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Wang JC, Tsai SH, Chien WC, Chung CH, Lin SJ, Chen YT, Huang PH. Association between gout and abdominal aortic aneurysm. J Cardiol 2023; 82:274-278. [PMID: 37149284 DOI: 10.1016/j.jjcc.2023.04.022] [Citation(s) in RCA: 1] [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: 01/16/2023] [Revised: 03/15/2023] [Accepted: 04/28/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Previous studies have shown an association between hyperuricemia and microvascular diseases, but the association between uric acid and abdominal aortic aneurysm (AAA) remains unclear. The aim of this study was to determine the relationship between gout and AAA. METHODS A population-based cohort study was conducted to validate the association between gout and AAA formation. The outcome in this study was the cumulative incidence of AAA in patients with or without gout during the 14-year follow-up period. RESULTS Our analysis included 121,236 patients with gout and 121,236 propensity score-matched controls from the National Health Insurance Research Database in Taiwan. Compared to the controls, patients who had gout exhibited a significantly increased incidence of AAA development [adjusted hazard ratio (HR) = 2.465, p < 0.001]. We also found that patients who were treated with anti-gout medications had a significantly lower risk of being diagnosed with an AAA than patients who were not treated with anti-gout medications (adjusted HR = 0.489, p < 0.001). CONCLUSIONS We have provided clinical evidence that gout is associated with the development of AAA.
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Affiliation(s)
- Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Shing-Jong Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Yung-Tai Chen
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsun Huang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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2
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Abstract
The medical disorders of alcoholism rank among the leading public health problems worldwide and the need for predictive and prognostic risk markers for assessing alcohol use disorders (AUD) has been widely acknowledged. Early-phase detection of problem drinking and associated tissue toxicity are important prerequisites for timely initiations of appropriate treatments and improving patient's committing to the objective of reducing drinking. Recent advances in clinical chemistry have provided novel approaches for a specific detection of heavy drinking through assays of unique ethanol metabolites, phosphatidylethanol (PEth) or ethyl glucuronide (EtG). Carbohydrate-deficient transferrin (CDT) measurements can be used to indicate severe alcohol problems. Hazardous drinking frequently manifests as heavy episodic drinking or in combinations with other unfavorable lifestyle factors, such as smoking, physical inactivity, poor diet or adiposity, which aggravate the metabolic consequences of alcohol intake in a supra-additive manner. Such interactions are also reflected in multiple disease outcomes and distinct abnormalities in biomarkers of liver function, inflammation and oxidative stress. Use of predictive biomarkers either alone or as part of specifically designed biological algorithms helps to predict both hepatic and extrahepatic morbidity in individuals with such risk factors. Novel approaches for assessing progression of fibrosis, a major determinant of prognosis in AUD, have also been made available. Predictive algorithms based on the combined use of biomarkers and clinical observations may prove to have a major impact on clinical decisions to detect AUD in early pre-symptomatic stages, stratify patients according to their substantially different disease risks and predict individual responses to treatment.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland.
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3
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Wang JC, Tsai SH, Tsai HY, Lin SJ, Huang PH. Hyperuricemia exacerbates abdominal aortic aneurysm formation through the URAT1/ERK/MMP-9 signaling pathway. BMC Cardiovasc Disord 2023; 23:55. [PMID: 36710339 PMCID: PMC9885634 DOI: 10.1186/s12872-022-03012-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/14/2022] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Previous studies have revealed associations between hyperuricemia and microvascular diseases, but the association between hyperuricemia and abdominal aortic aneurysm (AAA) remains unclear. The aim of this study was to elucidate the pathogenesis and prove the relationship between AAA and hyperuricemia. METHODS A retrospective study was performed to validate the growth rates of AAA in humans with different serum uric acid levels. A murine model of angiotensin II-induced AAA was used to assess the effects of hyperuricemia on AAA growth in vivo, and human aortic smooth muscle cells (HASMCs) were used to study the pathways involved in these effects in vitro. RESULTS We analyzed data from 107 AAA patients and found that patients with serum uric acid levels above 9 mg/dl had higher AAA growth rates than patients with serum uric acid levels between 4 and 7.9 mg/dl. In vivo, induction of hyperuricemia increased the incidence of AAA formation and the abdominal aortic diameter in mice. The hyperuricemic mice exhibited higher levels of urate transporter 1 (URAT1) expression, phospho-extracellular signal-regulated kinase (p-ERK)1/2 expression, reactive oxygen species (ROS) levels and matrix metalloproteinase (MMP)-9 expression in the abdominal aorta than the control mice. Soluble uric acid increased the expression of URAT1, p-ERK1/2, and MMP-9 and the levels of ROS in HASMCs in vitro. CONCLUSIONS We have provided human evidence that hyperuricemia exacerbates AAA formation. In addition, our murine experimental evidence suggests that hyperuricemia exacerbates AAA formation and reveals that the URAT1/ERK1/2/ROS/MMP-9 pathway is among the pathways activated by uric acid in HASMCs.
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Affiliation(s)
- Jen-Chun Wang
- grid.260565.20000 0004 0634 0356Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu Dist., Taipei City, 114 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang-Ming University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan
| | - Shih-Hung Tsai
- grid.260565.20000 0004 0634 0356Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu Dist., Taipei City, 114 Taiwan
| | - Hsiao-Ya Tsai
- grid.260565.20000 0004 0634 0356Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu Dist., Taipei City, 114 Taiwan
| | - Shing-Jong Lin
- grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang-Ming University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.278247.c0000 0004 0604 5314Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road., Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang-Ming University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.278247.c0000 0004 0604 5314Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road., Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Kurra V, Eräranta A, Paavonen T, Honkanen T, Myllymäki J, Riutta A, Tikkanen I, Lakkisto P, Mustonen J, Pörsti I. Moderate hyperuricaemia ameliorated kidney damage in a low-renin model of experimental renal insufficiency. Basic Clin Pharmacol Toxicol 2023; 132:21-32. [PMID: 36220802 PMCID: PMC10091954 DOI: 10.1111/bcpt.13806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/06/2022] [Accepted: 10/06/2022] [Indexed: 01/06/2023]
Abstract
Uric acid has promoted renal fibrosis and inflammation in experimental studies, but some studies have shown nephroprotective effects due to alleviated oxidative stress. We studied the influence of experimental hyperuricaemia in surgically 5/6 nephrectomized rats. Three weeks after subtotal nephrectomy or sham operation, the rats were allocated to control diet or 2.0% oxonic acid (uricase inhibitor) diet for 9 weeks. Then blood, urine and tissue samples were taken, and renal morphology and oxidative stress were examined. Inflammation and fibrosis were evaluated using immunohistochemistry and real-time PCR (RT-PCR). Remnant kidney rats ingesting normal or oxonic acid diet presented with ~60% reduction of creatinine clearance and suppressed plasma renin activity. Oxonic acid diet increased plasma uric acid levels by >80 μmol/L. In remnant kidney rats, moderate hyperuricaemia decreased glomerulosclerosis, tubulointerstitial damage and kidney mast cell count, without influencing the fibrosis marker collagen I messenger RNA (mRNA) content. In both sham-operated and 5/6 nephrectomized rats, the mast cell product 11-epi-prostaglandin-F2α excretion to the urine and kidney tissue cyclooxygenase-2 (COX-2) levels were decreased. To conclude, hyperuricaemic remnant kidney rats displayed improved kidney morphology and reduced markers of oxidative stress and inflammation. Thus, moderately elevated plasma uric acid had beneficial effects on the kidney in this low-renin model of experimental renal insufficiency.
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Affiliation(s)
- Venla Kurra
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Arttu Eräranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Timo Paavonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Teemu Honkanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juhani Myllymäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Asko Riutta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ilkka Tikkanen
- Minerva Institute for Medical Research, Biomedicum Helsinki 2U, Helsinki, Finland.,Abdominal Center, Nephrology, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Lakkisto
- Minerva Institute for Medical Research, Biomedicum Helsinki 2U, Helsinki, Finland.,Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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5
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Wu H, Wang Y, Ren Z, Li Y, Huang J, Lin Z, Zhang B. Overnutrition-induced gout: An immune response to NLRP3 inflammasome dysregulation by XOD activity increased in quail. Front Immunol 2022; 13:1074867. [PMID: 36569836 PMCID: PMC9771704 DOI: 10.3389/fimmu.2022.1074867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background Gout is a progressive metabolic disease closely related to hyperuricemia and urate deposition, with an increasing prevalence and incidence across the globe. Recent studies have shown that the pathological process of gout includes two stages: asymptomatic hyperuricemia and MSU crystal deposition. However, the immune response during the development of hyperuricemia to gouty arthritis is not fully elucidated. Methods Thus, an overnutrition-induced whole-course gout model was established to clarify the immune response and pathological changes in the development from hyperuricemia to gouty arthritis. The quails without urate oxidase were used as experimental animals. And we confirmed that uric acid metabolic targets were changed when quails were in the asymptomatic hyperuricemia stage. Results When the quail showed gout symptoms, the NLRP3 inflammasome was activated, and the expressions of IL-1β, TNF-α, IL-6, IL-8, and IL-18 were significantly increased. The relationship between the uric acid metabolism target and the NLRP3 inflammasome may be the critical immune response between hyperuricemia and gouty arthritis. Our data showed that, in the process of gout disease, the expression of xanthine oxidase (XOD) has been increasing, which increases the level of uric acid, disrupts the balance of oxidative stress, generates a large amount of ROS, activates the NLRP3 inflammasome, and release IL-1β. Treatment with the XOD inhibitor can reduce uric acid, restore the body's degree of peroxidative damage and antioxidant capacity, and inhibit NLRP3 inflammasome and IL-1β. In vitro, we extracted and identified primary fibroblast-like synoviocytes (FLS) from quail for the first time. Stimulating FLS with uric acid also caused ROS release and NLRP3 inflammasome activation. However, treatment with an XOD inhibitor prevented all these responses in FLS. Conclusion Our results indicate that the immune response between the uric acid metabolism target XOD and NLRP3 inflammasomes plays a crucial role in developing hyperuricemia to gouty arthritis, and inhibition of both XOD and NLRP3 inflammasomes may be an effective treatment for avoiding the development of asymptomatic hyperuricemia to MSU crystal deposition. Meanwhile, this study also provides an advantageous animal model for pathological mechanisms and research and development drugs for gout.
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Affiliation(s)
- Hao Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Wang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhixin Ren
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Yaolei Li
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Jingjian Huang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhijian Lin
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bing Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Bing Zhang,
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6
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Xie Q, Cai X, Dong X, Wang Y, Sun M, Tai L, Xu Y. Effects of epigallocatechin-3-gallate combined with ascorbic acid and glycerol on the stability and uric acid-lowering activity of epigallocatechin-3-gallate. PHARMACEUTICAL BIOLOGY 2021; 59:157-166. [PMID: 33556300 PMCID: PMC8871600 DOI: 10.1080/13880209.2021.1878235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 01/05/2021] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
CONTEXT Epigallocatechin-3-gallate (EGCG) is unstable and easily oxidized, which limits its applications. Ascorbic acid (Vc) is a natural antioxidant. OBJECTIVE The effects of EGCG combined with Vc and glycerol on stability and uric acid-lowering activity of EGCG were examined. MATERIALS AND METHODS EGCG (aqueous solution), EGCG + Vc (aqueous solution), EGCG (glycerol solution) and EGCG + Vc (glycerol solution) were prepared and incubated under different conditions in vitro. The recovery rate of EGCG was calculated by HPLC. Kunming mice were randomly divided into normal control group, model group, allopurinol (5 mg/kg), EGCG (10 mg/kg), EGCG + Vc (both 10 mg/kg), EGCG (10 mg/kg) + glycerol (60%), and EGCG (10 mg/kg) + Vc (10 mg/kg) + glycerol (60%) (n = 6). Allopurinol was injected intraperitoneally to mice, others were administered intragastrically to (2 cases) mice. All mice were continuously administrated for 7 days, once a day. RESULTS EGCG recovery rates of EGCG group and EGCG + Vc + glycerol group respectively reached to 32.34 ± 1.86% and 98.90 ± 0.64% when they were incubated for 4 h at 80 °C. EGCG recovery rates reached to 91.82 ± 5.13% (incubated for 6 h at pH 8) and 88.85 ± 2.63% (incubated for 4 h in simulated intestinal fluid) when EGCG incubated with Vc and glycerol. Compared with the model group, UA values of EGCG + Vc + glycerol group reduced by 43.49% while EGCG group reduced by 25.63%. The activities of xanthine oxidase (XOD, 31.41 U/gprot) and adenosine deaminase (ADA, 10.05 U/mgprot), and the mRNA expression levels of glucose transporter 9 (GLUT9, 1.03) and urate transporter 1 (URAT1, 0.44) in EGCG + Vc + glycerol group were notably lower than those of EGCG group (38.12 U/gprot, 13.16 U/mgprot, 1.54, and 0.55). The mRNA expression levels of ATP-binding cassette superfamily G member 2 (ABCG2, 1.39) and organic anion transport 1/2 (OAT1/2, 2.34, 2.53) in EGCG + Vc + glycerol group were notably higher than those of EGCG group (0.57, 1.13, and 1.16). DISCUSSION AND CONCLUSIONS Our findings suggest that when EGCG used in combination with Vc and glycerol could effectively increase its biology activities and can be generalized to the broader pharmacological studies. This sheds light on the development and application of EGCG in the fields of food and medicine.
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Affiliation(s)
- Qianjin Xie
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Xiaqiang Cai
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Xu Dong
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Ying Wang
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Minghui Sun
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Lingling Tai
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
| | - Yan Xu
- State Key Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China
- International Joint Laboratory on Tea Chemistry and Health Effects of Ministry of Education, Hefei, China
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7
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Hamid H, Kurra V, Choudhary MK, Bouquin H, Niemelä O, Kähönen MAP, Mustonen JT, Pörsti IH, Koskela JK. Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects. BMC Cardiovasc Disord 2021; 21:257. [PMID: 34039285 PMCID: PMC8152327 DOI: 10.1186/s12872-021-02072-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background Elevated level of plasma uric acid (PUA) has been associated with cardiovascular disease, but whether uric acid is an independent risk factor or merely a marker remains controversial. Methods We investigated in a cross-sectional setting the association of PUA with hemodynamics in 606 normotensive and never-medicated hypertensive subjects (295 men, 311 women, age range 19–73 years) without cardiovascular disease or gout. In all except 15 individuals, PUA was within the normal range. Supine hemodynamics were recorded using whole-body impedance cardiography and radial tonometric pulse wave analysis. Results The mean concentrations of PUA in age, sex and body mass index adjusted quartiles were 234, 278, 314, and 373 µmol/l, respectively. The highest PUA quartile presented with higher aortic to popliteal pulse wave velocity (PWV) than the lowest quartile (8.7 vs. 8.2 m/s, p = 0.026) in analyses additionally adjusted for plasma concentrations of C-reactive protein, low density lipoprotein cholesterol, triglycerides, and mean aortic blood pressure. No differences in radial and aortic blood pressure, wave reflections, heart rate, cardiac output, and systemic vascular resistance were observed between the quartiles. In linear regression analysis, PUA was an independent explanatory factor for PWV (β = 0.168, p < 0.001, R2 of the model 0.591), but not for systolic or diastolic blood pressure. When the regression analysis was performed separately for men and women, PUA was an independent predictor of PWV in both sexes. Conclusions PUA concentration was independently and directly associated with large arterial stiffness in individuals without cardiovascular disease and PUA levels predominantly within the normal range. Trial registration ClinicalTrials.gov NCT01742702.
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Affiliation(s)
- Humam Hamid
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland
| | - Venla Kurra
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland
| | - Manoj Kumar Choudhary
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland
| | - Heidi Bouquin
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland
| | - Onni Niemelä
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland.,Laboratory and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Mika A P Kähönen
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland.,Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Jukka T Mustonen
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka H Pörsti
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland. .,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | - Jenni K Koskela
- Faculty of Medicine and Health Technology, Tampere University, FI-33014, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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8
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Törmänen S, Lakkisto P, Eräranta A, Kööbi P, Tikkanen I, Niemelä O, Mustonen J, Pörsti I. Unfavorable Reduction in the Ratio of Endothelin B to A Receptors in Experimental 5/6 Nephrectomy and Adenine Models of Chronic Renal Insufficiency. Int J Mol Sci 2020; 21:ijms21030936. [PMID: 32023824 PMCID: PMC7037353 DOI: 10.3390/ijms21030936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/27/2020] [Accepted: 01/29/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic renal insufficiency (CRI) is characterized by increased endothelin 1 (ET-1) synthesis. We studied rat kidney endothelin receptor A (ETA) and receptor B (ETB) expressions after 12 and 27 weeks of 5/6 nephrectomy, and after 12 weeks of 0.3% adenine diet, representing proteinuric and interstitial inflammation models of CRI, respectively. Uric acid and calcium-phosphate metabolism were modulated after 5/6 nephrectomy, while ETA blocker and calcimimetic were given with adenine. Endothelin receptor mRNA levels were measured using RT-qPCR and protein levels using autoradiography (5/6 nephrectomy) or ELISA (adenine model). Both 12 and 27 weeks after 5/6 nephrectomy, kidney cortex ETA protein was increased by ~60% without changes in ETB protein, and the ETB:ETA ratio was reduced. However, the ETB:ETA mRNA ratio did not change. In the adenine model, kidney ETA protein was reduced by ~70%, while ETB protein was suppressed by ~95%, and the ETB:ETA ratio was reduced by ~85%, both at the protein and mRNA levels. The additional interventions did not influence the observed reductions in the ETB:ETA ratio. To conclude, unfavorable reduction in the ETB:ETA protein ratio was observed in two different models of CRI. Therefore, ETA blockade may be beneficial in a range of diseases that cause impaired kidney function.
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Affiliation(s)
- Suvi Törmänen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Päivi Lakkisto
- Minerva Institute for Medical Research, 00290 Helsinki, Finland
- Clinical Chemistry and Hematology, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Arttu Eräranta
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Peeter Kööbi
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Eye Centre, Tampere University Hospital, 33520 Tampere, Finland
| | - Ilkka Tikkanen
- Minerva Institute for Medical Research, 00290 Helsinki, Finland
- Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Onni Niemelä
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Department of Clinical Chemistry and Medical Research Unit, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
- Correspondence: ; Tel.: +358-331-166-010
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9
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Albu A, Para I, Porojan M. Uric Acid and Arterial Stiffness. Ther Clin Risk Manag 2020; 16:39-54. [PMID: 32095074 PMCID: PMC6995306 DOI: 10.2147/tcrm.s232033] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/01/2019] [Indexed: 12/21/2022] Open
Abstract
Hyperuricemia is usually associated with hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease. Accumulating data from epidemiological studies indicate an association of increased uric acid (UA) with cardiovascular diseases. Possible pathogenic mechanisms include enhancement of oxidative stress and systemic inflammation caused by hyperuricemia. Arterial stiffness may be one of the possible pathways between hyperuricemia and cardiovascular disease, but a clear relationship between increased UA and vascular alterations has not been confirmed. The review summarizes the epidemiological studies investigating the relationship between UA and arterial stiffness and highlights the results of interventional studies evaluating arterial stiffness parameters in patients treated with UA-lowering drugs.
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Affiliation(s)
| | - Ioana Para
- 4th Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Li Y, Liu M, Zhang X, Lu Y, Meng J. Switching from allopurinol to febuxostat: efficacy and safety in the treatment of hyperuricemia in renal transplant recipients. Ren Fail 2019; 41:595-599. [PMID: 31267805 PMCID: PMC6610515 DOI: 10.1080/0886022x.2019.1632717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to evaluate the efficacy and tolerability of febuxostat in renal transplant recipients who were previously treated with allopurinol (the daily oral dose is 100 mg). A 6-month cohort study was conducted with 46 renal transplant recipients who had hyperuricemia. In 22 patients, treatment was changed from allopurinol to febuxostat (febuxostat was given at an oral dose of 20 mg once a day), and the other 24 patients continued the allopurinol treatment (the daily oral dose is 100 mg). The serum levels of uric acid (UA), creatinine, other biochemical parameters, estimated glomerular filtration rate (eGFR), and adverse events were measured at baseline as well as at 1, 3, and 6 months after the switch to febuxostat. Serum UA levels significantly decreased from 470.82 ± 34.37 to 378.77 ± 51.97 μmol/L in the febuxostat group, and decreased from 469.46 ± 33.47 to 428.21 ± 23.37 μmol/L in the allopurinol group. The eGFR increased from 75.55 to 85.23 mL/min in the febuxostat group, and decreased from 78.79 to 70.31 mL/min in the allopurinol group. In renal transplant recipients, febuxostat reduced the serum UA levels resulting in minor short-term improvement of renal function with no changes in the other biochemical parameters.
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Affiliation(s)
- Yanchun Li
- a Department of Nephrology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , PR China
| | - Min Liu
- b Department of Rheumatology and Immunology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , PR China
| | - Xuelei Zhang
- b Department of Rheumatology and Immunology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , PR China
| | - Yuewu Lu
- b Department of Rheumatology and Immunology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , PR China
| | - Juan Meng
- b Department of Rheumatology and Immunology , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , PR China
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11
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Niemelä M, Kangastupa P, Niemelä O, Bloigu R, Juvonen T. Individual responses in biomarkers of health after marathon and half-marathon running: is age a factor in troponin changes? Scandinavian Journal of Clinical and Laboratory Investigation 2016; 76:575-580. [DOI: 10.1080/00365513.2016.1225122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Markus Niemelä
- Department of Cardiac Surgery, Oulu University Hospital, Oulu, Finland
| | - Päivikki Kangastupa
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, and University of Tampere, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, and University of Tampere, Finland
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Finland
| | - Tatu Juvonen
- Department of Cardiac Surgery, Oulu University Hospital, Oulu, Finland
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Niemelä M, Kangastupa P, Niemelä O, Bloigu R, Juvonen T. Acute Changes in Inflammatory Biomarker Levels in Recreational Runners Participating in a Marathon or Half-Marathon. SPORTS MEDICINE-OPEN 2016; 2:21. [PMID: 27747777 PMCID: PMC5005625 DOI: 10.1186/s40798-016-0045-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/22/2016] [Indexed: 12/30/2022]
Abstract
Background Strenuous physical activity activates the participant’s immune responses; however, few studies exist, observing exercise-induced simultaneous changes in mediators of inflammation. Methods We examined individual responses in soluble urokinase-type plasminogen activator receptor (suPAR), a marker of immune activation, soluble endocytic receptor for haptoglobin-hemoglobin complexes (CD163), a marker of monocyte-macrophage activation, C-reactive protein (CRP), and pro- and anti-inflammatory cytokines from blood samples drawn at baseline, at 3- and 48-h post-races from recreational runners who successfully completed the marathon (199 ± 8 min, n = 4) or half-marathon (132 ± 4 min, n = 4) run. For comparisons, biomarkers reflecting muscle, heart, kidney, and liver functions were measured. Results Significant 3-h post-race increases occurred in levels of suPAR (p < 0.01), CD163 (p < 0.05), white blood cells (p < 0.001), pro-inflammatory cytokines, interleukin-6 (IL-6) (p < 0.001), IL-8 (p < 0.05), and anti-inflammatory cytokine IL-10 (p < 0.05), whereas tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) remained relatively stable. Full-marathon running lead to more pronounced increases in suPAR, CD163, IL-8, and IL-10 than half-marathon running. In addition, 3-h post-race increases of all these parameters correlated significantly with changes in serum TNF-α and cortisol. The 48-h levels of serum suPAR and both pro- and anti-inflammatory cytokines had decreased to baseline levels, whereas CRP, a marker of acute phase response, increased in those with the most prominent IL-6 and IL-10 elevations in their preceding samples. The highest suPAR, CRP, IL-6, TNF-α, IL-10, and cortisol levels were noted in the individual with the most severe post-race fatigue. Conclusions Prolonged running increases mediators of inflammation in an exercise-dose-dependent manner which should be considered in the assessment of health status of physically active individuals after recent acute bouts of strenuous exercise.
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Affiliation(s)
- Markus Niemelä
- Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029 OYS, Oulu, Finland
| | - Päivikki Kangastupa
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Hanneksenrinne 7, 60220, Seinäjoki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Hanneksenrinne 7, 60220, Seinäjoki, Finland.
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Tatu Juvonen
- Department of Surgery, Oulu University Hospital, P.O. Box 21, 90029 OYS, Oulu, Finland
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Giallauria F, Predotti P, Casciello A, Grieco A, Russo A, Viggiano A, Citro R, Ravera A, Ciardo M, Guglielmi M, Maggio M, Vigorito C. Serum uric acid is associated with non-dipping circadian pattern in young patients (30-40 years old) with newly diagnosed essential hypertension. Clin Exp Hypertens 2016; 38:233-7. [PMID: 26817828 DOI: 10.3109/10641963.2015.1081230] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aimed at evaluating the relationship between the circadian blood pressure rhythm and UA level in young patients (30-40 years old) with newly diagnosed essential hypertension. METHODS The study included 62 essential hypertensive patients and 29 healthy controls (20 men, 35 ± 3 years) divided into two groups according to 24-hour ABPM results: 30 dippers and 32 nondippers. RESULTS Nondippers showed significantly higher both serum UA levels compared to dippers and controls (6.1 ± 0.7, 5.2 ± 0.9 and 4.1 ± 0.9 mg/dL, p < 0.001, respectively); and high sensitivity C-reactive protein (hsCRP) (4.1 ± 2.2 mg/L, 3.3 ± 1.9 mg/L, and 1.4 ± 0.9 mg/L, p < 0.001, respectively). After adjusting for age, sex, body mass index, smoking, creatinine levels, hsCRP and comorbidity, multivariate logistic regression analysis revealed an independent association between serum UA levels and nondipper pattern (OR 2.44, 95%CIs 1.4-4.1, p = 0.002). CONCLUSION Serum UA is independently associated with nondipper circadian pattern in young patients with newly diagnosed essential hypertension.
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Affiliation(s)
- Francesco Giallauria
- a Department of Translational Medical Sciences. Division of Internal Medicine and Cardiac Rehabilitation , "Federico II" University , Naples , Italy
| | - Pasquale Predotti
- b Hypertenion Care Unit; "S. Giovanni di Dio e Ruggi d'Aragona" Hospital , Salerno , Italy
| | - Antonio Casciello
- c Division of Cardiology; "Casa di Cura Tortorella" , Salerno , Italy
| | - Alessandra Grieco
- a Department of Translational Medical Sciences. Division of Internal Medicine and Cardiac Rehabilitation , "Federico II" University , Naples , Italy
| | - Angelo Russo
- a Department of Translational Medical Sciences. Division of Internal Medicine and Cardiac Rehabilitation , "Federico II" University , Naples , Italy
| | - Anna Viggiano
- b Hypertenion Care Unit; "S. Giovanni di Dio e Ruggi d'Aragona" Hospital , Salerno , Italy
| | - Rodolfo Citro
- b Hypertenion Care Unit; "S. Giovanni di Dio e Ruggi d'Aragona" Hospital , Salerno , Italy
| | - Amelia Ravera
- b Hypertenion Care Unit; "S. Giovanni di Dio e Ruggi d'Aragona" Hospital , Salerno , Italy
| | - Maurizio Ciardo
- d Critical Care Unit; "Ignazio Veris Delli Ponti" Hospital , Scorrano , Italy , and
| | - Michele Guglielmi
- c Division of Cardiology; "Casa di Cura Tortorella" , Salerno , Italy
| | - Marcello Maggio
- e Department of Clinical and Experimental Medicine , Section of Geriatrics, University of Parma , Italy
| | - Carlo Vigorito
- a Department of Translational Medical Sciences. Division of Internal Medicine and Cardiac Rehabilitation , "Federico II" University , Naples , Italy
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Niemelä O. Biomarker-Based Approaches for Assessing Alcohol Use Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:166. [PMID: 26828506 PMCID: PMC4772186 DOI: 10.3390/ijerph13020166] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 12/11/2022]
Abstract
Although alcohol use disorders rank among the leading public health problems worldwide, hazardous drinking practices and associated morbidity continue to remain underdiagnosed. It is postulated here that a more systematic use of biomarkers improves the detection of the specific role of alcohol abuse behind poor health. Interventions should be initiated by obtaining information on the actual amounts of recent alcohol consumption through questionnaires and measurements of ethanol and its specific metabolites, such as ethyl glucuronide. Carbohydrate-deficient transferrin is a valuable tool for assessing chronic heavy drinking. Activities of common liver enzymes can be used for screening ethanol-induced liver dysfunction and to provide information on the risk of co-morbidities including insulin resistance, metabolic syndrome and vascular diseases. Conventional biomarkers supplemented with indices of immune activation and fibrogenesis can help to assess the severity and prognosis of ethanol-induced tissue damage. Many ethanol-sensitive biomarkers respond to the status of oxidative stress, and their levels are modulated by factors of life style, including weight gain, physical exercise or coffee consumption in an age- and gender-dependent manner. Therefore, further attention should be paid to defining safe limits of ethanol intake in various demographic categories and establishing common reference intervals for biomarkers of alcohol use disorders.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki 60220, Finland.
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15
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Biscaglia S, Ceconi C, Malagù M, Pavasini R, Ferrari R. Uric acid and coronary artery disease: An elusive link deserving further attention. Int J Cardiol 2015; 213:28-32. [PMID: 26318389 DOI: 10.1016/j.ijcard.2015.08.086] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/07/2015] [Indexed: 12/11/2022]
Abstract
Uric acid is the final product of purine metabolism. Classically it is recognized as the cause of gouty arthritis and kidney stones. Western civilization has increased serum levels of uric acid which is no longer considered a benign plasma solute. It has been postulated and recently demonstrated that it can penetrate cell membrane and exerts damaging intracellular actions such as oxidation and inflammation. These observations have stimulated several epidemiological researches suggesting that hyperuricemia is linked or even provokes hypertension and coronary artery disease. In this review we summarize the current evidences regarding uric acid which contribute in the pathophysiology of coronary artery disease.
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Affiliation(s)
| | - Claudio Ceconi
- Department of Cardiology, University Hospital of Ferrara, Italy; LTTA Centre, University Hospital of Ferrara, Italy
| | - Michele Malagù
- Department of Cardiology, University Hospital of Ferrara, Italy
| | - Rita Pavasini
- Department of Cardiology, University Hospital of Ferrara, Italy
| | - Roberto Ferrari
- Department of Cardiology, University Hospital of Ferrara, Italy; LTTA Centre, University Hospital of Ferrara, Italy; Maria Cecilia Hospital, GVM Care & Research, E.S.: Health Science Foundation, Cotignola, Italy.
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Mehta T, Nuccio E, McFann K, Madero M, Sarnak MJ, Jalal D. Association of Uric Acid With Vascular Stiffness in the Framingham Heart Study. Am J Hypertens 2015; 28:877-83. [PMID: 25552515 DOI: 10.1093/ajh/hpu253] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/21/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Uric acid is associated with increased risk of cardiovascular disease and arterial stiffness in patients with hypertension or stroke. It remains unknown if uric acid is associated with arterial stiffness in the general population. METHODS We analyzed the association between serum uric acid levels and measures of arterial stiffness such as carotid-femoral pulse wave velocity (CF PWV), carotid-radial pulse wave velocity (CR PWV) and augmentation index (AI) in 4,140 participants from the Generation 3 Framingham cohort using linear regression. RESULTS Mean (SD) age was 40.0 (8.8) years and mean (SD) serum uric acid levels were 5.3 (1.5) mg/dl. Mean (SD) CF PWV was 7.0 (1.4) m/s. Individuals in the highest quartile of uric acid were more likely to be male, have a higher prevalence of hypertension, higher BMI, fasting glucose and insulin, and lower estimated glomerular filtration rate (eGFR). Multivariate adjusted means of CF PWV were 6.90, 6.94, 7.06, and 7.15 m/s for uric acid quartile 1, 2, 3, and 4 respectively. In unadjusted analysis each 1mg/dl increase in uric acid was associated with higher CF-PWV (β = 0.27; 95% CI = 0.25, 0.29; P < 0.0001). This was attenuated but remained significant after adjusting for age, sex, smoking, hypertension, BMI, fasting glucose, insulin, animal protein intake, and eGFR (β= 0.06; 95% CI = 0.02, 0.09; P < 0.0007). There was no association between serum uric acid levels and AI upon adjustment for cardiovascular risk factors. CONCLUSIONS Serum uric acid levels are significantly associated with CF PWV and CR PWV in a younger Caucasian population.
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Affiliation(s)
- Tapan Mehta
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA;
| | - Eugene Nuccio
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Kim McFann
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Magdalena Madero
- Department of Medicine, Division of Nephrology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico
| | - Mark J Sarnak
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Diana Jalal
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA
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Kurra V, Vehmas T, Eräranta A, Jokihaara J, Pirttiniemi P, Ruskoaho H, Tokola H, Niemelä O, Mustonen J, Pörsti I. Effects of oxonic acid-induced hyperuricemia on mesenteric artery tone and cardiac load in experimental renal insufficiency. BMC Nephrol 2015; 16:35. [PMID: 25886588 PMCID: PMC4377065 DOI: 10.1186/s12882-015-0033-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 03/17/2015] [Indexed: 02/07/2023] Open
Abstract
Background Recent studies suggest a causal role for increased plasma uric acid in the progression of chronic renal insufficiency (CRI). However, uric acid also functions as an antioxidant with possible beneficial effects. Methods We investigated the influence of hyperuricemia on mesenteric arterial tone (main and second order branch) and morphology in experimental CRI. Forty-four Sprague–Dawley rats were 5/6 nephrectomized (NX) or Sham-operated and fed 2.0% oxonic acid or control diet for 9 weeks. Results Oxonic acid feeding elevated plasma uric acid levels 2.4 and 3.6-fold in the NX and Sham groups, respectively. Plasma creatinine and urea were elevated 2-fold and blood pressure increased by 10 mmHg in NX rats, while hyperuricemia did not significantly influence these variables. Right and left ventricular weight, and atrial and B-type natriuretic peptide mRNA content were increased in NX rats, but were not affected by hyperuricemia. In the mesenteric artery, hyperuricemia did not influence vasoconstrictor responses in vitro to norepinephrine or potassium chloride. The small arteries of NX rats featured hypertrophic remodeling independent of uric acid levels: wall to lumen ratio, wall thickness and cross-sectional area were increased without changes in lumen diameter. In the main branch, vasorelaxations to acetylcholine were impaired in NX rats, but were not affected by hyperuricemia. In contrast, relaxations to the large-conductance Ca2+-activated K+-channel (BKCa) opener NS-1619 were reduced by oxonic acid feeding, whereas responses to nitroprusside were not affected. Conclusions Experimental hyperuricemia did not influence cardiac load or vascular remodeling, but impaired BKCa -mediated vasorelaxation in experimental CRI.
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Affiliation(s)
- Venla Kurra
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland.
| | - Tuija Vehmas
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland.
| | - Arttu Eräranta
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland.
| | - Jarkko Jokihaara
- Department of Hand Surgery, Tampere University Hospital, Tampere, Finland.
| | - Päivi Pirttiniemi
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland.
| | - Heikki Ruskoaho
- Department of Pharmacology and Toxicology, Institute of Biomedicine, University of Oulu, Oulu, Finland. .,Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
| | - Heikki Tokola
- Department of Pharmacology and Toxicology, Institute of Biomedicine, University of Oulu, Oulu, Finland. .,Department of Pathology, Oulu University Hospital, Oulu, Finland.
| | - Onni Niemelä
- Department of Clinical Chemistry, Seinäjoki Central Hospital Laboratory, Seinäjoki, Finland.
| | - Jukka Mustonen
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | - Ilkka Pörsti
- Department of Internal Medicine, School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
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Hsu YJ, Chiu CC, Li YP, Huang WC, Huang YT, Huang CC, Chuang HL. Effect of Intestinal Microbiota on Exercise Performance in Mice. J Strength Cond Res 2015; 29:552-8. [DOI: 10.1519/jsc.0000000000000644] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Dousdampanis P, Trigka K, Musso CG, Fourtounas C. Hyperuricemia and chronic kidney disease: an enigma yet to be solved. Ren Fail 2014; 36:1351-9. [PMID: 25112538 DOI: 10.3109/0886022x.2014.947516] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The role of uric acid (UA) on the pathogenesis and progression of chronic kidney disease (CKD) remains controversial. Experimental and clinical studies indicate that UA is associated with several risk factors of CKD including diabetes, hypertension, oxidative stress, and inflammation and hyperuricemia could be considered as a common dominator linking CKD and cardiovascular disease. Notably, the impact of serum UA levels on the survival of CKD, dialysis patients, and renal transplant recipients is also a matter of debate, as there are conflicting results from clinical studies. At present, there is no definite data whether UA is causal, compensatory, coincidental or it is only an epiphenomenon in these patients. In this article, we attempt to review and elucidate the dark side of this old molecule in CKD and renal transplantation.
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Kanbay M, Segal M, Afsar B, Kang DH, Rodriguez-Iturbe B, Johnson RJ. The role of uric acid in the pathogenesis of human cardiovascular disease. Heart 2013; 99:759-66. [PMID: 23343689 DOI: 10.1136/heartjnl-2012-302535] [Citation(s) in RCA: 284] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Hyperuricaemia is common in subjects with cardiovascular disease, but is not commonly considered a true risk factor. Recent studies suggest that uric acid is biologically active and can stimulate oxidative stress, endothelial dysfunction, inflammation and vasoconstriction. Epidemiological studies have found that uric acid can independently predict the development of hypertension, as well as stroke and heart failure. Experimentally raising uric acid in animals increases blood pressure, and pilot studies suggest that lowering uric acid in humans can reduce blood pressure in hypertensive individuals. Uric acid may also have emerging roles in the pathogenesis of kidney disease, metabolic syndrome and diabetes. More studies need to be performed on the pathophysiology and clinical consequences of hyperuricaemia in cardiovascular disease.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Medeniyet University School of Medicine, Kadikoy, Istanbul, Turkey.
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Abstract
Background Some experimental evidence suggests that uric acid impairs endothelial function. It is controversial if high uric acid levels and impaired endothelial function are related in healthy adults. In addition, the effect of uric acid on endothelial cells (ECs) of humans is unexplored. Methods Data of 107 healthy adult volunteers were analyzed. The association between serum uric acid and endothelial-dependant dilation (EDD) and endothelial-independent dilation (EID) was evaluated by linear regression models. We also examined the relations between uric acid and systemic and cellular markers of inflammation and oxidative stress in all or subsets of participants. Results Uric acid levels and EDD were not related in unadjusted or adjusted models. There was a significant negative correlation between uric acid and EID in the pooled sample (r = −0.34, P = 0.005). This correlation remained significant after adjusting for demographics (P = 0.04) and was attenuated after adjusting for other cardiac risk factors (P = 0.12). Higher serum uric acid levels were found to correlate significantly with C-reactive protein (CRP) (r = 0.31, P = 0.002). Serum uric acid levels were not associated with brachial artery EC nuclear factor-κB (NF-κB) p65 or NADPH oxidase p47phox expression or with nitrotyrosine staining, but were inversely associated with EC manganese superoxide dismutase (MnSOD) expression (r = −0.5, P = 0.01, n = 25). Conclusion Elevated serum uric acid is not associated with endothelial dysfunction among healthy adults, but is inversely related to EID and EC MnSOD, and positively related to systemic inflammation. These findings may have implications for cardiovascular risk in healthy adults.
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Álvarez-Prats A, Hernández-Perera O, Díaz-Herrera P, Ucero ÁC, Anabitarte-Prieto A, Losada-Cabrera A, Ortiz A, Rodríguez-Pérez JC. Combination therapy with an angiotensin II receptor blocker and an HMG-CoA reductase inhibitor in experimental subtotal nephrectomy. Nephrol Dial Transplant 2012; 27:2720-33. [PMID: 22302208 DOI: 10.1093/ndt/gfr671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Angiotensin receptor 1 blockers (ARB) are standard nephroprotective drugs in chronic kidney disease. There is less evidence for a nephroprotective effect of HMG-CoA reductase inhibitors (statins) and much less is known about potential benefits of combination therapy. We evaluated the therapeutic potential of a statin alone or in combination with an ARB in experimental chronic kidney disease. METHODS Subtotally nephrectomized (5/6 Nx) rats were treated early with vehicle, losartan, cerivastatin or losartan/cerivastatin. Expression of messenger RNA (mRNA) was assessed by real-time reverse transcription-polymerase chain reaction. Tissue proteins were localized by immunohistochemistry. Nuclear factor-κB (NF-κB) activation was measured in whole kidneys. RESULTS In contrast to the sham group, at 6 weeks, vehicle-treated 5/6 Nx rats displayed renal lesions, albuminuria and increased blood pressure, serum creatinine and total kidney NF-κB p65 DNA-binding activity and preproendothelin-1, fibronectin and type I and III collagen mRNA. NF-κB activation correlated with albuminuria and histological renal injury. Losartan or combination therapy preserved renal function, abrogated albuminuria and improved glomerular and interstitial histology. Cerivastatin alone preserved renal function and improved interstitial injury but did not influence albuminuria, glomerular histology or NF-κB activation. Losartan/cerivastatin normalized kidney NF-κB activation and extracellular matrix mRNA expression pattern. The effect of losartan alone on these parameters was less intense. All treatments decreased preproendothelin-1 mRNA and preserved interstitial capillaries. CONCLUSIONS In a chronic kidney disease model, early treatment with either an ARB or a statin preserved renal function although the mechanisms differed. Combination therapy with an ARB and a statin did not confer clear-cut advantages on biochemical and histological parameters over ARB alone, although it further improved the kidney NF-κB and gene expression profile.
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Affiliation(s)
- Alejandro Álvarez-Prats
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, and Morphology Department, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
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Durante P, Chávez M, Pérez M, Romero F, Rivera F. Effect of uric acid on hypertension progression in spontaneously hypertensive rats. Life Sci 2010; 86:957-64. [DOI: 10.1016/j.lfs.2010.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 03/30/2010] [Accepted: 04/27/2010] [Indexed: 02/07/2023]
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