Pathophysiology Gout can be considered a disorder of metabolism that allows uric acid/urate to accumulate in blood and tissues. When tissues becor aturated,., forming crystals. In addition, thE CryS are less soluble under acid conditions y reactive urate crystals are normally coated with serum protei ns(apolipoprotein apo]E or apo B)that physically inhibit th e binding of the crystals to cell receptors. A gout attack may be triggered by either a release of uncoated crystals(eg, due t o partial dissolution of a microtophus caused by changing ser um urate levels) or precipitation of crystals in a supersaturate d microenvironment (eg, release of urate due to cellular dam age) 浙医二院7 浙医二院 Pathophysiology Gout can be considered a disorder of metabolism that allows uric acid/urate to accumulate in blood and tissues. When tissues become super saturated, …, forming crystals. In addition, the crystals also are less soluble under acid conditions. reactive urate crystals are normally coated with serum protei ns (apolipoprotein [apo] E or apo B) that physically inhibit th e binding of the crystals to cell receptors. A gout attack may be triggered by either a release of uncoated crystals (eg, due t o partial dissolution of a microtophus caused by changing ser um urate levels) or precipitation of crystals in a supersaturate d microenvironment (eg, release of urate due to cellular dam age)