The intensely painful condition has for centuries been the butt of comedians’ jokes, because sufferers were thought to have made poor lifestyle or diet choices.
But a new international study has busted that myth.
The study, led by University of Otago researchers, analysed the genetic information of 2.6million people from around the world and found gout is actually a chronic illness where inherited genetics is an important part of why some people get gout and most others do not.
Gout is a common and complex form of arthritis, characterised by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints — most often in the big toes — and can feel like they are on fire.
It is most common in men, affecting about 3-4 times more men than women.
Senior author and University of Otago microbiology and immunology researcher Prof Tony Merriman hoped the findings would remove some of the stigma around gout.
"This widespread myth causes shame in people with gout, making some people more likely to suffer in silence and not go and see the doctor to get a preventive drug that lowers urate in the blood and will prevent their pain."
People needed to understand that while specific dietary factors, such as eating red meat, could trigger gout attacks, the fundamental cause was high urate levels, crystals in the joints and an immune system primed to attack the crystals, he said.
"Genetics plays an important role in all of these processes."
The research identified a large number of immune genes and immune pathways that provided new targets and approaches for preventing gout attacks.
Prof Merriman hoped these findings would lead to improved and more accessible treatment for gout sufferers.
One such option could be the repurposing of a drug used to treat a range of other immune-related diseases, including rheumatoid arthritis.
Tocilizumab targeted a receptor for an immune signaller, interleukin-6, which the research identified as a new gene for gout, he said.
Gout could be effectively treated by drugs such as allopurinol, which lower the urate in the blood and prevent urate crystals forming in the joints, or dissolve them if they are already there.
However, it was a chronic disease so treatment was lifelong, he said.
