Centers of Research Translation (CoRT)

痛风影响约1%至2%的美国人口。随着人口老龄化，痛风的社会负担可能会增加。遗传因素在不同种族/民族的痛风和高尿酸血症中的作用以及高尿酸血症治疗可能影响血管疾病的机制仍然知之甚少。虽然高尿酸血症的原因是已知的，有效的治疗痛风是可用的，有很大的差距在痛风患者的护理质量。这些护理差距、痛风的社会影响以及对高尿酸血症有害影响的日益关注使这些疾病成为转化研究的理想目标。我们的多学科UAB CORT包括4个研究项目和一个专注于“痛风和高尿酸血症：从实验室到床边到后院”主题的行政核心。痛风、高尿酸血症和血管疾病在非裔美国人中比白种人更常见，但对这一少数人群中与痛风风险增加相关的遗传和环境因素知之甚少。因此，我们的四个项目通过痛风和高尿酸血症的种族/民族差异的子主题进一步团结起来。我们将分析非洲裔美国人痛风和高尿酸血症与心血管疾病的关系，并确定这一少数群体中高尿酸血症和痛风的遗传变异、环境和医学因素（项目1）；表征与ULT别嘌呤醇相关的炎症（CRP）、血管疾病（内皮功能）和血压变化的生物标志物（项目2）；在非裔美国人和白种人中检查与次优痛风护理相关的因素以及影响别嘌呤醇和秋水仙碱有效和安全剂量的因素（项目3）；并比较新型基于药物的“虚拟”痛风诊所的有效性，该诊所包括治疗慢性痛风的方案驱动护理与常规护理（项目4）。我们的CORT的总体目标是通过应用科学严谨、最先进的方法来解决转化研究中的临床重要问题，并通过丰富计划教育临床研究者，从而改善痛风和高尿酸血症患者的健康。利用许多UAB中心，部门和项目的独特优势，并与代表5个学科的20名经验丰富的研究人员团队合作，我们的创新项目有望显著改善我们对痛风，高尿酸血症和相关合症发病机制的理解，并可能最终导致更好的方法来预测，治疗或预防痛风和高尿酸血症。

Gout affects ~1 to 2% of the U.S. population. With an aging population, the societal burden of gout will likely grow. The role of genetic factors on gout and hyperuricemia among different races/ethnicities and the mechanisms by which treatment of hyperuricemia may impact vascular disease remain poorly understood. While the causes of hyperuricemia are known, and efficacious treatments for gout are available, there are large gaps in the quality of care of gout patients. These care gaps, the societal impact of gout, and rising concerns about deleterious effects of hyperuricemia make these conditions ideal targets for translational research. Our multi-disciplinary UAB CORT includes 4 research projects and an administrative core focused on the theme of "Gout and Hyperuricemia: from Bench to Bedside to Backyard. Gout, hyperuricemia, and vascular disease are more common among African Americans than Caucasians, yet little is known about genetic and environmental factors associated with increased risk of gout in this minority population. Our four projects are thus further united by a sub-theme of racial/ethnic disparities in gout and hyperuricemia. We will analyze the association of gout and hyperuricemia with cardiovascular disease in African-Americans and define genetic variants and environmental and medical factors underlying hyperuricemia and gout in this minority group (Project 1); characterize biomarkers of inflammation (CRP), vascular disease (endothelial function), and blood pressure changes associated with the ULT allopurinol (Project 2); examine factors associated with suboptimal gout care and factors influencing effective and safer dosing of allopurinol and colchicine in African-Americans and Caucasians (Project 3); and compare the effectiveness of a novel pharmacy-based "virtual" Gout Clinic that includes protocol-driven care to usual care in the treatment of chronic gout (Project 4). The overall goal of our CORT is to improve the health of patients with gout and hyperuricemia by applying scientifically rigorous, state-of-the-art methodology to clinically important questions in translational investigation and to educate clinical investigators through an enrichment program. Drawing on the unique strengths of many UAB Centers, Departments, and Programs, and in collaboration with an experienced team of 20 investigators representing 5 disciplines, our innovative projects hold the promise of significant improvements in our understanding of the pathogenesis of gout, hyperuricemia, and related co-morbid conditions, and may ultimately lead to better ways to predict, treat, or prevent gout and hyperuricemia.