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Skalny AV, Korobeinikova TV, Sotnikova TI, Tazina SI, Morozova GD, Guo X, Zhang F, Nekhoroshev SV, Ning Y, Tinkov AA. Estimation of Hair Toxic and Essential Trace Element and Mineral Profiles of Patients with Chronic Gout. Biol Trace Elem Res 2024:10.1007/s12011-024-04273-7. [PMID: 38907829 DOI: 10.1007/s12011-024-04273-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
The objective of the present study was to evaluate hair levels of toxic and essential trace elements and minerals in male and female patients with chronic gout. A total of 223 examinees aged from 27 to 82 years old including 116 healthy controls (64 women and 52 men) and 107 patients with gout (56 women and 51 men) were enrolled in the current cross-sectional study. Analysis of hair toxic and essential trace element and mineral content was performed using inductively-coupled plasma mass-spectrometry. The obtained data demonstrate that hair B, Fe, I, and Mo levels in gout patients were 67%, 8%, 46%, and 21% higher in comparison to the respective control values. Hair Cr and V content in patients was more than twofold higher than in the controls. Hair Mg and Zn levels were found to be 34% and 11% lower when compared to the respective control values. Hair toxic metal and metalloid content was also significantly affected in gout patients. Specifically, hair Al, As, and Pb levels were 24%, 43%, and 33% higher in gout patients than in healthy controls, respectively. Analysis of covariance demonstrated that sex also had a significant influence on hair trace element and mineral levels in gout patients. Specifically, gout-associated overaccumulation of hair trace elements including was more profound in male than in female patients. It is assumed that trace element dysregulation may contribute to gout development and progression, especially in men. However, further studies are required to elucidate this association and the underlying molecular mechanisms.
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Affiliation(s)
- Anatoly V Skalny
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia.
| | - Tatiana V Korobeinikova
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia
| | - Tatiana I Sotnikova
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia
- City Clinical Hospital N. a. S.P. Botkin of the Moscow City Health Department, 125284, Moscow, Russia
| | - Serafima Ia Tazina
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia
| | - Galina D Morozova
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | | | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Alexey A Tinkov
- Center of Bioelementology and Human Ecology, and Department of Therapy of the Institute of Postgraduate Education, IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 2-4, Moscow, 119146, Russia
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Sovetskaya Str. 14, Yaroslavl, 150000, Russia
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Piao W, Li S, Guo Q, Cheng X, Xu X, Zhao L, Yu D. Bean and Nut Intake Were Protective Factors for Comorbid Hypertension and Hyperuricemia in Chinese Adults: Results from China Nutrition and Health Surveillance (2015-2017). Nutrients 2024; 16:192. [PMID: 38257085 PMCID: PMC10820914 DOI: 10.3390/nu16020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
This study aimed to describe the prevalence of comorbid hypertension and hyperuricemia (HH) and detected the dietary factors for HH in Chinese adults aged 18 to 64 years. All of the data were collected from the China Nutrition and Health Surveillance 2015-2017, with a stratified, multistage, random sampling method on a national scale. A total of 52,627 adult participants aged 18~64 years from the CNHS 2015-2017 were included in this study. HH was identified as SUA level cut-offs for males and females of 420 μmol/L and 360 μmol/L, respectively, with mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥ 90 mmHg and/or received antihypertensive treatment within two weeks. The differences in HH prevalence between or among the subgroups were compared by the Rao-Scott chi-square test. The correlations between HH and covariates or metabolic factors were detected by a weighted two-level multivariate survey logistic regression. The total weighted sufficient intake ratios of beans and nuts, vegetables, and red meat were 59.1%, 46.6%, and 64.8%, respectively. The weighted prevalence of HH in the total participants was 4.7% (95% CI: 4.3-5.0%). The positive effects of bean and nut on HH were observed. The participants who had sufficient bean and nut intake showed lower risk for HH (for the total participants: OR = 0.734, 95% CI = 0.611-0.881). The prevalence of HH might have been a public health problem, and bean and nut intake might be a protective factor for HH in the Chinese population.
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Affiliation(s)
| | | | | | | | | | | | - Dongmei Yu
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Peng X, Li X, Xie B, Lai Y, Sosnik A, Boucetta H, Chen Z, He W. Gout therapeutics and drug delivery. J Control Release 2023; 362:728-754. [PMID: 37690697 DOI: 10.1016/j.jconrel.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
Gout is a common inflammatory arthritis caused by persistently elevated uric acid levels. With the improvement of people's living standards, the consumption of processed food and the widespread use of drugs that induce elevated uric acid, gout rates are increasing, seriously affecting the human quality of life, and becoming a burden to health systems worldwide. Since the pathological mechanism of gout has been elucidated, there are relatively effective drug treatments in clinical practice. However, due to (bio)pharmaceutical shortcomings of these drugs, such as poor chemical stability and limited ability to target the pathophysiological pathways, traditional drug treatment strategies show low efficacy and safety. In this scenario, drug delivery systems (DDS) design that overcome these drawbacks is urgently called for. In this review, we initially describe the pathological features, the therapeutic targets, and the drugs currently in clinical use and under investigation to treat gout. We also comprehensively summarize recent research efforts utilizing lipid, polymeric and inorganic carriers to develop advanced DDS for improved gout management and therapy.
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Affiliation(s)
- Xiuju Peng
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China
| | - Xiaotong Li
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China
| | - Bing Xie
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China
| | - Yaoyao Lai
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China
| | - Alejandro Sosnik
- Department of Materials Science and Engineering, Technion - Israel Institute of Technology, Technion City, Haifa 3200003, Israel
| | - Hamza Boucetta
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China
| | - Zhongjian Chen
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China.
| | - Wei He
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 2111198, PR China; Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China.
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Steunou AS, Babot M, Durand A, Bourbon ML, Liotenberg S, Miotello G, Armengaud J, Ouchane S. Discriminating Susceptibility of Xanthine Oxidoreductase Family to Metals. Microbiol Spectr 2023; 11:e0481422. [PMID: 37458582 PMCID: PMC10434068 DOI: 10.1128/spectrum.04814-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/16/2023] [Indexed: 08/19/2023] Open
Abstract
The xanthine oxidoreductase (XOR) family are metal-containing enzymes that use the molybdenum cofactor (Moco), 2Fe-2S clusters, and flavin adenine dinucleotide (FAD) for their catalytic activity. This large molybdoenzyme family includes xanthine, aldehyde, and CO dehydrogenases. XORs are widely distributed from bacteria to humans due to their key roles in the catabolism of purines, aldehydes, drugs, and xenobiotics, as well as interconversions between CO and CO2. Assessing the effect of excess metals on the Rubrivivax gelatinosus bacterium, we found that exposure to copper (Cu) or cadmium (Cd) caused a dramatic decrease in the activity of a high-molecular-weight soluble complex exhibiting nitroblue tetrazolium reductase activity. Mass spectrometry and genetic analyses showed that the complex corresponds to a putative CO dehydrogenase (pCOD). Using mutants that accumulate either Cu+ or Cd2+ in the cytoplasm, we show that Cu+ or Cd2+ is a potent inhibitor of XORs (pCOD and the xanthine dehydrogenase [XDH]) in vivo. This is the first in vivo demonstration that Cu+ affects Moco-containing enzymes. The specific inhibitory effect of these compounds on the XOR activity is further supported in vitro by direct addition of competing metals to protein extracts. Moreover, emphasis is given on the inhibitory effect of Cu on bovine XOR, showing that the XOR family could be a common target of Cu. Given the conservation of XOR structure and function across the tree of life, we anticipate that our findings could be transferable to other XORs and organisms. IMPORTANCE The high toxicity of Cu, Cd, Pb, As, and other metals arises from their ability to cross membranes and target metalloenzymes in the cytoplasm. Identifying these targets provides insights into the toxicity mechanisms. The vulnerability of metalloenzymes arises from the accessibility of their cofactors to ions. Accordingly, many enzymes whose cofactors are solvent exposed are likely to be targets of competing metals. Here, we describe for the first time, with in vivo and in vitro experiments, a direct effect of excess Cu on the xanthine oxidoreductase family (XOR/XDH/pCOD). We show that toxic metal affects these Moco enzymes, and we suggest that access to the Moco center by Cu ions could explain the Cu inhibition of XORs in living organisms. Human XOR activity is associated with hyperuricemia, xanthinuria, gout arthritis, and other diseases. Our findings in vivo highlight XOR as a Cu target and thus support the potential use of Cu in metal-based therapeutics against these diseases.
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Affiliation(s)
- Anne-Soisig Steunou
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Marion Babot
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Anne Durand
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Marie-Line Bourbon
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Sylviane Liotenberg
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Guylaine Miotello
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI, Bagnols-sur-Cèze, France
| | - Jean Armengaud
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI, Bagnols-sur-Cèze, France
| | - Soufian Ouchane
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
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Lin Z, Chen H, Lan Q, Chen Y, Liao W, Guo X. Composite Dietary Antioxidant Index Is Negatively Associated with Hyperuricemia in US Adults: An Analysis of NHANES 2007-2018. Int J Endocrinol 2023; 2023:6680229. [PMID: 37636314 PMCID: PMC10449592 DOI: 10.1155/2023/6680229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
Hyperuricemia and its complications are severe risks to human health. Dietary intervention is considered an essential part of the management of hyperuricemia. Studies have reported that the intake of antioxidants has a positive effect on hyperuricemia. Here, we collected data from 8761 participants of the National Health and Nutrition Examination Survey for this analysis. Daily intakes of vitamins A, C, and E; manganese; selenium; and zinc were calculated as the composite dietary antioxidant index (CDAI). The participants were divided into four groups (Q1, Q2, Q3, and Q4) according to the CDAI. Univariate analysis was used to assess the association of covariates with hyperuricemia. The association between the CDAI and hyperuricemia was evaluated using multinomial logistic regression, and its stability was determined by stratified analysis. Our results revealed that the CDAI has a significant negative association with hyperuricemia (Q2: 0.81 (0.69, 0.95); Q3: 0.75 (0.62, 0.90); Q4: 0.65 (0.51, 0.82); P < 0.01). The results of stratified analysis emphasize that this association between CDAI and hyperuricemia is stable. In conclusion, this study suggested a negative association between the CDAI and hyperuricemia.
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Affiliation(s)
- Zhenzong Lin
- Department of Clinical Laboratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haokai Chen
- Department of Clinical Laboratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiwen Lan
- Department of Medical Imageology, The Second Clinical School of Guangzhou Medical University, Guangzhou 511436, China
| | - Yinghan Chen
- Department of Medical Imageology, The Second Clinical School of Guangzhou Medical University, Guangzhou 511436, China
| | - Wanzhe Liao
- Department of Clinical Medicine, The Nanshan College of Guangzhou Medical University, Guangzhou 511436, China
| | - Xuguang Guo
- Department of Clinical Laboratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China
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Ai G, Huang R, Xie J, Zhong L, Wu X, Qin Z, Su Z, Chen J, Yang X, Dou Y. Hypouricemic and nephroprotective effects of palmatine from Cortex Phellodendri Amurensis: A uric acid modulator targeting Keap1-Nrf2/NLRP3 axis. JOURNAL OF ETHNOPHARMACOLOGY 2023; 301:115775. [PMID: 36198377 DOI: 10.1016/j.jep.2022.115775] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Palmatine (Pal) is a major bioactive alkaloid originated from ancient Chinese herbal medicine Cortex Phellodendri Amurensis (CPA), which has long been applied to treat hyperuricemia (HUA)-related diseases. Pal possesses potent anti-inflammatory and anti-oxidant effects against metabolic diseases. However, its potential beneficial effect against PO (potassium oxonate)/HX (hypoxanthine)-induced HUA remains elusive. AIM OF THE STUDY This study aimed to investigate the potential pharmacological effect and mechanism of Pal on PO/HX-induced HUA in mice. MATERIAL AND METHODS A mouse model of HUA was established by co-administration of PO/HX once daily for 7 consecutive days. The HUA mice were orally given three doses (25, 50 and 100 mg/kg) of Pal daily for a week. Febuxostat (Feb, 5 mg/kg) was given as a positive control. At the scheduled termination of the experiment, the whole blood, liver and kidney were collected for subsequent analyses. The concentrations of uric acid (UA), creatinine (CRE) and blood urea nitrogen (BUN), and activities of adenosine deaminase (ADA) and xanthine oxidase (XOD) were evaluated. Histopathological alterations of the kidney were detected by H&E staining. The inflammatory and oxidative stress status was detected by assay kits. Additionally, key proteins involved in the urate transporter, Keap1-Nrf2 and TXNIP/NLRP3 signaling pathways were evaluated by immunohistochemistry and Western blotting. Finally, molecular docking was employed to probe the binding characteristics of Pal and target proteins Keap1, NLRP3, URAT1 and HO-1. RESULTS Administration of Pal substantially decreased the elevated kidney weight, lowered UA, CRE and BUN levels, and attenuated abnormal histopathological alterations. Meanwhile, treatment with Pal also dramatically lowered hepatic XOD and ADA activities. Besides, Pal treatment effectively mitigated the renal inflammatory and oxidative stress markers. Further mechanistic investigation indicated Pal distinctly downregulated the protein levels of GLUT9 and URAT1, while up-regulated the expression levels of OAT1 and ABCG2. Pal also restored Nrf2 activation, promoted subsequent expression of anti-oxidative enzymes, and downregulated the expressions of TXNIP, NLRP3, apoptosis-associated speck-like (ASC), caspase-1, IL-1β and IL-18. Molecular docking analysis also indicated Pal firmly bound with Keap1, NLRP3, URAT1 and HO-1. CONCLUSIONS These findings indicated that Pal exhibited favorable anti-HUA effect via modulating the expressions of transporter-related proteins and suppressing XOD activity. Furthermore, Pal also alleviated HUA-induced kidney injury, which was at least partially related to restoring Keap1-Nrf2 pathway and inhibiting TXNIP/NLRP3 inflammasome. Our investigation was envisaged to provide experimental support for the traditional application of CPA and CPA-containing classical herbal formulas in the management of HUA-related diseases and might provide novel dimension to the clinical application of Pal.
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Affiliation(s)
- Gaoxiang Ai
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Ronglei Huang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Jianhui Xie
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, 510006, PR China
| | - Linjiang Zhong
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Xiaoyan Wu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Zehui Qin
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Ziren Su
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Jiannan Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Xiaobo Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, 510006, PR China.
| | - Yaoxing Dou
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China; The Second Clinical Medical College of Guangzhou University of Chinese Medicine/Post-Doctoral Research Station, Guangzhou, 510006, PR China.
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Kiyani MM, Butt MA, Rehman H, Mustafa M, Sajjad AG, Shah SSH, Mahmood T, Bokhari SAI. Evaluation of Antioxidant Activity and Histopathological Changes Occurred by the Oral Ingestion of CuO Nanoparticles in Monosodium Urate Crystal-Induced Hyperuricemic BALB/c Mice. Biol Trace Elem Res 2022; 200:217-227. [PMID: 33594526 DOI: 10.1007/s12011-021-02615-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
Nanotechnology is an intensive branch of science due to the unique features of nano range particles (1-100 nm). Their nano size results in a high surface area of absorption when orally administered. Monosodium urate crystal excessive deposition causes a commonly known inflammatory disease called gout into the synovial joints. Previously it has been observed that copper oxide nanoparticles (CuONPs) had a significant effect in reducing the serum uric acid levels in BALB/c mice as well as reducing the inflammation in the ankles of mice. This study was made to investigate the antioxidant and histopathological changes in hyperuricemic BALB/c mice upon the oral administration of copper oxide nanoparticles. Different concentrations of copper oxide nanoparticles 5, 10, and 20 ppm were given orally to gouty mice. To investigate the antioxidant activity of CuONPs, various antioxidant protocols were applied. It was noted that the nanoparticle-treated group of 20 ppm showed no significant changes in superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), thiobarbituric acid reactive substances (TBARS), and ROS values while the protein estimation values of the negative control group exhibited a significant increase (0.001). When compared to negative control, no significant effect was shown on the interpretation of histopathological changes of muscles, kidney, and liver tissues.
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Affiliation(s)
- Mubin Mustafa Kiyani
- Shifa College of Medical Technology, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Maisra Azhar Butt
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Hamza Rehman
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad, Pakistan.
| | - Moheen Mustafa
- Faculty of Engineering, Federal Urdu University, Islamabad, Pakistan
| | - Abdul Ghafoor Sajjad
- Department of Physical Therapy, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | | | - Tariq Mahmood
- Department of Nanoscience and Technology, National Center for Physics, Islamabad, Pakistan
| | - Syed Ali Imran Bokhari
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad, Pakistan
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Zou F, Zhao X, Wang F. A review on the fruit components affecting uric acid level and their underlying mechanisms. J Food Biochem 2021; 45:e13911. [PMID: 34426969 DOI: 10.1111/jfbc.13911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022]
Abstract
Uric acid (UA) is produced in the liver and excreted through the kidneys and intestines. If UA is overproduced or its excretion reduces, the concentration of UA increases, leading to hyperuricemia and gout. The high concentration of UA is also related to cardiovascular disease, hypertension, obesity, and other diseases. Fruits are healthy foods. However, fruits contain fructose and small amounts of purine, and the product of their metabolism is UA. Therefore, theoretically, eating fruits will increase the concentration of serum UA. Fruit components are numerous, and their effects on serum UA are complex. According to the current research, fructose, purine, polyphenols, vitamin C, dietary fiber, and minerals present in fruits influence serum UA concentrations. In addition to the UA synthesized by fructose and purine metabolism, the mechanisms by which other components affect the concentration of serum UA can be summarized as follows: (a) inhibiting xanthine oxidase; (b) reducing reabsorption of UA; and (c) improving the excretion of UA. In this review, we comprehensively discussed the fruit components that affect serum UA concentrations, and explained their mechanisms for the first time, which references for patients with hyperuricemia to take fruits. PRACTICAL APPLICATIONS: With the rising prevalence, hyperuricemia and gout have become public health problems that endanger our daily life. The key to the treatment of hyperuricemia is to control the level of serum UA within the normal range. Fruits are healthy foods. However, fruit components are numerous, and their effects on serum UA are complex. According to the current research, fructose, purine, polyphenols, vitamin C, dietary fiber, and minerals present in fruits influence serum UA concentrations. In this review, we comprehensively discussed the fruit components that affect serum UA concentrations. We also explained their mechanisms, which references for patients with hyperuricemia to take fruits.
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Affiliation(s)
- Fengmao Zou
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, China
| | - Xu Zhao
- Faculty of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
| | - Fuqi Wang
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, China
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Leal M, Zampini IC, Mercado MI, Moreno MA, Simirgiotis MJ, Bórquez J, Ponessa G, Isla MI. Flourensia fiebrigii S.F. blake: A medicinal plant from the Argentinean highlands with potential use as anti-rheumatic and anti-inflammatory. JOURNAL OF ETHNOPHARMACOLOGY 2021; 264:113296. [PMID: 32841690 DOI: 10.1016/j.jep.2020.113296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/30/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Flourensia fiebrigii is a plant used in traditional medicine in the Argentine Calchaquí Valley as purgative, expectorant, anti-rheumatic and anti-inflammatory. AIM OF THE STUDY The aim of this study was to analyze the macroscopic and microscopic characteristics of F. fiebrigii leaf and stem, the phytochemical composition of leaves ethanolic extracts and to validate its traditional use as anti-rheumatic and anti-inflammatory. MATERIALS AND METHODS The macroscopic and microscopic description of F. fiebrigii leaf and stem was carried out. Two extracts (immersions and tinctures) from leaves were obtained. The phytochemical analysis and UHPLC-OT-MS metabolome fingerprinting of both extracts were performed. The anti-rheumatic and anti-inflammatory activities of both extracts were determined using enzymatic inhibition assays of xanthine-oxidase (XOD), secretory phospholipase A2 (sPLA2) and lipoxygenase (LOX). RESULTS The macroscopic and micrographic characters of F. fiebrigii were described to allow the botanical characterization of the plant species. The leaves extracts showed a high level of phenolic compounds with similar chromatographic patterns. Forty-five compounds were identified based on UHPLC-OT-MS including several sesquiterpenes, chalcones, flavonoids, isoflavonoids, a lignan and phenylpropanoids phenolic acids that have been identified for the first time in this plant species. F. fiebrigii extracts were able to inhibit the XOD activity and, consequently, the formation of uric acid and reactive oxygen species, primary cause of diseases, such as gouty arthritis (IC50 values of 1.10-2.12 μg/mL). Pro-inflammatory enzymes like sPLA2 and LOX were also inhibited by F. fiebrigii extracts (IC50 values of 22.00-2.20 μg/mL) decreasing the production of inflammation mediators. CONCLUSIONS The present work validates the traditional medicinal use of F. fiebrigii as anti-rheumatic and anti-inflammatory through the use of enzymatic assays. The presence of several chemical compounds with demonstrated anti-rheumatic and anti-inflammatory properties also supports the bioactivity of the F. fiebrigii.
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Affiliation(s)
- Mariana Leal
- Laboratorio de Investigación de Productos Naturales (LIPRON), Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV-CONICET), Facultad de Ciencias Naturales e IML, Universidad Nacional de Tucumán, San Lorenzo 1469, San Miguel de Tucumán, Tucumán, Argentina
| | - Iris Catiana Zampini
- Laboratorio de Investigación de Productos Naturales (LIPRON), Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV-CONICET), Facultad de Ciencias Naturales e IML, Universidad Nacional de Tucumán, San Lorenzo 1469, San Miguel de Tucumán, Tucumán, Argentina; Instituto de Morfología Vegetal. Área Botánica. Fundación Miguel Lillo, Miguel Lillo 251, San Miguel de Tucumán, Tucumán, Argentina
| | - María Inés Mercado
- Instituto de Morfología Vegetal. Área Botánica. Fundación Miguel Lillo, Miguel Lillo 251, San Miguel de Tucumán, Tucumán, Argentina
| | - María Alejandra Moreno
- Laboratorio de Investigación de Productos Naturales (LIPRON), Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV-CONICET), Facultad de Ciencias Naturales e IML, Universidad Nacional de Tucumán, San Lorenzo 1469, San Miguel de Tucumán, Tucumán, Argentina
| | - Mario Juan Simirgiotis
- Instituto de Farmacia, Universidad Austral de Chile, Campus Isla Teja, Valdivia, 5090000, Chile
| | - Jorge Bórquez
- Laboratorio de Productos Naturales, Departamento de Química, Facultad de Ciencias Básicas, Universidad de Antofagasta, Casilla 170, Antofagasta, 1240000, Chile
| | - Graciela Ponessa
- Instituto de Morfología Vegetal. Área Botánica. Fundación Miguel Lillo, Miguel Lillo 251, San Miguel de Tucumán, Tucumán, Argentina
| | - María Inés Isla
- Laboratorio de Investigación de Productos Naturales (LIPRON), Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV-CONICET), Facultad de Ciencias Naturales e IML, Universidad Nacional de Tucumán, San Lorenzo 1469, San Miguel de Tucumán, Tucumán, Argentina; Instituto de Morfología Vegetal. Área Botánica. Fundación Miguel Lillo, Miguel Lillo 251, San Miguel de Tucumán, Tucumán, Argentina.
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From Xanthine Oxidase Inhibition to In Vivo Hypouricemic Effect: An Integrated Overview of In Vitro and In Vivo Studies with Focus on Natural Molecules and Analogues. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9531725. [PMID: 32184901 PMCID: PMC7060854 DOI: 10.1155/2020/9531725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/10/2019] [Accepted: 12/24/2019] [Indexed: 01/05/2023]
Abstract
Hyperuricemia is characterized by elevated uric acid (UA) levels on blood, which can lead to gout, a common pathology. These high UA levels are associated with increased purine ingestion and metabolization and/or its decreased excretion. In this field, xanthine oxidase (XO), by converting hypoxanthine and xanthine to UA, plays an important role in hyperuricemia control. Based on limitations and adverse effects associated with the use of allopurinol and febuxostat, the most known approved drugs with XO inhibitory effect, the search for new molecules with XO activity is growing. However, despite the high number of studies, it was found that the majority of tested products with relevant XO inhibition were left out, and no further pharmacological evaluation was performed. Thus, in the present review, available information published in the past six years concerning isolated molecules with in vitro XO inhibition complemented with cytotoxicity evaluation as well as other relevant studies, including in vivo hypouricemic effect, and pharmacokinetic/pharmacodynamic profile was compiled. Interestingly, the analysis of data collected demonstrated that molecules from natural sources or their mimetics and semisynthetic derivatives constitute the majority of compounds being explored at the moment by means of in vitro and in vivo animal studies. Therefore, several of these molecules can be useful as lead compounds and some of them can even have the potential to be considered in the future clinical candidates for the treatment of hyperuricemia.
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A negative association between urinary iodine concentration and the prevalence of hyperuricemia and gout: a cross-sectional and population-based study in Mainland China. Eur J Nutr 2020; 59:3659-3668. [PMID: 32078063 DOI: 10.1007/s00394-020-02199-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/06/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Iodine is one of the most important trace elements in the human body. It is not only the main component of thyroid hormones but also has extrathyroid biological functions. To date, there have been no large-scale epidemiological studies on the relationship between hyperuricemia and iodine intake, although both are closely related to health. A population-based epidemiological survey in China offers such an opportunity. METHODS This population-based cross-sectional study recruited 75,653 adults aged ≥ 18 years from 2015 to 2017 with a randomized, multistage, stratified sampling strategy. Serum uric acid levels and urinary iodine concentrations (UICs) were measured. RESULTS Stratified by UIC, the prevalence of hyperuricemia was 17.8%, 18.8%, 16.0% and 13.7% in the UIC < 100, 100-199, 200-299, and ≥ 300 μg/L groups, respectively; the prevalence of gout was 4.0%, 3.4%, 2.4% and 1.7%, respectively. The prevalence of gout decreased significantly as the UIC increased. The prevalence of hyperuricemia and gout were markedly higher in postmenopausal females than in the premenopausal population (hyperuricemia: 15.9% vs. 8.3%, X2 = 520.072, p < 0.001; gout: 3.6% vs. 1.3%, X2 = 219.889, p < 0.001), and the prevalence decreased as the UIC increased. Subjects in the more than adequate and excessive iodine groups had lower likelihoods of having hyperuricemia [aOR = 0.81 (95% CI 0.77-0.85), aOR = 0.68 (95% CI 0.64-0.72)] and lower odds of having gout than subjects in the adequate iodine (AI) group [aOR = 0.77 (95% CI 0.68-0.86), aOR = 0.59 (95% CI 0.51-0.68)]. CONCLUSIONS UIC was inversely associated with the occurrence of hyperuricemia and gout. More in-depth research and prospective studies are needed to explore the molecular mechanisms and confirm the observed association.
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Kiyani MM, Rehman H, Hussain MA, Jahan S, Afzal M, Nawaz I, Mahmood T, Bokhari SAI. Inhibition of Hyperuricemia and Gouty Arthritis in BALB/c Mice Using Copper Oxide Nanoparticles. Biol Trace Elem Res 2020; 193:494-501. [PMID: 31079329 DOI: 10.1007/s12011-019-01734-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/12/2019] [Indexed: 12/23/2022]
Abstract
Nanoparticles are known for their unique properties and are being utilized in various disciplines of sciences. Their nanosize enables them to higher exposure and higher availability when given orally. Gout is an inflammatory disease caused by deposition of monosodium urate (MSU) crystal deposition into the joints. The objective of this study was to evaluate the effects of copper oxide nanoparticles on hyperuricemia and gouty arthritis in mice. In this research, synthesized copper oxide nanoparticles of size ranging from 30 to 50 nm were administered orally to mice having gouty arthritis and hyperuricemia. Various biochemical markers were conducted to determine the effects of copper oxide nanoparticles. It was observed that the mice treated with CuO NPs at various concentrations showed a significant (0.001) decrease in the serum uric acid levels in comparison with the negative control. Furthermore, creatinine levels were also normal in comparison with the control mice. Measurement of synovial joints also revealed that mice administered with CuO NPs had reduced inflammation of synovial joints in comparison with the negative control. From this research, it was concluded that copper oxide nanoparticles have potential in the treatment of hyperuricemia and gouty arthritis by decreasing serum uric acid and inflammation in synovial joints.
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Affiliation(s)
- Mubin Mustafa Kiyani
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied Sciences, International Islamic University Islamabad, P.O. Box: 1243, Islamabad, Pakistan.
- Riphah College of Rehabilitation Sciences, Riphah International University, Islamabad, Pakistan.
| | - Hamza Rehman
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied Sciences, International Islamic University Islamabad, P.O. Box: 1243, Islamabad, Pakistan
| | - Mir Arif Hussain
- Riphah College of Rehabilitation Sciences, Riphah International University, Islamabad, Pakistan
| | - Saira Jahan
- Riphah College of Rehabilitation Sciences, Riphah International University, Islamabad, Pakistan
| | - Muhammad Afzal
- Faculty of Basic medical Sciences, Department of Biochemistry, Riphah International University, Islamabad, Pakistan
| | - Irum Nawaz
- Riphah College of Rehabilitation Sciences, Riphah International University, Islamabad, Pakistan
| | - Tariq Mahmood
- Department of Nanoscience and Technology, National Center for Physics, Islamabad, Pakistan
| | - Syed Ali Imran Bokhari
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied Sciences, International Islamic University Islamabad, P.O. Box: 1243, Islamabad, Pakistan
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Kiyani MM, Butt MA, Rehman H, Ali H, Hussain SA, Obaid S, Arif Hussain M, Mahmood T, Bokhari SAI. Antioxidant and anti-gout effects of orally administered zinc oxide nanoparticles in gouty mice. J Trace Elem Med Biol 2019; 56:169-177. [PMID: 31479800 DOI: 10.1016/j.jtemb.2019.08.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/16/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Zinc is an essential trace element which is involved in controlling oxidative stress, growth and immune system by regulating inflammatory cytokines. Gouty arthritis is the inflammation of joints and tissues caused by the accumulation of monosodium urate crystals. METHOD AND OBJECTIVE This study involved the oral administration of zinc oxide nanoparticles at a various concentration (5 ppm, 10 ppm, and 20 ppm) and study their antioxidant and anti-gout effects on Balb/C mice. Various parameters such as ROS, superoxide, peroxide, catalase, TBARS, RFTs, LFTs, lipid profile and blood count were studied. RESULTS ZnO nanoparticles at the concentrations of 10 and 20 ppm were significant (P < 0.001) in reducing serum uric acid concentration thus treating gouty arthritis. Reactive oxygen species and thiobarbituric acid reactive substances were significantly increased in comparison to zinc oxide nanoparticles treated groups. Furthermore, blood count and LFTs also showed the effectiveness of zinc oxide in the reduction of hyperuricemia. Histopathological analysis showed no apparent changes in liver, kidney and muscles tissues. CONCLUSION Zinc oxide nanoparticles can be effective in reducing oxidative stress and the treatment of gouty arthritis.
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Affiliation(s)
- Mubin Mustafa Kiyani
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied sciences, International Islamic university Islamabad, Pakistan; Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Maisra Azhar Butt
- Department of animal sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Hamza Rehman
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied sciences, International Islamic university Islamabad, Pakistan.
| | - Hussain Ali
- Veterinary Farms Management, National Institute of Health, Islamabad, Pakistan
| | - Syed Ali Hussain
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Sumaiyah Obaid
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Mir Arif Hussain
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Tariq Mahmood
- Department of Nanoscience and Technology, National Center for Physics, Islamabad, Pakistan
| | - Syed Ali Imran Bokhari
- Department of Bioinformatics and Biotechnology, Faculty of Basic and Applied sciences, International Islamic university Islamabad, Pakistan
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Kaur P, Purewal SS, Sandhu KS, Kaur M. DNA damage protection: an excellent application of bioactive compounds. BIORESOUR BIOPROCESS 2019. [DOI: 10.1186/s40643-019-0237-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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DNA-binding, enzyme inhibition, and photochemical properties of chalcone-containing metallophthalocyanine compounds. Bioorg Chem 2018; 81:71-78. [DOI: 10.1016/j.bioorg.2018.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 01/11/2023]
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Ko YL, Morihara D, Shibata K, Yamauchi R, Fukuda H, Kunimoto H, Takata K, Tanaka T, Inomata S, Yokoyama K, Takeyama Y, Shakado S, Sakisaka S. Factors Attenuating Zinc Deficiency Improvement in Direct-Acting Antiviral Agent-Treated Chronic Hepatitis C Virus Infection. Nutrients 2018; 10:E1620. [PMID: 30400133 PMCID: PMC6266757 DOI: 10.3390/nu10111620] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/20/2018] [Accepted: 10/24/2018] [Indexed: 12/17/2022] Open
Abstract
Zinc deficiency is frequently observed in chronic liver diseases. However, no studies have focused on the zinc status in chronic hepatitis C (HCV)-infected patients receiving direct-acting antiviral agents (DAAs). In this retrospective study, we assessed the serum zinc status in DAA-treated HCV patients with sustained virologic response for over two years (Zn-2y). Ninety-five patients were enrolled, whose baseline characteristics and blood parameters at DAA therapy initiation were collected. Baseline Zn < 65 µg/dL (odds ratio (OR) = 10.56, p < 0.001) and baseline uric acid (UA) > 5.5 mg/dL (OR = 9.99, p = 0.001) were independent risk factors for Zn-2y deficiency. A decision-tree algorithm classified low-baseline Zn and high-baseline UA as the first two variables, suggesting that baseline hypozincemia and hyperuricemia are prognosticators for long-term zinc deficiency. Baseline Zn was negatively correlated with the Fibrosis-4 (FIB-4) index, while baseline UA was significantly higher in habitual alcohol drinkers. In conclusion, serum zinc levels should be closely monitored, considering that zinc status improvement is related to liver fibrosis regression. Hyperuricemia indicates risks of developing metabolic disorders and subsequent zinc deficiency, for which an adjustment of personal lifestyle or dietary habits should be recommended clinically.
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Affiliation(s)
- Yi-Ling Ko
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Daisuke Morihara
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Kumiko Shibata
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Ryo Yamauchi
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Hiromi Fukuda
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Hideo Kunimoto
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Kazuhide Takata
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Takashi Tanaka
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Shinjiro Inomata
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Keiji Yokoyama
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Yasuaki Takeyama
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Satoshi Shakado
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Shotaro Sakisaka
- Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
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