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Understanding the Role of Uric Acid in Gout

Ruth Jessen Hickman, MD  |  Issue: September 2022  |  September 6, 2022

Certainly, self-experimentation by physicians, which played a role in many important and historic medical discoveries, especially in the first part of the twentieth century, is now not viewed through the same lens. “I’d like to find the rheumatologists who would be brave enough to repeat these studies on themselves,” says Dr. Mikuls. “Gout is hugely painful. People who get it say, ‘This is the worst thing I’ve ever had.’ To do this to yourself is gutsy and shows a high level of commitment and intellectual curiosity.”


Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.

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References

  1. Faires JS, McCarty DJ. Acute arthritis in man and dog after intrasynovial injection of sodium urate crystals. Lancet. 1962 Oct 6;2(7258):682–685.
  2. Seegmiller JE, Howell R, Malawista SE. The inflammatory reaction to sodium urate: Its possible relationship to the genesis of acute gouty arthritis. JAMA. 1962 May 12;180(6):469–475.
  3. Nuki G, Simkin PA. A concise history of gout and hyperuricemia and their treatment. Arthritis Res Ther. 2006;8 Suppl 1(Suppl 1):S1.
  4. Garrod AB. Treatise on Gout and Rheumatic Gout (Rheumatoid Arthritis). 3rd ed. Longmans, Green & Co Inc; 1876.
  5. Brill JM, McCarty DJ. ‘Studies on the nature of gouty tophi’ by Max Freudweiler, 1899. (An inflammatory response to injected sodium urate.) An abridged translation, with comments. Ann Intern Med. 1964 Mar;60:486–505.
  6. Malawista SE, de Boisfleury AC, Naccache PH. Inflammatory gout: Observations over a half-century. FASEB J. 2011 Dec;25(12):4073–4078.
  7. McCarty DJ, Hollander JL. Identification of urate crystals in gouty synovial fluid. Ann Intern Med. 1961 Mar;54:452–460.
  8. Rundles RW, Wyngaarden JB, Hitchings GH, et al. Effects of a xanthine oxidase inhibitor on thiopurine metabolism, hyperuricemia and gout. Trans Ass Am Physicians. 1963;76:126–140.
  9. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020 Jun;72(6):744–760.
  10. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective—A review. J Adv Res. 2017 Sep;8(5):495–511.
  11. Qaseem A, Harris RP, Forciea MA, et al. Management of acute and recurrent gout: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Jan 3;166(1):58–68.
  12. Weisse AB. Self-experimentation and its role in medical research. Tex Heart Inst J. 2012;39(1):51–54.

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