, Nicola Dalbeth

Abstract

The tophus is the cardinal feature of advanced gout. This review summarises recent research into the biology, impact and treatment of tophaceous gout. Microscopically, tophi are chronic foreign body granuloma-like structures containing collections of monosodium urate (MSU) crystals surrounded by inflammatory cells and connective tissue. Extracellular trap formation mediated by neutrophil interactions with MSU crystals may be a central checkpoint in tophus formation. Gouty tophi impact on many aspects of health-related quality of life. Tophi are also implicated in the development of structural joint damage and increased mortality risk in people with gout. Effective treatment of tophaceous gout requires long-term urate-lowering therapy, ideally to achieve a serum urate concentration of <5 mg/dL (300 μmol/L). Recent advances in gout therapeutics have expanded urate-lowering therapy options for patients with severe tophaceous disease to allow faster regression of tophi, improved health-related quality of life and, potentially, improved structural outcomes.

References

Nov 30, 1979·JAMA : the Journal of the American Medical Association·D Resnick
Jun 1, 1989·Endocrinology·M Noda, J J Camilliere
Sep 5, 2002·Arthritis and Rheumatism·Fernando Perez-RuizAna Ruibal
Mar 6, 2004·Science·Volker BrinkmannArturo Zychlinsky
Apr 9, 2005·The Journal of Immunology : Official Journal of the American Association of Immunologists·Ru Liu-BryanRobert Terkeltaub
Dec 11, 2008·Annals of the Rheumatic Diseases·H K ChoiS Nicolaou
Dec 17, 2009·Blood·Maren von Köckritz-BlickwedeVictor Nizet
Feb 5, 2010·Arthritis and Rheumatism·Nicola DalbethJillian Cornish
Mar 18, 2011·Orthopedics·Jeremy M GilillandStephen K Aoki
Mar 18, 2011·Journal of Clinical Ultrasound : JCU·Aravindakannan TherimadasamyEinar Patrick Vincent Wilder-Smith
May 25, 2011·The Journal of Immunology : Official Journal of the American Association of Immunologists·Andrew M LinAllen T Bruce
Jun 11, 2011·Arthritis Research & Therapy·Jade E Hollis-MoffattTony R Merriman
Jul 19, 2011·The Breast Journal·Richard GreenPeter Surtees
Aug 6, 2011·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Fernando RadiceGiovanni Carcuro
Oct 28, 2011·Clinics and Research in Hepatology and Gastroenterology·Justine VarinotDominique Wendum
Dec 14, 2011·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Nicola DalbethFiona M McQueen
Mar 30, 2012·Journal of Clinical Ultrasound : JCU·Gil RodasManuel Cusi
Aug 4, 2012·Journal of Electron Microscopy·Kaoru SasakiMitsuru Sekido
Aug 24, 2012·Spine·Jose Luis Sanmillan BlascoJuan José Acebes Martín
Sep 5, 2012·The Journal of Cell Biology·Volker Brinkmann, Arturo Zychlinsky
Nov 13, 2012·Annals of the Rheumatic Diseases·Michael A BeckerJohn S Sundy
Dec 12, 2012·Journal of Clinical Imaging Science·Atooshe RohaniJavad Ramezani
Dec 25, 2012·The Journal of Hand Surgery·Yukinori YaegashiKotaro Oyama
Jan 22, 2013·Annals of the Rheumatic Diseases·Nicola DalbethFiona M McQueen
Jul 10, 2013·Joint, Bone, Spine : Revue Du Rhumatisme·Daniel WendlingXavier Guillot
Jul 17, 2013·CytoJournal·Vaishali WalkeVinod Jadhao
Dec 18, 2013·American Journal of Respiratory and Critical Care Medicine·Rosemary AdamsonDavid R Park

❮ Previous
Next ❯

Citations

Sep 8, 2016·The Journal of Dermatology·Mariko AsaharaHidehisa Saeki
Oct 30, 2016·Biomedical Journal·John Chung-Han WuChih-Hao Chen
Oct 23, 2016·Seminars in Arthritis and Rheumatism·Adey A BerhanuMichael H Pillinger
Apr 20, 2017·Medicine·David MartinOlivier Gié
Mar 9, 2017·Arthritis Research & Therapy·Wendy HeNicola Dalbeth
Dec 3, 2016·The Journal of Immunology : Official Journal of the American Association of Immunologists·Payel SilBalázs Rada
Oct 17, 2018·Skin Research and Technology : Official Journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)·Linda TognettiJean Luc Perrot
Dec 13, 2019·The FEBS Journal·Shrikant R MulayHans-Joachim Anders
Oct 23, 2015·Current Rheumatology Reports·Michael ToproverMichael H Pillinger
Jul 16, 2016·The American Journal of Case Reports·Heidi Dahl ChristensenInger Marie Jensen Hansen
Nov 18, 2016·Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.]·Payel SilBalázs Rada
Jun 23, 2018·Nature Reviews. Rheumatology·Falko ApelElaine F Kenny
Sep 25, 2019·Rheumatology·Mihaela GamalaRuth Klaasen
Jun 24, 2017·Journal of Community Hospital Internal Medicine Perspectives·Amr Salama, Richard Alweis
Mar 17, 2018·Rheumatology·Tristan Pascart, Frédéric Lioté
Feb 18, 2020·Clinical Rheumatology·Beilei LuPeilei Wang
Apr 5, 2017·Journal of Immunology Research·Balázs Rada
May 24, 2019·International Journal of Rheumatic Diseases·Zhengping HuangTianwang Li
Jun 14, 2019·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Aurelian Anghelescu
Nov 1, 2020·BMJ Case Reports·Emma RichardsLisha McClelland
Nov 25, 2018·Joint, Bone, Spine : Revue Du Rhumatisme·Tuhina NeogiMichael H Pillinger
Jun 1, 2021·Expert Review of Clinical Immunology·Paola GalozziFrancesca Oliviero

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cell Checkpoints & Regulators

Cell cycle checkpoints are a series of complex checkpoint mechanisms that detect DNA abnormalities and ensure that DNA replication and repair are complete before cell division. They are primarily regulated by cyclins, cyclin-dependent kinases, and the anaphase-promoting complex/cyclosome. Here is the latest research.