In the pathogenesis of gout, uric acid crystals activate the NLRP3 inflammasome in macrophages, leading to release of which key pro-inflammatory cytokine responsible for acute gout attacks?
- A TNF-α
- B IL-6
- C IL-1β ✓
- D IL-17
Correct answer: C. IL-1β
Explanation
Monosodium urate crystals activate the NLRP3 (NALP3) inflammasome in macrophages, triggering caspase-1 activation and cleavage of pro-IL-1β to active IL-1β. This is the central cytokine driving acute gout inflammation. This mechanism is the basis for the efficacy of IL-1β inhibitors (anakinra, canakinumab, rilonacept) in refractory gout. Colchicine also inhibits NLRP3 inflammasome assembly at a different step. TNF-α and IL-6 play secondary roles.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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