Gout Disease Research Articles

Global burden of gout in 1990-2019: A systematic analysis of the Global Burden of Disease study 2019.

Although gout is one of the most common rheumatic diseases, world data are lacking because most studies have focused on industrialized countries. Therefore, we aimed to investigate the global burden of gout and its associations with the year of diagnosis, age, geographical region, sociodemographic status and various further risk factors. Retrospective data from the Global Burden of Disease (GBD) were used, initially collected between 1990 and 2019. Raw numbers and age-standardized rates (per 100,000 persons) of prevalence, incidence and years lived with disability (YLDs) of gout were extracted from GBD 2019 for 204 countries and territories and stratified by sex, age, year, sociodemographic index and geographic region. Correlations between gout and other chronic diseases were identified, and the burden attributable to high body mass index (BMI) and kidney dysfunction was described. The total number of patients and gout age-standardized prevalence rate increased between 1990 and 2019. Gout was most prevalent in Australasia and high-income North America, and a higher sociodemographic index (SDI) was associated with higher age-standardized prevalence, incidence and YLDs. High BMI and kidney dysfunction were risk factors for gout, while gout was correlated with other kidney diseases. The global prevalence of gout, as well as incidence, and YLDs increased worldwide from 1990 to 2019 and had a significant association with sex, age, geographic region, SDI and risk factors. Understanding the complex interplay of environmental, sociodemographic and geographic risk factors is essential in mitigating the ever-rising disease burden of gout.

A single blind randomized controlled clinical trial of Munditika churna adjuvant Chinna kwath in the management of vatarakta with special reference to Gout

Kayachikitsa is First branch of Ashtang ayurveda described by Vagbhatacharya. Samhitas like Charak Samhita, Shushrut, Vaghbhat Samhita etc. Vatarakta is described as a disease and symptoms also.
 Vatarakta is a Sammurchana Janit (combined) Vyadhi of Vata and Rakta. The aggravated Vata is being obstructed in its passage by Dushit Rakta. This Vata again vitiates the whole Rakta. This condition is known as Vatarakta. It can be corelated to the Gout disease in modern science due to similar sign and symptoms. Munditika Churna has been mentioned in Chakradutta and Bhaishajyaratnavali is effective in the management of Vatarakta and thus selected as a trial drug. Amrutadi Kwath Previously tested drug is selected for control group.
 Aim: To evaluate the clinical efficacy of Munditika Churna Adjuvant Chinna Kwath in Management of Vatarakta w.s.r. to Gout. Materials and Method: A total 70 patients of the age group 20-70 years presenting with signs and symptoms of Vatarakta w.s.r Gout were selected randomly from OPD of the department of Kayachikitsa. The 35 patients of trial group were treated with Munditika Churna Adjuvant Chinna Kwath and 35 patients of control group were subjected to Amrutadi Kwath. Results: Munditika Churna Adjuvant Chinna Kwath is effective on Vatarakta. Conclusion: Munditita Churna is an effective, safe and potent treatment of Vatarakta w.s.r. to Gout.

Anti-Inflammatory Effects of Polyphenols from Plum (Prunus salicina Lindl) on RAW264.7 Macrophages Induced by Monosodium Urate and Potential Mechanisms.

Acute gouty arthritis is an acute inflammatory reaction caused by the deposition of monosodium urate (MSU) crystals in joints and surrounding soft tissues. Controlling inflammation is the key to preventing acute gouty arthritis. Anti-inflammatory activities and the possible molecular mechanisms of plum (Prunus salicina Lindl cv. "furong") polyphenols (PSLP) on RAW264.7 macrophage cells induced by monosodium urate were investigated. PPSF significantly inhibited the activity of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-18 (IL-18). In addition, PPSF exhibited excellent activation of superoxide dismutase (SOD) activity and reduction of intracellular reactive oxygen species (ROS) and malondialdehyde (MDA) levels in RAW264.7 macrophages. The results of global screening of all transcripts by RNA-seq revealed 8585 differentially expressed genes between the PSLP-treated group and the MUS group. From GO analysis, PSLP could affect the occurrence and development of RAW264.7 macrophage inflammation through biological processes, such as organic substance metabolism, intracellular organelles, and binding function. The regulation mechanism of PSLP on MSU-induced RAW264.7 macrophage inflammation may be achieved through the HIF-1 signaling pathway, renal cell carcinoma, the ErbB signaling pathway, and the FoxO signaling pathway. Therefore, PSLP has great prospects in the prevention of gout and similar inflammatory diseases.

Phenolic Profile, Antioxidant, Antidiabetic, and Antigout Potential of Stem Extracts of Four Sweet Cherry Cultivars.

In order to highlight the activities of bioactive compounds present in the stem of sweet cherries, four different cultivars (Van, Burlat, Napoleon, and Cœur pigeon) were collected in Sefrou city in Morocco and were studied. Several assays were performed for this purpose, such as the quantification of phenolic compounds (TPC, TFC, and CTC) and the evaluation of the antioxidant activity using DPPH, ABTS, and FRAP assays. The phenolic profile of each extract was characterized by UHPLC-DAD/MS analysis. The antidiabetic (α-amylase inhibition) and antigout (xanthine oxidase inhibition) activities were also investigated. The results showed high levels of phenolic compounds, with the values of 340 ± 12.06, 244 ± 10.20, 232 ± 5.07, and 19 ± 3.10 mg gallic acid equivalent/g extract for the cultivars Napoleon, Coeur de pigeon, Van, and Burlat, respectively. According to the same order, the flavonoids showed amounts of 34.31 ± 2.08, 23.75 ± 1.02, 24.37 ± 1.20, and 23.31 ± 0.90 mg (rutin equivalent) RE/g extract. These values were correlated with the results of the antioxidant assays, where the Napoleon cultivar proved to be the most potent using the DPPH (IC50 = 2.51 µg/mL) and ABTS (IC50 = 55.38 µg/mL) assays. The phenolic profile of each extract resulted in the identification of twenty-two compounds belonging to five distinct groups. The major phenolic compounds identified were sakuranetin and dihydrowgonin with their glucosides. Antidiabetic activity assays showed that only stem extracts from Burlat and Napoleon cultivars were able to inhibit the α-amylase enzyme with values of 85.57 ± 1.09% and 68.01 ± 3.52%, respectively. All stem extracts proved their ability to inhibit the xanthine oxidase enzyme which is directly linked to the gout disease, with a high value for Van cultivar (40.63 ± 2.37%). These new findings could provide new opportunities for the valorization of cherry stems for the pharmaceutical application of their active phytochemicals.

Single Nucleotide Polymorphisms Associated with the Safety and Efficacy of Anti-Gout Medications

Single Nucleotide Polymorphisms Associated with the Safety and Efficacy of Anti-Gout Medications

The Risk of BPPV, Meniere's Disease, and Vestibular Neuronitis in Patients with Gout: A Longitudinal Follow-Up Study Using a National Health Screening Cohort.

This study evaluated the impact of pre-existing gout on the occurrence of benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and vestibular neuronitis, with the goal of identifying novel associations of gout with other comorbid diseases. The 2002−2019 Korean National Health Insurance Service Health Screening Cohort data were retrospectively analyzed. 23,827 patients with gout were matched to 95,268 controls without gout for age, sex, income, region of residence, and index date. The occurrence of BPPV, Meniere’s disease, and vestibular neuronitis was evaluated in both groups. The hazard ratios (HRs) of gout for BPPV, Meniere’s disease, and vestibular neuronitis were calculated using a stratified Cox proportional hazard model. Participants with gout demonstrated a 1.13-fold higher risk of BPPV (95% CI, 1.06−1.21, p < 0.001) and a 1.15-fold higher risk of Meniere’s disease (95% CI, 1.15−1.37, p < 0.001) than the matched control group. However, the HR for vestibular neuronitis was not significantly higher in the gout group (adjusted HR = 1.06, 95% CI, 0.93−1.21, p = 0.391). A previous history of gout was related to a higher risk of BPPV and Meniere’s disease. Additional studies are necessary to elucidate the mechanism underlying the relationship between gout and comorbid diseases such as BPPV and Meniere’s disease.

Overnutrition-induced gout: An immune response to NLRP3 inflammasome dysregulation by XOD activity increased in quail.

Gout is a progressive metabolic disease closely related to hyperuricemia and urate deposition, with an increasing prevalence and incidence across the globe. Recent studies have shown that the pathological process of gout includes two stages: asymptomatic hyperuricemia and MSU crystal deposition. However, the immune response during the development of hyperuricemia to gouty arthritis is not fully elucidated. Thus, an overnutrition-induced whole-course gout model was established to clarify the immune response and pathological changes in the development from hyperuricemia to gouty arthritis. The quails without urate oxidase were used as experimental animals. And we confirmed that uric acid metabolic targets were changed when quails were in the asymptomatic hyperuricemia stage. When the quail showed gout symptoms, the NLRP3 inflammasome was activated, and the expressions of IL-1β, TNF-α, IL-6, IL-8, and IL-18 were significantly increased. The relationship between the uric acid metabolism target and the NLRP3 inflammasome may be the critical immune response between hyperuricemia and gouty arthritis. Our data showed that, in the process of gout disease, the expression of xanthine oxidase (XOD) has been increasing, which increases the level of uric acid, disrupts the balance of oxidative stress, generates a large amount of ROS, activates the NLRP3 inflammasome, and release IL-1β. Treatment with the XOD inhibitor can reduce uric acid, restore the body's degree of peroxidative damage and antioxidant capacity, and inhibit NLRP3 inflammasome and IL-1β. In vitro, we extracted and identified primary fibroblast-like synoviocytes (FLS) from quail for the first time. Stimulating FLS with uric acid also caused ROS release and NLRP3 inflammasome activation. However, treatment with an XOD inhibitor prevented all these responses in FLS. Our results indicate that the immune response between the uric acid metabolism target XOD and NLRP3 inflammasomes plays a crucial role in developing hyperuricemia to gouty arthritis, and inhibition of both XOD and NLRP3 inflammasomes may be an effective treatment for avoiding the development of asymptomatic hyperuricemia to MSU crystal deposition. Meanwhile, this study also provides an advantageous animal model for pathological mechanisms and research and development drugs for gout.

Gout among Patients with Dialysis: Prevalence, Associated Factors, Treatment Patterns, and Outcomes-Population-Based Retrospective Cohort Study.

Key Points Population-based retrospective cohort study to evaluate clinical correlates of gout and its impact on patients undergoing chronic dialysis.13.5% of US dialysis-dependent patients had gout and were older and male, with a higher prevalence of hypertension and cardiovascular disease.Gout diagnosis was associated with a higher incidence of cardiovascular conditions, levels of anemia, hospitalization, and mortality. Background An association between gout and nondialysis chronic renal disease has long been recognized, yet limited research exists regarding prevalence, treatment, anemia management, and outcomes in patients with ESKD undergoing dialysis. Methods Using data from United States Renal Data System, we conducted a population-based retrospective cohort study in adult patients covered by Medicare and on dialysis in 2017. Multivariate logistic regression models were used to estimate potential factors and odds of gout diagnosis. Antigout medications and impact on anemia management were assessed and compared between gout and nongout dialysis patients using descriptive and regression analyses. Associations for all-cause mortality and cardiovascular-related hospitalizations during 1 year of study follow-up were compared between gout and nongout patients using multivariate Cox regression models. Results Of 231,841 ESKD Medicare patients in 2017 undergoing continuous dialysis, 31,300 (13.5%) had one or more gout diagnostic code(s). Increased odds of having a gout diagnosis were independently associated with older age, male sex, Asian race, obesity, hypertension, and cardiovascular disease. Gout diagnosis was associated with higher prevalence for anemia as indicated by increased erythropoietin-stimulating agent requirements (odds ratio=1.18 for high versus low erythropoietin-stimulating agent dose, 95% confidence interval [95% CI], 1.14 to 1.22) and likelihood of blood transfusions (odds ratio=1.34, 95% CI, 1.30 to 1.38). During the 1-year study follow-up, mortality among gout versus nongout patients was higher by 3% (95% CI, 0 to 6) and a composite association of mortality and cardiovascular disease hospitalization was higher by 6% (95% CI, 3 to 9) after adjusting for comorbid conditions. Conclusions A gout diagnosis was found in 13.5% of US dialysis-dependent patients and was associated with a higher burden of comorbid cardiovascular conditions as well as an elevated incidence of hospitalization and mortality. These observations improve our current understanding of gout among the dialysis population and highlight the importance of new and better treatments to improve outcomes.

A Graphene/Prussian Blue/Rhodium Printed Biosensor for Detecting Uric Acid and Its Clinical Evaluation

Uric acid is produced via the purine metabolism pathway, and an abnormal level of uric acid could lead to serious diseases and complications, such as gout, renal, and cardiovascular diseases. A rapid, convenient, and accurate detection of uric acid is highly desired for healthcare applications. Here, we report a screen-printed amperometric biosensor for uric acid based on a composite ink consisting of graphene, Prussian blue (PB), and rhodium (Rh)/carbon catalyst. The working electrode is printed by a graphene/PB ink and an Rh/carbon (Rh/C) ink sequentially with drying in between. The linear detection range for uric acid is 0.04–0.8 mM with a response time of 30 s and a detection limit of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.55 ~\mu \text{M}$ </tex-math></inline-formula> . The biosensor could be stored in a refrigerator at 4 °C for 80 days without a significant decrease in response. Furthermore, compared to the detection results from the clinical standard method, the relative error of the biosensor is within 20% for detecting uric acid in human blood samples. It is anticipated that this work could advance exciting fundamental studies for uric acid-sensing devices, as well as the clinical applications for the detection of uric acid.

Sex differences in coronary artery bypass grafting-related morbidity and mortality.

Coronary artery bypass grafting (CABG) is associated with both cardiovascular disease (CVD) and non-CVD traits. In addition, women's prognosis after coronary events and revascularizations is worse than in men. As the course of CVD in women differs from that of men, we performed a phenome-wide analysis on the sex differences in CABG -related morbidity and mortality. We performed an untargeted analysis on the sex differences in predictors and outcomes of CABG. We studied a sample of 176,680 FinnGen participants, including 5,950 individuals who underwent CABG (4,988 men and 962 women) and were followed between 1998 and 2019. Over 1,100 different traits were analyzed for both sexes and the results were adjusted with age, smoking status and BMI. Cox proportional hazards models with sex-trait interactions were used to estimate the associations between (1) traits and incident CABG; and (2) CABG and incident traits. In women, CABG was more strongly related to greater increases in risk of diseases such as hypertension, Alzheimer's, aortic aneurysms, gout, and chronic kidney disease compared to risk increases observed in men (all interaction p-values < 0.03). After CABG, men had 2.5-fold (p = 3.1E-15) and women 6.3-fold (p = 9.4E-08) greater risk of cardiac death compared to same-sex individuals who did not undergo CABG (p for interaction 8.2E-4). Moreover, the risk of death in women remained higher even 12 years after CABG, whereas the long-term risk of death in men was not increased, compared to same-sex individuals who did not undergo CABG. The adverse outcomes after CABG, both quantity and quality, also appear to differ between men and women. In women, CABG is related to greater long-term increases in risk of cardiac death and several other disease states than in men. Consideration should therefore be given to whether women receive adequate long-term post-operative therapy and follow-up as CABG is not associated with equally improved cardiovascular disease prognosis in women than in men.

Gout, Urate, and Crystal Deposition Disease: Launch of the First Journal Dedicated to a Rapidly Growing Field

Gout and crystal deposition-associated disorders are among the leading causes of inflammation and arthritis throughout the world [...]

Supplementation of Lactobacillus plantarum (TCI227) Prevented Potassium-Oxonate-Induced Hyperuricemia in Rats.

Hyperuricemia (HC) is one of the important risk factors for gout, arteriosclerosis, and cardiovascular disease. Animal studies have shown that Lactobacillus plantarum can improve microbiota and immune regulation, as well as inhibit uric acid production. However, it is not clear whether L. plantarum can improve HC and intestinal microbiota. We used potassium oxonate (PO) to induce HC in male SD rats and then treated them with L. plantarum TCI227 in a dose-dependent manner (HC + LD, HC + MD, HC + HD) for 4 weeks. We examined organ weight, conducted biochemical examinations of blood and urine, and analyzed the intestinal microbiota in feces through a 16s rDNA sequence analysis. In this study, TCI227 improved body weight, decreased creatinine and serum uric acid, and increased urine uric acid compared to the HC group. Furthermore, TCI227 increased short-chain fatty acids (SCFAs). In the fecal microbiota (family), TCI227 increased the level of Lactobacillaceae and then decreased the levels of Deferribacteres and Prevotellaceae compared to the HC group. Finally, in the fecal microbiota (genus), TCI227 decreased the level of Prevotella and then increased the levels of Lactobacillus and Ruminococcus compared to the HC group. This study suggested that TCI227 can improve HC and can change the composition of intestinal microbiota in PO-induced male HC SD rats.

A peptide-based ELISA for detection of antibodies against novel goose astrovirus type 1

Goose gout disease is a high morbidity and mortality disease caused by novel serotype 1 goose astrovirus (GAstV-1), which has resulted in huge economic loss to the goose industry of China. However, few diagnostic methods have been developed for serological surveillance of GAstV-1. In our previous study, several novel B cell epitopes were identified in the ORF2 protein of GAstV-1. In this study, one novel peptide of 627–646 aa in the ORF2 recognized by monoclonal antibody (mAb) 6C6 was used as an antigen to develop an efficient peptide-based ELISA (pELISA) for detection of antibodies against GAstV-1. Specificity analysis showed that the pELISA only reacted with sera against GAstV-1, but not with sera against other pathogens tested. The sensitivity of the pELISA in detecting positive sera was higher than that of the IFA (Indirect immunofluorescence assay). The coefficients of variation (CV) of the intra-assay and inter-assay were both < 10%, indicating that the reproducibility of pELISA was good. For detection of clinical samples, the pELISA had 87.5% concordance with the IFA. Our data demonstrate that the pELISA generated here provides an accurate, rapid, and economical method for the detection antibodies against GAstV-1 for serological surveillance.

A Tennis Elbow, A First Presentation of Gout Disease.

Gout is a common disease, which affects more than 8 million of patients in the US alone. Typically, gout present as articular surfaces are well described in literature. However, the extra articular manifestations are being increasingly reported in the last few years. The extra-articular manifestations of gout disease can present in several ways, including tenosynovitis, and most commonly affecting the lower limb. Here in, the authors are going to present a rare case of recurrent tennis elbow episodes. The only clinical explanation of this novel presentation was presence of high serum uric acid levels.

Design, synthesis, and biological studies of dual URAT1 inhibitor and FXR agonist based on benzbromarone

With increased unhealthy dietary patterns and a sedentary lifestyle, the prevalence of hyperuricemia is growing rapidly, placing a tremendous burden on the public health system. Persistent hyperuricemia in extreme cases induces gout, gouty arthritis, and other metabolic diseases. Benzbromarone is a potent human urate transporter 1 (URAT1) inhibitor that is widely used as a uric acid-lowering drug. Recent studies indicated that benzbromarone can also activate farnesoid X receptor (FXR), whereas its agonistic activity on FXR is rather poor. Mounting evidence suggested that the etiology of gout is directly related to NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasomes, and FXR suppresses the expression of NLRP3 in various ways. Therefore, the dual URAT1 inhibitor and FXR agonist may exert synergistic effects on decreasing uric acid (UA) levels and inhibiting inflammation. To obtain a better dual URAT1 inhibitor and FXR agonist, we performed the structure-based drug design (SBDD) strategy to improve the FXR activation of benzbromarone by forming strong interactions with ARG331 in FXR binding pocket. All of these efforts lead to the identification of compound 4, which exerts better activity on FXR and uric acid-lowering effect than benzbromarone.

Purification of Xanthine Oxidase Enzyme and Investigation of Its Immobilization with Glutaraldehyde

In this study, the xanthine oxidase (XO) enzyme was purified by affinity chromatography technique using Sepharose-4B-L-tyrosine-4-aminobenzamidine gel and its immobilization with glutaraldehyde was investigated. Using ammonium sulfate precipitation and affinity gel, xanthine oxidase was purified 643.04-fold in an 11.5% yield. The purity of the enzyme was checked by SDS polyacrylamide gel electrophoresis and a single band around 150 kDa was observed. KM (the Michaelis constant) and VMax (the asymptotic reaction velocity at infinite substrate concentration) of the enzyme were determined at 1.67x10-4 M and 0.56 U/mL.min respectively by using a xanthine compound as a substrate. The in vitro effects of NH4F, NH4Cl, CaCl2, ZnCl2, HgCl2, Hg(NO3)2.H2O compounds and commercially named colchicum dispert, commonly used in the treatment of gout disease in the clinic, were investigated. The IC50 values of compounds showing inhibition effects were determined. Afterward, XO was immobilized with glutaraldehyde. The highest XO activity was observed in the sample of the immobilized enzyme at a rate of 6% glutaraldehyde. The kinetic constants (KM and VMax) of the immobilized enzyme were determined as 5.18x10-4 M and 0.73 U mL-1 min-1 respectively. These values revealed that the catalytic activity of the free enzyme was higher than the immobilized enzyme.

Gout in the course of systemic lupus erythematosus: Literature review and case study report

Gout is one of the relatively common inflammatory diseases of the joints. It is caused by the deposition of uric acid crystals in the tissues, which induces an acute or chronic inflammatory process. Elevated serum uric acid levels are usually found long before symptoms appear, and it is worth emphasizing that not every hyperuricemic patient will ever develop gout symptoms. The onset of gout is characterized by periodic joint inflammation, which may be triggered by various stress factors (trauma, infection), certain medications, dietary mistakes, and excessive exercise. Over time, repeated joint inflammation causes permanent joint damage. Most often, deposits of urate crystals are located in places with poorer blood supply and exposed to increased pressure, such as joints and soft tissues (e.g., auricles). The coexistence of gout and autoimmune diseases is relatively rare. While for many years it was believed that gout was not associated with other systemic connective tissue diseases, gout has been described in the course of systemic lupus erythematosus, systemic sclerosis, mixed connective tissue disease, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis. The presented systematic review also describes a case of a patient with longlasting systemic lupus erythematosus who was diagnosed with gout.

INDEX ASSESSMENT OF PERIODONTAL TISSUES IN PATIENTS WITH GOUT

Periodontal disease is a global public health concern. The presence of accompanying somatic pathology, in particular, rheumatologic, is a significant factor that underlies the course and prognosis of periodontal diseases. Gout is a chronic, progressive disease associated with a purine metabolism disorder that is characterized by an increase in the level of uric acid in the blood, hyperuricemia, and deposits of the sodium salt of uric acid in the tissues of the musculoskeletal system and internal organs&#x0D; with the further development of acute arthritis and the formation of gouty nodules (tophus). Though gout is considered as well studied diseases, but, nevertheless, its aetiology and pathogenesis are not completely clear. Recent studies have reported a rapid increase in prevalence of gout, especially in young people, early complications, involvement of the cardiovascular system and kidneys in the pathological process. Moreover, patients with gout demonstrate the growth of dental pathology, in particular, periodontal disease. Despite the difference in the causative factors, the commonality of inflammation in the tissues of the periodontium and joints, kidneys, and endothelium in gout is quite natural, since sodium monourate crystals induce a response of a non-specific link of innate immunity, similar to a microbial process. There are a few studies investigating the condition of periodontal tissues in patients with gout. The aim of this work is to perform the index assessment of periodontal tissues in patients with gout. The participants were divided into 2 groups: the main one included 131 patients with gout and periodontal diseases; and the group of comparison was composed of 54 people with periodontal disease without rheumatologic pathology. The age of the participants ranged from 30 to 59 years. In patients with gout, the values ​​of periodontal indices were significantly higher in all age categories, compared to the individuals without rheumatologic pathology. The average value of the PI index in patients with gout corresponded to a severe degree of periodontitis, and was 2.5 times higher than in people without comorbid pathology, who had moderate periodontitis. Over the age of 40, the patients of the main group developed severe periodontitis. The reference value of the PMA index in both examined groups corresponded to the average degree of gingivitis; however, in the patients with gout, this indicator was 1.5 times higher than in the comparison group. Thus, the pathogenetic mechanisms formed in gout, the main of which is hyperuricemia, are determinants of the development and severity of destructive-inflammatory lesions of the periodontium.

Bioactivity of Heterotrigona itama Propolis as Anti-Inflammatory: A Review

Chronic inflammation is common in infectious diseases, rheumatoid arthritis, gout, and autoimmune diseases. Several pharmaceutical therapies are readily available. However, using non-steroidal anti-inflammatory drugs (NSAIDs) is accompanied by dangerous side effects. Therefore, searching for safer alternative therapies with no side effects is very important. Currently, natural sources of kelulut bee (Heterotrigona itama) propolis have not been fully utilized for treatment, especially for inflammation. This study aims to study the bioactivity of kelulut bee propolis H. itama as an anti-inflammatory. The literature review was used as a method by searching related journals using Google Scholar, PubMed, Scopus, and Garuda. Based on the study's results, it was found that H. itama propolis has the potential to suppress inflammation through the inhibition of free radicals and decrease COX-2. The compounds that have the potential to have this activity are influenced by the resin source collected by the kelulut bees. This information can be used as a reference for developing natural ingredients from propolis for anti-inflammatory properties.

A Review of the Emerging Poultry Visceral Gout Disease Linked to Avian Astrovirus Infection.

Avian astroviruses, including chicken astrovirus (CAstV), avian nephritisvirus (ANV), and goose astrovirus (GoAstV), are ubiquitous enteric RNA viruses associated with enteric disorders in avian species. Recent research has found that infection of these astroviruses usually cause visceral gout in chicken, duckling and gosling. However, the underlying mechanism remains unknown. In the current article, we review recent discoveries of genetic diversity and variation of these astroviruses, as well as pathogenesis after astrovirus infection. In addition, we discuss the relation between avian astrovirus infection and visceral gout in poultry. Our aim is to review recent discoveries about the prevention and control of the consequential visceral gout diseases in poultry, along with the attempt to reveal the possible producing process of visceral gout diseases in poultry.