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血清尿酸与多发性硬化症。

Serum uric acid and multiple sclerosis.

作者信息

Rentzos M, Nikolaou C, Anagnostouli M, Rombos A, Tsakanikas K, Economou M, Dimitrakopoulos A, Karouli M, Vassilopoulos D

机构信息

Department of Neurology, Aeginition Hospital-Athens Medical School, 72-74 Vas.Sophias Av, Greece.

出版信息

Clin Neurol Neurosurg. 2006 Sep;108(6):527-31. doi: 10.1016/j.clineuro.2005.08.004. Epub 2005 Oct 3.

Abstract

UNLABELLED

Peroxynitrite (PN) has been implicated in multiple sclerosis (MS) and its animal model experimental allergic encephalomyelitis. Uric acid (UA) serum levels of MS patients, a natural scavenger of PN, were found lowered in some recent studies.

OBJECTIVE/PURPOSE: The objective of our study was to correlate UA serum levels and several clinical parameters of MS. We also tried to investigate serum UA changes during treatment with immunomodulating or immunosuppressing drugs in the last 6 months.

PATIENTS AND METHODS

We measured UA serum levels in 190 patients with MS and 58 age and gender matched patients with inflammatory (IND) and non-inflammatory diseases (NIND) studied as control groups. UA levels were correlated with clinical parameters as type of the disease, duration, disability, magnetic resonance imaging (MRI) activity and female gender.

RESULTS

In the overall MS group, patients were found to have significantly lower mean serum uric acid levels compared with the IND (p = 0.0029) and the NIND group (p < 0.0001). UA serum concentrations were not inversely correlated with duration of the disease (p = 0.87), with disability as assessed by Expanded Disability Status Scale (EDSS) score (p = 0.67) and MRI activity (p = 0.36). Treatment with immunomodulating or immunosuppressing drugs had no influence in UA levels (p = 0.85). Patients with Clinically Isolated Syndromes (CIS) were found to have significantly lower UA concentrations compared with IND and NIND patients (p = 0.009 and <0.001, respectively).

CONCLUSIONS

Our findings suggest that lower serum UA levels in MS patients may represent a primary, constitutive loss of protection against nitric oxide and the development of CNS inflammation and tissue damage may not have a direct effect to UA serum levels. They also provide support that the earlier increase of UA serum levels might be beneficial in the future treatment of MS.

摘要

未标记

过氧亚硝酸盐(PN)与多发性硬化症(MS)及其动物模型实验性自身免疫性脑脊髓炎有关。在最近的一些研究中发现,MS患者的尿酸(UA)血清水平,即PN的天然清除剂,有所降低。

目的/目标:我们研究的目的是将UA血清水平与MS的几个临床参数相关联。我们还试图调查过去6个月中使用免疫调节或免疫抑制药物治疗期间血清UA的变化。

患者和方法

我们测量了190例MS患者以及58例年龄和性别匹配的炎症性(IND)和非炎症性疾病(NIND)患者作为对照组中的UA血清水平。UA水平与疾病类型、病程、残疾程度、磁共振成像(MRI)活动以及女性性别等临床参数相关联。

结果

在整个MS组中,发现患者的平均血清尿酸水平明显低于IND组(p = 0.0029)和NIND组(p <0.0001)。UA血清浓度与疾病病程(p = 0.87)、通过扩展残疾状态量表(EDSS)评分评估的残疾程度(p = 0.67)和MRI活动(p = 0.36)均无负相关关系。免疫调节或免疫抑制药物治疗对UA水平没有影响(p = 0.85)。发现临床孤立综合征(CIS)患者与IND和NIND患者相比UA浓度明显更低(分别为p = 0.009和<0.001)。

结论

我们的研究结果表明MS患者较低的血清UA水平可能代表针对一氧化氮的主要的、先天性保护缺失状态,并且中枢神经系统炎症和组织损伤的发展可能对UA血清水平没有直接影响。这些结果还支持了血清UA水平的早期升高可能对未来MS治疗有益的观点。

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