Dysuricemia: Recent Advances in Urate Research from Hypouricemia to Hyperuricemia/Gout

Dear Colleagues,

Gout caused by hyperuricemia is a globally widespread and increasingly burdensome disease. Recent studies have illuminated the pathophysiology of gout and hyperuricemia, as well as its genetic background, epidemiology, diagnosis, treatment, and complications.

It is of interest that the molecular targets for these diseases were initially provided by research on renal hypouricemia, which is often accompanied by complications such as exercise-induced acute kidney injury. The notion of “the lower, the better” when it comes to blood urate levels is in fact incorrect: a better understanding of urate handling and metabolism comes from an awareness that both excessively high and low levels cause problems.

Several studies have also revealed the physiological role of urate as an antioxidant and prooxidant, acting as both a scavenger and generator of reactive oxygen species (ROSs). These discoveries have prompted research interest in not only serum urate levels but also in xanthine oxidoreductase (XOR), an enzyme that synthesizes both urate and ROSs, as status or progression biomarkers of chronic kidney disease and cardiovascular disease.

The current body of evidence clearly indicates that urate is much more than just a metabolic waste product. The aim of this Special Issue, therefore, is to propose the novel disease concept of “Dysuricemia” to describe disorders of urate handling and/or metabolism via XOR, and to interpret the spectrum from hypouricemia to hyperuricemia/gout as a single disease category.

We believe that recent advances in dysuricemia research covered in the present Special Issue will illuminate many currently unknown roles of urate.

Dr. Akiyoshi Nakayama
Dr. Masafumi Kurajoh
Guest Editors

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