Nove mogućnosti u liječenju uričkog artritisa

master's thesis

• Title (english): New treatment possibilities in gout
• Author: Mirta Kauzler
• Mentor: Iva Žagar (mentor)
• Committee member: Porin Perić (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Iva Žagar (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Physical Medicine and Rehabilitation

Abstract

Urični artritis je najčešći upalni artritis u svijetu. Glavno obilježje bolesti je taloženje kristala mononatrijevog urata koji su ključni pokretač akutne upale. Prevalencija i učestalost uričnog artritisa rastu u mnogim razvijenim zemljama svijeta, no unatoč dobrom razumijevanju patofiziologije bolesti i dostupnih terapija, opterećenje uričnim artritisom i dalje ostaje visoko, a liječenje i dalje nije optimalno. Temelj liječenja uričnog artritisa je smanjenje razine urata pomoću ULT-a, koji uključuje inhibitore ksantin oksidaze, urikozurike i rekombinantnu urikazu nalik svinjskoj. Liječenje napadaja gihta se u prvoj liniji provodi nesteroidnim protuupalnim lijekovima, kolhicinom ili glukokortikoidima, a u drugoj liniji terapije inhibitorima IL-1. Novosti u liječenju gihta uključuju nove terapije koje moduliraju upalne putove, kao što su Dapansutril koji inhibira NLRP3 i beta-karoten koji smanjuje upalu induciranu kristalima MSU. Crijevna mikrobiota također igra važnu ulogu pa se prehrambene intervencije i transplantacija fekalne mikrobiote istražuju kao nove terapijske strategije. Strategija liječenja do cilja (T2T) je nedavno uspostavljen pristup kako bi se poboljšalo liječenje gihta, s ciljem postizanja ciljne razine urata u serumu ispod 6 mg/dL. Sve ove inovacije predstavljaju napredak u liječenju uričnog artritisa.

Abstract (english)

Gouty arthritis is the most common inflammatory arthritis in the world. The main feature of the disease is the deposition of monosodium urate crystals, which are the key driver of acute inflammation. The prevalence and incidence of gouty arthritis are increasing in many developed countries worldwide, but despite a good understanding of the pathophysiology of the disease and available therapies, the burden of gouty arthritis still remains high, and treatment is still suboptimal. The mainstay of treatment for gouty arthritis is urate reduction using ULT, which includes xanthine oxidase inhibitors, uricosurics, and recombinant porcine-like uricase. Treatment of gout attacks is carried out in the first line with non-steroidal anti-inflammatory drugs, colchicine or glucocorticoids, and in the second line of therapy with IL-1 inhibitors. Innovations in the treatment of gout include new therapies that modulate inflammatory pathways, such as Dapansutril, which inhibits NLRP3, and beta-carotene, which reduces inflammation induced by MSU crystals. Gut microbiota also plays an important role, so dietary interventions and faecal microbiota transplantation are being investigated as new therapeutic strategies. The treat-to-target (T2T) approach is a recently established approach to improve the management of gout, aiming to achieve a target serum urate level below 6 mg/dL. All these innovations represent progress in the treatment of gouty arthritis.

• Keywords: urični artritis; akutni napadaj gihta; kronični giht; crijevna mikrobiota; strategija liječenja do cilja
• Keywords (english): gouty arthritis; acute attack of gout; chronic gout; intestinal microbiota; treat-to-target
• Language: croatian
• URN:NBN: urn:nbn:hr:105:199734
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-09-06 09:20:55