Waugh William H
Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Gerontology. 2008;54(4):238-43. doi: 10.1159/000122618. Epub 2008 Mar 27.
Alzheimer's disease (AD) has become one of the major health problems of the developed world. Previous studies have shown that oxidant-induced changes occur in cerebral tissue in AD and in late-onset amnestic mild cognitive impairment. The oxidative damage begins early and involves free radical-mediated effects that cause lipid peroxidations and oxidative protein and nucleic acid damages which begin before the cardinal neuropathologic manifestations. Impaired cerebral iron homeostasis and iron accumulation are postulated to be primary and seminal in the pathogenesis.
To demonstrate that the Fenton reaction involving hydrogen peroxide and iron at very low concentrations as has been found in human plasma and cerebrospinal fluid may produce promptly oxidations which may be inhibited by preventive use of uric acid and ascorbic acid as hydrophilic antioxidants.
A photometric study in vitro at physiologic pH using concentrations of uric acid and ascorbic acid readily attainable in human extracellular fluids.
Uric acid levels of 0.5 and 6.0 mg/dl (below the saturation level for urate precipitation) and ascorbic acid at a level readily attainable in blood plasma inhibited significantly and completely, respectively, oxidations caused by reactions of 20 microM concentrations of hydrogen peroxide with free bivalent iron at 9.8 muM and at a low hemoglobin level of 12 mg/dl of saline.
Results suggest that supplemental use orally of ascorbic acid combined with use of metabolic precursor to uric acid, like inosine or hypoxanthine, has the potential for preventing or attenuating the progression of AD and amnestic mild cognitive impairment.
阿尔茨海默病(AD)已成为发达国家主要的健康问题之一。先前的研究表明,在AD以及晚发性遗忘型轻度认知障碍患者的脑组织中会发生氧化应激诱导的变化。氧化损伤在早期就已开始,涉及自由基介导的效应,会导致脂质过氧化以及蛋白质和核酸的氧化损伤,这些损伤在主要神经病理表现出现之前就已发生。脑铁稳态受损和铁蓄积被认为在发病机制中起主要和关键作用。
证明在人血浆和脑脊液中发现的极低浓度的过氧化氢和铁所引发的芬顿反应可能会迅速产生氧化反应,而预防性使用尿酸和抗坏血酸作为亲水性抗氧化剂可以抑制这种氧化反应。
在生理pH值条件下,使用人细胞外液中易于达到的尿酸和抗坏血酸浓度进行体外光度研究。
尿酸水平为0.5和6.0mg/dl(低于尿酸盐沉淀的饱和水平)以及血浆中易于达到的抗坏血酸水平,分别显著且完全抑制了20μM浓度的过氧化氢与9.8μM游离二价铁在12mg/dl低血红蛋白水平的盐溶液中反应所引起的氧化反应。
结果表明,口服补充抗坏血酸并联合使用尿酸的代谢前体,如肌苷或次黄嘌呤,有可能预防或减轻AD和遗忘型轻度认知障碍的进展。