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ABCG2 dysfunction increases the risk of renal overload hyperuricemia.

Hirotaka Matsuo1, Tappei Takada, Akiyoshi Nakayama

  • 1a Department of Integrative Physiology and Bio-Nano Medicine , National Defense Medical College , Tokorozawa , Saitama , Japan.

Nucleosides, Nucleotides & Nucleic Acids
|June 19, 2014
PubMed
Summary

Dysfunctional ATP-binding cassette transporter G2 (ABCG2) reduces gut urate excretion, increasing hyperuricemia risk. This suggests reclassifying "overproduction type" hyperuricemia to "renal overload type" for better diagnosis and treatment.

Keywords:
ABC transportersextra-renal underexcretion typehyperuricemia/goutrenal urate overload

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Area of Science:

  • Biochemistry
  • Genetics
  • Nephrology

Background:

  • ATP-binding cassette transporter G2 (ABCG2) is a key urate exporter.
  • ABCG2 dysfunction is linked to serum uric acid levels and gout risk.
  • Current hyperuricemia classification overlooks extra-renal excretion pathways like the gut.

Purpose of the Study:

  • To investigate the impact of ABCG2 dysfunction on human urate handling.
  • To elucidate the mechanism of hyperuricemia development due to ABCG2 variants.
  • To propose a revised classification for hyperuricemia.

Main Methods:

  • Examined clinical parameters of urate handling in 644 Japanese male hyperuricemia outpatients.
  • Assessed ABCG2 dysfunction severity using genotypes of Q126X and Q141K variants.
  • Analyzed urinary urate excretion (UUE) in relation to ABCG2 dysfunction.

Main Results:

  • Contrary to expectations, ABCG2 dysfunction significantly increased UUE (P=3.60×10(-10)).
  • Mild, moderate, and severe ABCG2 dysfunction increased hyperuricemia risk (RR 1.36, 1.66, 2.35).
  • Common dysfunctional ABCG2 variants decrease extra-renal urate excretion, causing hyperuricemia.

Conclusions:

  • ABCG2 dysfunction impairs extra-renal urate excretion, particularly in the gut.
  • Hyperuricemia classification needs revision, renaming "overproduction type" to "renal overload type."
  • This new concept facilitates accurate diagnosis and effective gout/hyperuricemia treatment strategies.