The precise cause of gout is not known, but it is suspected to be due to a genetic deficiency of one or another enzyme concerned in purine metabolism.
Gout can be effectively treated by a combination of nutritional and drug therapies. Foods especially rich in nucleotides and nucleic acids, such as liver or glandular products, are withheld from the diet. In addition, major improvement follows use of the drug allopurinol (Fig. 21-40), an inhibitor of xanthine oxidase, the enzyme responsible for converting purines into uric acid. When xanthine oxidase is inhibited, the excreted products of purine metabolism are xanthine and hypoxanthine, which are more soluble in water than uric acid and less likely to form crystalline deposits. Allopurinol was developed by Gertrude Elion and George Hitchings, who also developed acyclovir, used to treat AIDS, and other purine analogs used in cancer chemotherapy.
Lehninger-Nelson-Cox: Principles of Biochemistry, 730.o.
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