Gouty arthritis is caused by the inflammatory reaction that arises in response to the deposition of MSU crystals into the joints of patients with hyperuricemia. This MSU-induced inflammation is driven by components of the innate immune system which normally provide the initial nonspecific immune response to invading pathogens. Research has shown that injured and dying mammalian cells release uric acid, which forms MSU crystals that activate innate immunity in a manner similar to that caused by microbial infection [7]. The initial process of the gouty arthritis inflammatory response occurs when macrophages that are present within the joint space phagocytose MSU crystals (Fig. 2). This internalization of MSU crystals then triggers the formation of a protein scaffold known as an inflammasome within the cytosol of the macrophage. The inflammasome is a high-molecular weight protein complex that provides a platform for the enzymatic processing of inactive pro-IL-1β into biologically active IL-1β, which is then secreted from the cell [8]. Interestingly, MSU crystals alone may not be sufficient to trigger the activation/release of IL-1β from macrophages, instead requiring co-stimulation with free fatty acids or lipopolysaccharide to release IL-1β [9]. Given that the consumption of alcohol or a large meal can lead to increases in free fatty acid concentrations, it stands to reason that the involvement of free fatty acids in triggering release of IL-1β may be an important factor in the development of gouty arthritis flares [9].