Dujmovic Irena, Pekmezovic Tatjana, Obrenovic Radmila, Nikolić Aleksandra, Spasic Mihailo, Mostarica Stojkovic Marija, Drulovic Jelena
Institute of Neurology, Clinical Center of Serbia, Belgrade, Serbia.
Clin Chem Lab Med. 2009;47(7):848-53. doi: 10.1515/CCLM.2009.192.
Peroxynitrite was hypothesized to be involved in the pathogenesis of multiple sclerosis (MS) through its various neurotoxic effects. Uric acid (UA) was shown to be a strong peroxynitrite scavenger.
We analyzed cerebrospinal fluid (CSF) and serum UA concentrations in 30 MS patients and 20 controls with non-inflammatory neurological diseases (NIND) and correlated these findings with demographic and clinical characteristics of MS patients. Disease activity was assessed by brain magnetic resonance imaging (MRI) and the CSF/serum albumin quotient as an indicator of the state of blood-brain-barrier (BBB).
Serum UA concentrations were found to be significantly lower in MS patients compared with controls (p=0.019). CSF UA concentrations were lower in MS patients as compared to controls, as well as in patients with active MS (clinical and/or MRI activity) in comparison to patients with inactive MS or controls, but these differences were not statistically significant. Significant correlation was found between CSF and serum UA concentrations (p=0.016) in MS patients, but not in controls; and between CSF UA concentrations and the CSF/serum albumin quotient in MS patients (p=0.043), but not in controls.
Our results support the significance of UA in the pathogenesis of MS. Decreased serum UA concentrations in MS patients might be due to both intrinsically reduced antioxidant capacity and increased UA consumption in MS. CSF UA concentrations may not be a reliable marker of disease activity in MS since its concentration is dependent on leakage of UA molecules from serum through the damaged BBB and the balance between consumption/production within the central nervous system (CNS).
有人提出过氧亚硝酸盐通过其多种神经毒性作用参与多发性硬化症（MS）的发病机制。尿酸（UA）被证明是一种强大的过氧亚硝酸盐清除剂。
我们分析了30例MS患者和20例患有非炎性神经系统疾病（NIND）的对照者的脑脊液（CSF）和血清尿酸浓度，并将这些结果与MS患者的人口统计学和临床特征相关联。通过脑磁共振成像（MRI）和脑脊液/血清白蛋白商数评估疾病活动，脑脊液/血清白蛋白商数作为血脑屏障（BBB）状态的指标。
发现MS患者的血清尿酸浓度显著低于对照组（p = 0.019）。与对照组相比，MS患者的脑脊液尿酸浓度较低，与非活动型MS患者或对照组相比，活动型MS患者（临床和/或MRI活动）的脑脊液尿酸浓度也较低，但这些差异无统计学意义。在MS患者中，脑脊液和血清尿酸浓度之间存在显著相关性（p = 0.016），而在对照组中则无；在MS患者中，脑脊液尿酸浓度与脑脊液/血清白蛋白商数之间存在显著相关性（p = 0.043），而在对照组中则无。
我们的结果支持尿酸在MS发病机制中的重要性。MS患者血清尿酸浓度降低可能是由于抗氧化能力内在降低以及MS中尿酸消耗增加所致。脑脊液尿酸浓度可能不是MS疾病活动的可靠标志物，因为其浓度取决于尿酸分子从血清通过受损的血脑屏障的渗漏以及中枢神经系统（CNS）内消耗/产生之间的平衡。
