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Wu C, Wu B, Qu Y, Fu H, Chen Y, Lu Y, Ji S, Ding L, Li Z, Sun Q, Zhang M, Zhang X, Ying B, Zhao F, Zheng X, Qiu Y, Zhang Z, Li K, Zhu Y, Cao Z, Lv Y, Shi X. Blood mercury mediates the associations between fish consumption and serum uric acid levels among Chinese adults: A nationally representative study. ENVIRONMENTAL RESEARCH 2024; 260:119612. [PMID: 39004394 DOI: 10.1016/j.envres.2024.119612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/17/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024]
Abstract
Fish consumption can increase purine load in human body, and the enrichment of mercury in fish may affect the glomerular filtration function, both resulting in increased serum uric acid (SUA) levels. The data of blood mercury (BHg), fish consumption frequency and SUA levels of 7653 participants aged 18 years or older was from China National Human Biomonitoring (2017-2018). The associations between fish consumption frequency, ln-transformed BHg and SUA levels were explored through weighted multiple linear regressions. The mediating effect of BHg levels between fish consumption frequency and SUA levels was evaluated by mediation analysis. We found that both the fish consumption frequency and BHg were positively associated with SUA levels in both sexes. Compared to participants who had never consumed fish, participants who consumed fish once a week or more had higher SUA levels [β (95% confidence interval, CI): 20.39 (2.16, 38.62) in males; β (95% CI): 10.06 (0.76, 19.37) in females] and ln-transformed BHg [β (95% CI): 0.97 (0.61, 1.34) in males; β (95% CI): 0.84 (0.63, 1.05) in females]. Each 1-unit increase in ln-transformed BHg, the SUA levels rose by 4.78 (95% CI: 0.01, 9.54) μmol/L for males and 3.81 (95% CI: 1.60, 6.03) μmol/L for females. The association between fish consumption with SUA levels was mediated by ln-transformed BHg with the percent mediated of 34.66% in males and 26.58% in females. It revealed that BHg played mediating roles in the elevation of SUA levels caused by fish consumption. This study's findings could promote the government to intervene in mercury pollution in fish, so as to ensure the safety of fish consumption.
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Affiliation(s)
- Changzi Wu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bing Wu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yingli Qu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Fu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Saisai Ji
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liang Ding
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Miao Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xu Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xulin Zheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yidan Qiu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zheng Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Kexin Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaojin Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Sodders MJ, Avila-Pacheco J, Okorie EC, Shen M, Kumari N, Marathi A, Lakhani M, Bullock K, Pierce K, Dennis C, Jeanfavre S, Sarkar S, Scherzer CR, Clish C, Olsen AL. Genetic screening and metabolomics identify glial adenosine metabolism as a therapeutic target in Parkinson's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.15.594309. [PMID: 38798570 PMCID: PMC11118494 DOI: 10.1101/2024.05.15.594309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder and lacks disease-modifying therapies. We developed a Drosophila model for identifying novel glial-based therapeutic targets for PD. Human alpha-synuclein is expressed in neurons and individual genes are independently knocked down in glia. We performed a forward genetic screen, knocking down the entire Drosophila kinome in glia in alpha-synuclein expressing flies. Among the top hits were five genes (Ak1, Ak6, Adk1, Adk2, and awd) involved in adenosine metabolism. Knockdown of each gene improved locomotor dysfunction, rescued neurodegeneration, and increased brain adenosine levels. We determined that the mechanism of neuroprotection involves adenosine itself, as opposed to a downstream metabolite. We dove deeper into the mechanism for one gene, Ak1, finding rescue of dopaminergic neuron loss, alpha-synuclein aggregation, and bioenergetic dysfunction after glial Ak1 knockdown. We performed metabolomics in Drosophila and in human PD patients, allowing us to comprehensively characterize changes in purine metabolism and identify potential biomarkers of dysfunctional adenosine metabolism in people. These experiments support glial adenosine as a novel therapeutic target in PD.
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Houle N, Feaster T, Mira A, Meeks K, Stepp CE. Sex Differences in the Speech of Persons With and Without Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:96-116. [PMID: 37889201 PMCID: PMC11000784 DOI: 10.1044/2023_ajslp-22-00350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/24/2023] [Accepted: 08/30/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Sex differences are apparent in the prevalence and the clinical presentation of Parkinson's disease (PD), but their effects on speech have been less studied. METHOD Speech acoustics of persons with (34 females and 34 males) and without (age- and sex-matched) PD were examined, assessing the effects of PD diagnosis and sex on ratings of dysarthria severity and acoustic measures of phonation (fundamental frequency standard deviation, smoothed cepstral peak prominence), speech rate (net syllables per second, percent pause ratio), and articulation (articulatory-acoustic vowel space, release burst precision). RESULTS Most measures were affected by PD (dysarthria severity, fundamental frequency standard deviation) and sex (smoothed cepstral peak prominence, net syllables per second, percent pause ratio, articulatory-acoustic vowel space), but without interactions between them. Release burst precision was differentially affected by sex in PD. Relative to those without PD, persons with PD produced fewer plosives with a single burst: females more frequently produced multiple bursts, whereas males more frequently produced no burst at all. CONCLUSIONS Most metrics did not indicate that speech production is differentially affected by sex in PD. Sex was, however, associated with disparate effects on release burst precision in PD, which deserves further study. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24388666.
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Affiliation(s)
- Nichole Houle
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Taylor Feaster
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Amna Mira
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Kirsten Meeks
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Cara E. Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston University, MA
- Department of Otolaryngology–Head & Neck Surgery, Boston University School of Medicine, MA
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Korczowska-Łącka I, Słowikowski B, Piekut T, Hurła M, Banaszek N, Szymanowicz O, Jagodziński PP, Kozubski W, Permoda-Pachuta A, Dorszewska J. Disorders of Endogenous and Exogenous Antioxidants in Neurological Diseases. Antioxidants (Basel) 2023; 12:1811. [PMID: 37891890 PMCID: PMC10604347 DOI: 10.3390/antiox12101811] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
In diseases of the central nervous system, such as Alzheimer's disease (AD), Parkinson's disease (PD), stroke, amyotrophic lateral sclerosis (ALS), Huntington's disease (HD), and even epilepsy and migraine, oxidative stress load commonly surpasses endogenous antioxidative capacity. While oxidative processes have been robustly implicated in the pathogenesis of these diseases, the significance of particular antioxidants, both endogenous and especially exogenous, in maintaining redox homeostasis requires further research. Among endogenous antioxidants, enzymes such as catalase, superoxide dismutase, and glutathione peroxidase are central to disabling free radicals, thereby preventing oxidative damage to cellular lipids, proteins, and nucleic acids. Whether supplementation with endogenously occurring antioxidant compounds such as melatonin and glutathione carries any benefit, however, remains equivocal. Similarly, while the health benefits of certain exogenous antioxidants, including ascorbic acid (vitamin C), carotenoids, polyphenols, sulforaphanes, and anthocyanins are commonly touted, their clinical efficacy and effectiveness in particular neurological disease contexts need to be more robustly defined. Here, we review the current literature on the cellular mechanisms mitigating oxidative stress and comment on the possible benefit of the most common exogenous antioxidants in diseases such as AD, PD, ALS, HD, stroke, epilepsy, and migraine. We selected common neurological diseases of a basically neurodegenerative nature.
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Affiliation(s)
- Izabela Korczowska-Łącka
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
| | - Bartosz Słowikowski
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (B.S.); (P.P.J.)
| | - Thomas Piekut
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
| | - Mikołaj Hurła
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
| | - Natalia Banaszek
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
| | - Oliwia Szymanowicz
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
| | - Paweł P. Jagodziński
- Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (B.S.); (P.P.J.)
| | - Wojciech Kozubski
- Chair and Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Agnieszka Permoda-Pachuta
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
| | - Jolanta Dorszewska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland (M.H.)
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Raheel K, Deegan G, Di Giulio I, Cash D, Ilic K, Gnoni V, Chaudhuri KR, Drakatos P, Moran R, Rosenzweig I. Sex differences in alpha-synucleinopathies: a systematic review. Front Neurol 2023; 14:1204104. [PMID: 37545736 PMCID: PMC10398394 DOI: 10.3389/fneur.2023.1204104] [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: 04/11/2023] [Accepted: 06/13/2023] [Indexed: 08/08/2023] Open
Abstract
Background Past research indicates a higher prevalence, incidence, and severe clinical manifestations of alpha-synucleinopathies in men, leading to a suggestion of neuroprotective properties of female sex hormones (especially estrogen). The potential pathomechanisms of any such effect on alpha-synucleinopathies, however, are far from understood. With that aim, we undertook to systematically review, and to critically assess, contemporary evidence on sex and gender differences in alpha-synucleinopathies using a bench-to-bedside approach. Methods In this systematic review, studies investigating sex and gender differences in alpha-synucleinopathies (Rapid Eye Movement (REM) Behavior Disorder (RBD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) from 2012 to 2022 were identified using electronic database searches of PubMed, Embase and Ovid. Results One hundred sixty-two studies were included; 5 RBD, 6 MSA, 20 DLB and 131 PD studies. Overall, there is conclusive evidence to suggest sex-and gender-specific manifestation in demographics, biomarkers, genetics, clinical features, interventions, and quality of life in alpha-synucleinopathies. Only limited data exists on the effects of distinct sex hormones, with majority of studies concentrating on estrogen and its speculated neuroprotective effects. Conclusion Future studies disentangling the underlying sex-specific mechanisms of alpha-synucleinopathies are urgently needed in order to enable novel sex-specific therapeutics.
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Affiliation(s)
- Kausar Raheel
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Gemma Deegan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
| | - Irene Di Giulio
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom
| | - Diana Cash
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Katarina Ilic
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Lecce, Italy
| | - K. Ray Chaudhuri
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, United Kingdom
| | - Panagis Drakatos
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Rosalyn Moran
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
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DuMont M, Agostinis A, Singh K, Swan E, Buttle Y, Tropea D. Sex representation in neurodegenerative and psychiatric disorders' preclinical and clinical studies. Neurobiol Dis 2023:106214. [PMID: 37385457 DOI: 10.1016/j.nbd.2023.106214] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/10/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
Many studies show the importance of biological sex for the onset, progression, and response to treatment in brain disorders. In line with these reports, health agencies have requested that all trials, both at the clinical and preclinical level, use a similar number of male and female subjects to correctly interpret the results. Despite these guidelines, many studies still tend to be unbalanced in the use of male and female subjects. In this review we consider three neurodegenerative disorders: Alzheimer's disease, Parkinson's disease, Amyotrophic lateral sclerosis, and three psychiatric disorders: Depression, Attention Deficit Hyperactivity Disorder, and Schizophrenia. These disorders were chosen because of their prevalence and their recognized sex-specific differences in onset, progression, and response to treatment. Alzheimer's disease and Depression demonstrate higher prevalence in females, whereas Parkinson's Disease, Amyotrophic lateral sclerosis, Attention Deficit Hyperactivity Disorder, and schizophrenia show higher prevalence in males. Results from preclinical and clinical studies examining each of these disorders revealed sex-specific differences in risk factors, diagnostic biomarkers, and treatment response and efficacy, suggesting a role for sex-specific therapies in neurodegenerative and neuropsychiatric disorders. However, the qualitative analysis of the percentage of males and females enrolled in clinical trials in the last two decades shows that for most of the disorders, there is still a sex bias in the patients' enrolment.
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Affiliation(s)
- Mieke DuMont
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Kiran Singh
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Evan Swan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Yvonne Buttle
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Daniela Tropea
- Department of Psychiatry and Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Dublin, Ireland; FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases.
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7
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Otani N, Hoshiyama E, Ouchi M, Takekawa H, Suzuki K. Uric acid and neurological disease: a narrative review. Front Neurol 2023; 14:1164756. [PMID: 37333005 PMCID: PMC10268604 DOI: 10.3389/fneur.2023.1164756] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Hyperuricemia often accompanies hypertension, diabetes, dyslipidemia, metabolic syndrome, and chronic renal disease; it is also closely related to cardiovascular disease. Moreover, several epidemiological studies have linked hyperuricemia and ischemic stroke. However, uric acid may also have neuroprotective effects because of its antioxidant properties. An association between low uric acid levels and neurodegenerative diseases has been suggested, which may be attributed to diminished neuroprotective effects as a result of reduced uric acid. This review will focus on the relationship between uric acid and various neurological diseases including stroke, neuroimmune diseases, and neurodegenerative diseases. When considering both the risk and pathogenesis of neurological diseases, it is important to consider the conflicting dual nature of uric acid as both a vascular risk factor and a neuroprotective factor. This dual nature of uric acid is important because it may help to elucidate the biological role of uric acid in various neurological diseases and provide new insights into the etiology and treatment of these diseases.
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Affiliation(s)
- Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikkyo Medical Center, Mibu, Japan
| | - Eisei Hoshiyama
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Motoshi Ouchi
- Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Hidehiro Takekawa
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
- Stroke Center, Dokkyo Medical University, Mibu, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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8
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Nicoletti A, Baschi R, Cicero CE, Iacono S, Re VL, Luca A, Schirò G, Monastero R. Sex and gender differences in Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis: a narrative review. Mech Ageing Dev 2023; 212:111821. [PMID: 37127082 DOI: 10.1016/j.mad.2023.111821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023]
Abstract
Neurodegenerative diseases (NDs), including Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS), exhibit high phenotypic variability and they are very common in the general population. These diseases are associated with poor prognosis and a significant burden on patients and their caregivers. Although increasing evidence suggests that biological sex is an important factor for the development and phenotypical expression of some NDs, the role of sex and gender in the diagnosis and prognosis of NDs has been poorly explored. Current knowledge relating to sex- and gender-related differences in the epidemiology, clinical features, biomarkers, and treatment of AD, PD, and ALS will be summarized in this narrative review. The cumulative evidence hitherto collected suggests that sex and gender are factors to be considered in explaining the heterogeneity of these NDs. Clarifying the role of sex and gender in AD, PD, and ALS is a key topic in precision medicine, which will facilitate sex-specific prevention and treatment strategies to be implemented in the near future.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Roberta Baschi
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Salvatore Iacono
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Vincenzina Lo Re
- Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy; Women's Brain Project, Guntershausen, Switzerland
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy.
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Helget LN, England BR, Roul P, Sayles H, Petro AD, Neogi T, O’Dell JR, Mikuls TR. Cause-Specific Mortality in Patients With Gout in the US Veterans Health Administration: A Matched Cohort Study. Arthritis Care Res (Hoboken) 2023; 75:808-816. [PMID: 35294114 PMCID: PMC9477976 DOI: 10.1002/acr.24881] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 02/08/2022] [Accepted: 03/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare all-cause and cause-specific mortality risk between patients with gout and patients without gout in the Veteran's Health Administration (VHA). METHODS We performed a matched cohort study, identifying patients with gout in the VHA from January 1999 to September 2015 based on the presence of ≥2 International Classification of Diseases, Ninth Revision codes for gout (274.X). Gout patients were matched up to 1:10 on birth year, sex, and year of VHA enrollment with patients without gout and followed until death or end of study (December 2017). Cause of death was obtained from the National Death Index. Associations of gout with all-cause and cause-specific mortality were examined using multivariable Cox regression. RESULTS Gout (n = 559,243) and matched non-gout controls (n = 5,428,760) had a mean age of 67 years and were 99% male. There were 246,291 deaths over 4,250,371 patient-years in gout patients and 2,000,000 deaths over 40,441,353 patient-years of follow-up in controls. After matching, gout patients had an increased risk of death (hazard ratio [HR] 1.09 [95% confidence interval (95% CI) 1.08-1.09]), which was no longer present after adjusting for comorbidities (HR 0.98 [95% CI 0.97-0.98]). The strongest association of gout with cause-specific mortality was observed with genitourinary conditions (HR 1.50 [95% CI 1.47-1.54]). Gout patients were at lower risk of death related to neurologic (e.g., Alzheimer's disease and Parkinson's disease) (HR 0.63 [95% CI 0.62-0.65]) and mental health (HR 0.66 [95% CI 0.65-0.68]) conditions. CONCLUSION A higher risk of death among gout patients in the VHA was related to comorbidity burden. While deaths attributable to neurologic and mental health conditions were less frequent among gout patients, genitourinary conditions were the most overrepresented causes of death.
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Affiliation(s)
- Lindsay N. Helget
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Bryant R. England
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Punyasha Roul
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Harlan Sayles
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Alison D. Petro
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, MA
| | - James R. O’Dell
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Ted R. Mikuls
- Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
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Longitudinal follow-up study of the association with gout and Alzheimer's disease and Parkinson's disease in Korea. Sci Rep 2023; 13:3696. [PMID: 36878976 PMCID: PMC9988850 DOI: 10.1038/s41598-023-30379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
To date, no clear conclusion on the relationships of gout with the occurrence of typical neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD), has been reached. This study aimed to determine whether the patients with gout are at a lower or higher probability of developing AD or PD than those without gout. Longitudinal follow-up data of a representative sample of Korean adults were assessed. 18,079 individuals diagnosed with gout between 2003 and 2015 were enrolled in the gout group. The comparison group comprised 72,316 demographics-matched individuals not diagnosed with gout. Longitudinal associations of gout with AD or PD were estimated using Cox proportional hazard regression adjusting for potential confounders. The adjusted hazard ratios (HRs) of AD and PD in the gout group were 1.01 and 1.16 times higher than controls, but these differences were not statistically significant (95% confidence interval [CI] = 0.92-1.12 and 95% CI = 0.97-1.38, respectively). Although there was no significant association in the entire sample, AD and PD probabilities in patients with gout were significantly higher in participants < 60 years, and PD probabilities in patients with gout were significantly higher in overweight participants. Our findings identify significant correlations of gout with AD and PD in participants < 60 years and gout with PD in those with overweight, indicating that gout may play a role in the development of neurodegenerative diseases in younger or overweight populations. Further investigations should be performed to corroborate these findings.
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Koros C, Simitsi AM, Papagiannakis N, Bougea A, Prentakis A, Papadimitriou D, Pachi I, Beratis I, Stanitsa E, Angelopoulou E, Antonelou R, Bregianni M, Lourentzos K, Papageorgiou SG, Bonakis A, Trapali XG, Stamelou M, Stefanis L. Serum Uric Acid as a Putative Biomarker in Prodromal Parkinson's Disease: Longitudinal Data from the PPMI Study. JOURNAL OF PARKINSON'S DISEASE 2023; 13:811-818. [PMID: 37424476 PMCID: PMC10473106 DOI: 10.3233/jpd-230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The role of blood uric acid as a biomarker in symptomatic motor PD has been increasingly established in the literature. OBJECTIVE Our present study assessed the role of serum uric acid as a putative biomarker in a prodromal PD cohort [REM Sleep Behavior disorder (RBD) and Hyposmia] followed longitudinally. METHODS Longitudinal 5-year serum uric acid measurement data of 39 RBD patients and 26 Hyposmia patients with an abnormal DATSCAN imaging were downloaded from the Parkinson's Progression Markers Initiative database. These cohorts were compared with 423 de novo PD patients and 196 healthy controls enrolled in the same study. RESULTS After adjusting for age, sex, body mass index, and concomitant disorders (hypertension/gout), baseline and longitudinal serum uric acid levels were higher in the RBD subgroup as compared to the established PD cohort (p = 0.004 and p = 0.001). (Baseline RBD 6.07±1.6 vs. Baseline PD 5.35±1.3 mg/dL and Year-5 RBD 5.7±1.3 vs. Year-5 PD 5.26±1.33). This was also true for longitudinal measurements in the Hyposmic subgroup (p = 0.008) (Baseline Hyposmic 5.7±1.6 vs. PD 5.35±1.3 mg/dL and Year-5 Hyposmic 5.58±1.6 vs. PD 5.26±1.33). CONCLUSION Our results indicate that serum uric acid levels are higher in prodromal PD subjects with ongoing dopaminergic degeneration compared to those with manifest PD. These data indicate that the well-established decrease in the levels of serum uric acid occurs with the transition from prodromal to clinical PD. Whether the higher levels of serum uric acid observed in prodromal PD may provide protection against conversion to full-blown clinical PD will require further study.
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Affiliation(s)
- Christos Koros
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athina-Maria Simitsi
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papagiannakis
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Bougea
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Prentakis
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Nuclear Medicine Unit, Attikon Hospital, Athens, Greece
| | | | - Ioanna Pachi
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ion Beratis
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Stanitsa
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthalia Angelopoulou
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Roubina Antonelou
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianna Bregianni
- 2 Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Lourentzos
- 2 Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis G. Papageorgiou
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Bonakis
- 2 Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Maria Stamelou
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Neurology Clinic, Philipps University, Marburg, Germany
- Parkinsons disease and Movement Disorders Dept., HYGEIA Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1 Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Seifar F, Dinasarapu AR, Jinnah HA. Uric Acid in Parkinson's Disease: What Is the Connection? Mov Disord 2022; 37:2173-2183. [PMID: 36056888 PMCID: PMC9669180 DOI: 10.1002/mds.29209] [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: 05/09/2022] [Revised: 07/18/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Numerous studies have linked Parkinson's disease (PD) with low levels of uric acid (UA). Low UA has been associated with the risk of developing PD, and its progression and severity. The biological mechanisms underlying these relationships have never been firmly established. The most frequently proposed mechanism is that UA is an antioxidant. Low UA is thought to predispose to oxidative stress, which contributes to dopamine neuron degeneration, and leads to initial appearance of symptoms of PD and its worsening over time. Several recent studies have questioned this explanation. In this review, we describe the biology of UA, its many links with PD, evidence regarding UA as an antioxidant, and we question whether UA causes PD or contributes to its progression. We also address the possibility that something about PD causes low UA (reverse causation) or that low UA is a biomarker of some other more relevant mechanism in PD. We hope the evidence provided here will stimulate additional studies to better understand the links between UA and PD. Elucidating these mechanisms remains important, because they may provide new insights into the pathogenesis of PD or novel approaches to treatments. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Fatemeh Seifar
- Neurosciences Graduate Program, Graduate Division of Biological and Biomedical Sciences, Laney Graduate School, Emory University, Atlanta GA, USA
- Department of Neurology, Emory University, Atlanta GA, USA
| | | | - H. A. Jinnah
- Department of Neurology, Emory University, Atlanta GA, USA
- Department of Human Genetics, Emory University, Atlanta GA, USA
- Department of Pediatrics, Emory University, Atlanta GA, USA
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Basile MS, Bramanti P, Mazzon E. Inosine in Neurodegenerative Diseases: From the Bench to the Bedside. Molecules 2022; 27:molecules27144644. [PMID: 35889517 PMCID: PMC9316764 DOI: 10.3390/molecules27144644] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Neurodegenerative diseases, such as Alzheimer′s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), currently represent major unmet medical needs. Therefore, novel therapeutic strategies are needed in order to improve patients’ quality of life and prognosis. Since oxidative stress can be strongly involved in neurodegenerative diseases, the potential use of inosine, known for its antioxidant properties, in this context deserves particular attention. The protective action of inosine treatment could be mediated by its metabolite urate. Here, we review the current preclinical and clinical studies investigating the use of inosine in AD, PD, ALS, and MS. The most important properties of inosine seem to be its antioxidant action and its ability to raise urate levels and to increase energetic resources by improving ATP availability. Inosine appears to be generally safe and well tolerated; however, the possible formation of kidney stones should be monitored, and data on its effectiveness should be further explored since, so far, they have been controversial. Overall, inosine could be a promising potential strategy in the management of neurodegenerative diseases, and additional studies are needed in order to further investigate its safety and efficacy and its use as a complementary therapy along with other approved drugs.
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Sex Differences in Parkinson’s Disease: From Bench to Bedside. Brain Sci 2022; 12:brainsci12070917. [PMID: 35884724 PMCID: PMC9313069 DOI: 10.3390/brainsci12070917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and gender differences have been described on several aspects of PD. In the present commentary, we aimed to collect and discuss the currently available evidence on gender differences in PD regarding biomarkers, genetic factors, motor and non-motor symptoms, therapeutic management (including pharmacological and surgical treatment) as well as preclinical studies. Methods: A systematic literature review was performed by searching the Pubmed and Scopus databases with the search strings “biomarkers”, “deep brain stimulation”, “female”, “gender”, “genetic”, “levodopa”, “men”, “male”, “motor symptoms”, “non-motor symptoms”, “Parkinson disease”, “sex”, “surgery”, and “women”. Results: The present review confirms the existence of differences between men and women in Parkinson Disease, pointing out new information regarding evidence from animal models, genetic factors, biomarkers, clinical features and pharmacological and surgical treatment. Conclusions: The overall goal is to acquire new informations about sex and gender differences in Parkinson Disease, in order to develop tailored intervetions.
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Evidence for Oxidative Pathways in the Pathogenesis of PD: Are Antioxidants Candidate Drugs to Ameliorate Disease Progression? Int J Mol Sci 2022; 23:ijms23136923. [PMID: 35805928 PMCID: PMC9266756 DOI: 10.3390/ijms23136923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023] Open
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder that arises due to a complex and variable interplay between elements including age, genetic, and environmental risk factors that manifest as the loss of dopaminergic neurons. Contemporary treatments for PD do not prevent or reverse the extent of neurodegeneration that is characteristic of this disorder and accordingly, there is a strong need to develop new approaches which address the underlying disease process and provide benefit to patients with this debilitating disorder. Mitochondrial dysfunction, oxidative damage, and inflammation have been implicated as pathophysiological mechanisms underlying the selective loss of dopaminergic neurons seen in PD. However, results of studies aiming to inhibit these pathways have shown variable success, and outcomes from large-scale clinical trials are not available or report varying success for the interventions studied. Overall, the available data suggest that further development and testing of novel therapies are required to identify new potential therapies for combating PD. Herein, this review reports on the most recent development of antioxidant and anti-inflammatory approaches that have shown positive benefit in cell and animal models of disease with a focus on supplementation with natural product therapies and selected synthetic drugs.
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Banerjee P, Saha I, Sarkar D, Maiti AK. Contributions and Limitations of Mitochondria-Targeted and Non-Targeted Antioxidants in the Treatment of Parkinsonism: an Updated Review. Neurotox Res 2022; 40:847-873. [PMID: 35386026 DOI: 10.1007/s12640-022-00501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
Abstract
As conventional therapeutics can only treat the symptoms of Parkinson's disease (PD), major focus of research in recent times is to slow down or prevent the progression of neuronal degeneration in PD. Non-targeted antioxidants have been an integral part of the conventional therapeutics regimen; however, their importance have lessened over time because of their controversial outcomes in clinical PD trials. Inability to permeate and localize within the mitochondria remains the main drawback on the part of non-targeted antioxidants inspite of possessing free radical scavenging properties. In contrast, mitochondrial-targeted antioxidants (MTAs), a special class of compounds have emerged having high advantages over non-targeted antioxidants by virtue of efficient pharmacokinetics and better absorption rate with capability to localize many fold inside the mitochondrial matrix. Preclinical experimentations indicate that MTAs have the potential to act as better alternatives compared to conventional non-targeted antioxidants in treating PD; however, sufficient clinical trials have not been conducted to investigate the efficacies of MTAs in treating PD. Controversial clinical outcomes on the part of non-targeted antioxidants and lack of clinical trials involving MTAs have made it difficult to go ahead with a direct comparison and in turn have slowed down the progress of development of safer and better alternate strategies in treating PD. This review provides an insight on the roles MTAs and non-targeted antioxidants have played in the treatment of PD till date in preclinical and clinical settings and discusses about the limitations of mitochondria-targeted and non-targeted antioxidants that can be resolved for developing effective strategies in treating Parkinsonism.
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Affiliation(s)
- Priyajit Banerjee
- Department of Zoology, University of Burdwan, Burdwan, West Bengal, Pin-713104, India
| | - Ishita Saha
- Department of Physiology, Medical College Kolkata, Kolkata, West Bengal, Pin-700073, India
| | - Diptendu Sarkar
- Department of Microbiology, Ramakrishna Mission Vidyamandira, Belur Math, Howrah, West Bengal, 711202, India
| | - Arpan Kumar Maiti
- Mitochondrial Biology and Experimental Therapeutics Laboratory, Department of Zoology, University of North Bengal, District - Darjeeling, P.O. N.B.U, Raja Rammohunpur, West Bengal, Pin-734013, India.
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Serum Uric Acid Levels in Parkinson’s Disease: A Cross-Sectional Electronic Medical Record Database Study from a Tertiary Referral Centre in Romania. Medicina (B Aires) 2022; 58:medicina58020245. [PMID: 35208569 PMCID: PMC8877142 DOI: 10.3390/medicina58020245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Parkinson’s disease (PD) is a prevalent neurodegenerative condition responsible for progressive motor and non-motor symptoms. Currently, no prophylactic or disease-modifying interventions are available. Uric acid (UA) is a potent endogenous antioxidant, resulting from purine metabolism. It is responsible for about half of the antioxidant capacity of the plasma. Increasing evidence suggests that lower serum UA levels are associated with an increased risk of developing PD and with faster disease progression. Materials and Methods: We conducted an electronic medical record database study to investigate the associations between UA levels and different characteristics of PD. Results: Out of 274 datasets from distinct patients with PD, 49 complied with the predefined inclusion and exclusion criteria. Lower UA levels were significantly associated with the severity of parkinsonism according to the Hoehn and Yahr stage (rs = 0.488, p = 0.002), with the motor complications of long-term dopaminergic treatment (r = 0.333, p = 0.027), and with the presence of neurocognitive impairment (r = 0.346, p = 0.021). Conclusions: Oxidative stress is considered a key player in the etiopathogenesis of PD, therefore the involvement of lower UA levels in the development and progression of PD is plausible. Data on the potential therapeutic roles of elevating serum UA (e.g., by precursor administration or diet manipulation) are scarce, but considering the accumulating epidemiological evidence, the topic warrants further research.
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Abstract
PURPOSE OF REVIEW This review aims to summarize recent evidence regarding the complex relationship between uric acid (UA), gout, and brain diseases. RECENT FINDINGS Observational studies have suggested that patients with hyperuricemia or gout might have a decreased risk of neurodegenerative diseases. Conversely, they may be at increased risk of cerebrovascular disease. Mendelian randomization (MR) studies use a genetic score as an instrumental variable to address the causality of the association between a risk factor (here, UA or gout) and an outcome. So far, MR analyses do not support a causal relationship of UA or gout with Alzheimer's disease and dementia, and of UA with Parkinson's disease or stroke. Observation studies indicate a U-shaped association between UA and brain diseases, but MR studies do not support that this association is causal. Further studies should address the causal role of gout as well as the impact of urate-lowering therapy on these outcomes.
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Goldberg A, Garcia-Arroyo F, Sasai F, Rodriguez-Iturbe B, Sanchez-Lozada LG, Lanaspa MA, Johnson RJ. Mini Review: Reappraisal of Uric Acid in Chronic Kidney Disease. Am J Nephrol 2021; 52:837-844. [PMID: 34673651 DOI: 10.1159/000519491] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/06/2021] [Indexed: 12/16/2022]
Abstract
Hyperuricemia predicts the development of chronic kidney disease (CKD) and metabolic complications, but whether it has a causal role has been controversial. This is especially true given the 2 recently conducted randomized controlled trials that failed to show a benefit of lowering uric acid in type 1 diabetes-associated CKD and subjects with stage 3-4 CKD. While these studies suggest that use of urate-lowering drugs in unselected patients is unlikely to slow the progression of CKD, there are subsets of subjects with CKD where reducing uric acid synthesis may be beneficial. This may be the case in patients with gout, hyperuricemia (especially associated with increased production), and urate crystalluria. Here, we discuss the evidence and propose that future clinical trials targeting these specific subgroups should be performed.
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Affiliation(s)
- Avi Goldberg
- Clalit Health Services, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Fumihiko Sasai
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | | | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Rocky Mountain VA Medical Center, Aurora, Colorado, USA
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Pirooznia SK, Rosenthal LS, Dawson VL, Dawson TM. Parkinson Disease: Translating Insights from Molecular Mechanisms to Neuroprotection. Pharmacol Rev 2021; 73:33-97. [PMID: 34663684 DOI: 10.1124/pharmrev.120.000189] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Parkinson disease (PD) used to be considered a nongenetic condition. However, the identification of several autosomal dominant and recessive mutations linked to monogenic PD has changed this view. Clinically manifest PD is then thought to occur through a complex interplay between genetic mutations, many of which have incomplete penetrance, and environmental factors, both neuroprotective and increasing susceptibility, which variably interact to reach a threshold over which PD becomes clinically manifested. Functional studies of PD gene products have identified many cellular and molecular pathways, providing crucial insights into the nature and causes of PD. PD originates from multiple causes and a range of pathogenic processes at play, ultimately culminating in nigral dopaminergic loss and motor dysfunction. An in-depth understanding of these complex and possibly convergent pathways will pave the way for therapeutic approaches to alleviate the disease symptoms and neuroprotective strategies to prevent disease manifestations. This review is aimed at providing a comprehensive understanding of advances made in PD research based on leveraging genetic insights into the pathogenesis of PD. It further discusses novel perspectives to facilitate identification of critical molecular pathways that are central to neurodegeneration that hold the potential to develop neuroprotective and/or neurorestorative therapeutic strategies for PD. SIGNIFICANCE STATEMENT: A comprehensive review of PD pathophysiology is provided on the complex interplay of genetic and environmental factors and biologic processes that contribute to PD pathogenesis. This knowledge identifies new targets that could be leveraged into disease-modifying therapies to prevent or slow neurodegeneration in PD.
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Affiliation(s)
- Sheila K Pirooznia
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering (S.K.P., V.L.D., T.M.D.), Departments of Neurology (S.K.P., L.S.R., V.L.D., T.M.D.), Departments of Physiology (V.L.D.), Solomon H. Snyder Department of Neuroscience (V.L.D., T.M.D.), Department of Pharmacology and Molecular Sciences (T.M.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Adrienne Helis Malvin Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.); and Diana Helis Henry Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.)
| | - Liana S Rosenthal
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering (S.K.P., V.L.D., T.M.D.), Departments of Neurology (S.K.P., L.S.R., V.L.D., T.M.D.), Departments of Physiology (V.L.D.), Solomon H. Snyder Department of Neuroscience (V.L.D., T.M.D.), Department of Pharmacology and Molecular Sciences (T.M.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Adrienne Helis Malvin Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.); and Diana Helis Henry Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.)
| | - Valina L Dawson
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering (S.K.P., V.L.D., T.M.D.), Departments of Neurology (S.K.P., L.S.R., V.L.D., T.M.D.), Departments of Physiology (V.L.D.), Solomon H. Snyder Department of Neuroscience (V.L.D., T.M.D.), Department of Pharmacology and Molecular Sciences (T.M.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Adrienne Helis Malvin Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.); and Diana Helis Henry Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.)
| | - Ted M Dawson
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering (S.K.P., V.L.D., T.M.D.), Departments of Neurology (S.K.P., L.S.R., V.L.D., T.M.D.), Departments of Physiology (V.L.D.), Solomon H. Snyder Department of Neuroscience (V.L.D., T.M.D.), Department of Pharmacology and Molecular Sciences (T.M.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Adrienne Helis Malvin Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.); and Diana Helis Henry Medical Research Foundation, New Orleans, Louisiana (S.K.P., V.L.D., T.M.D.)
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Schwarzschild MA, Ascherio A, Casaceli C, Curhan GC, Fitzgerald R, Kamp C, Lungu C, Macklin EA, Marek K, Mozaffarian D, Oakes D, Rudolph A, Shoulson I, Videnovic A, Scott B, Gauger L, Aldred J, Bixby M, Ciccarello J, Gunzler SA, Henchcliffe C, Brodsky M, Keith K, Hauser RA, Goetz C, LeDoux MS, Hinson V, Kumar R, Espay AJ, Jimenez-Shahed J, Hunter C, Christine C, Daley A, Leehey M, de Marcaida JA, Friedman JH, Hung A, Bwala G, Litvan I, Simon DK, Simuni T, Poon C, Schiess MC, Chou K, Park A, Bhatti D, Peterson C, Criswell SR, Rosenthal L, Durphy J, Shill HA, Mehta SH, Ahmed A, Deik AF, Fang JY, Stover N, Zhang L, Dewey RB, Gerald A, Boyd JT, Houston E, Suski V, Mosovsky S, Cloud L, Shah BB, Saint-Hilaire M, James R, Zauber SE, Reich S, Shprecher D, Pahwa R, Langhammer A, LaFaver K, LeWitt PA, Kaminski P, Goudreau J, Russell D, Houghton DJ, Laroche A, Thomas K, McGraw M, Mari Z, Serrano C, Blindauer K, Rabin M, Kurlan R, Morgan JC, Soileau M, Ainslie M, Bodis-Wollner I, Schneider RB, Waters C, Ratel AS, Beck CA, Bolger P, Callahan KF, Crotty GF, Klements D, Kostrzebski M, McMahon GM, Pothier L, Waikar SS, Lang A, Mestre T. Effect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial. JAMA 2021; 326:926-939. [PMID: 34519802 PMCID: PMC8441591 DOI: 10.1001/jama.2021.10207] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/05/2021] [Indexed: 01/13/2023]
Abstract
Importance Urate elevation, despite associations with crystallopathic, cardiovascular, and metabolic disorders, has been pursued as a potential disease-modifying strategy for Parkinson disease (PD) based on convergent biological, epidemiological, and clinical data. Objective To determine whether sustained urate-elevating treatment with the urate precursor inosine slows early PD progression. Design, Participants, and Setting Randomized, double-blind, placebo-controlled, phase 3 trial of oral inosine treatment in early PD. A total of 587 individuals consented, and 298 with PD not yet requiring dopaminergic medication, striatal dopamine transporter deficiency, and serum urate below the population median concentration (<5.8 mg/dL) were randomized between August 2016 and December 2017 at 58 US sites, and were followed up through June 2019. Interventions Inosine, dosed by blinded titration to increase serum urate concentrations to 7.1-8.0 mg/dL (n = 149) or matching placebo (n = 149) for up to 2 years. Main Outcomes and Measures The primary outcome was rate of change in the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS; parts I-III) total score (range, 0-236; higher scores indicate greater disability; minimum clinically important difference of 6.3 points) prior to dopaminergic drug therapy initiation. Secondary outcomes included serum urate to measure target engagement, adverse events to measure safety, and 29 efficacy measures of disability, quality of life, cognition, mood, autonomic function, and striatal dopamine transporter binding as a biomarker of neuronal integrity. Results Based on a prespecified interim futility analysis, the study closed early, with 273 (92%) of the randomized participants (49% women; mean age, 63 years) completing the study. Clinical progression rates were not significantly different between participants randomized to inosine (MDS-UPDRS score, 11.1 [95% CI, 9.7-12.6] points per year) and placebo (MDS-UPDRS score, 9.9 [95% CI, 8.4-11.3] points per year; difference, 1.26 [95% CI, -0.59 to 3.11] points per year; P = .18). Sustained elevation of serum urate by 2.03 mg/dL (from a baseline level of 4.6 mg/dL; 44% increase) occurred in the inosine group vs a 0.01-mg/dL change in serum urate in the placebo group (difference, 2.02 mg/dL [95% CI, 1.85-2.19 mg/dL]; P<.001). There were no significant differences for secondary efficacy outcomes including dopamine transporter binding loss. Participants randomized to inosine, compared with placebo, experienced fewer serious adverse events (7.4 vs 13.1 per 100 patient-years) but more kidney stones (7.0 vs 1.4 stones per 100 patient-years). Conclusions and Relevance Among patients recently diagnosed as having PD, treatment with inosine, compared with placebo, did not result in a significant difference in the rate of clinical disease progression. The findings do not support the use of inosine as a treatment for early PD. Trial Registration ClinicalTrials.gov Identifier: NCT02642393.
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Affiliation(s)
- Michael A Schwarzschild
- Mass General Institute for Neurodegenerative Disease, Boston, Massachusetts
- Massachusetts General Hospital, Boston
| | | | | | | | - Rebecca Fitzgerald
- Parkinson's Foundation Research Advocates, Parkinson's Foundation, New York, New York
| | | | - Codrin Lungu
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Eric A Macklin
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, Connecticut
| | - Dariush Mozaffarian
- Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
- Friedman School of Nutrition Science and Policy, Boston, Massachusetts
| | - David Oakes
- University of Rochester, Rochester, New York
| | | | - Ira Shoulson
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | | | | | | | - Jason Aldred
- Inland Northwest Research, Spokane, Washington
- Selkirk Neurology, Spokane, Washington
| | | | | | | | - Claire Henchcliffe
- University of California, Irvine
- Weill Cornell Medical College, New York, New York
| | | | | | | | | | | | | | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, Englewood, Colorado
| | | | | | | | | | | | | | | | | | | | | | | | - David K Simon
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Tanya Simuni
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Cynthia Poon
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Mya C Schiess
- The University of Texas Health Science Center, Houston McGovern Medical School, Houston
| | | | - Ariane Park
- The Ohio State University Wexner Medical Center, Columbus
| | | | | | - Susan R Criswell
- Washington University School of Medicine in St Louis, St Louis, Missouri
| | | | | | - Holly A Shill
- Banner Sun Health Research Institute, Sun City, Arizona
- University of Arizona School of Medicine-Phoenix
| | | | | | | | - John Y Fang
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | | | - Ashley Gerald
- University of Texas Southwestern Medical Center, Dallas
| | | | | | | | | | - Leslie Cloud
- VCU Parkinson's & Movement Disorders Center, Richmond, Virginia
| | | | | | | | | | - Stephen Reich
- University of Maryland School of Medicine, Baltimore
| | - David Shprecher
- Banner Sun Health Research Institute, Sun City, Arizona
- University of Arizona School of Medicine-Phoenix
| | - Rajesh Pahwa
- University of Kansas Medical Center, Kansas City
| | | | - Kathrin LaFaver
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Peter A LeWitt
- Henry Ford Hospital-West Bloomfield, West Bloomfield Township, Michigan
| | - Patricia Kaminski
- Henry Ford Hospital-West Bloomfield, West Bloomfield Township, Michigan
| | | | | | | | | | - Karen Thomas
- Sentara Neurology Specialists, Norfolk, Virginia
| | - Martha McGraw
- Center for Movement Disorders and Neurodegenerative Disease, Northwestern Medicine/Central DuPage Hospital, Winfield, Illinois
| | - Zoltan Mari
- Cleveland Clinic-Las Vegas, Las Vegas, Nevada
| | | | | | - Marcie Rabin
- Atlantic Neuroscience Institute, Summit, New Jersey
| | - Roger Kurlan
- Atlantic Neuroscience Institute, Summit, New Jersey
| | | | - Michael Soileau
- Texas Movement Disorder Specialists, Georgetown
- Scott & White Healthcare/Texas A&M University, Temple
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sushrut S Waikar
- Boston University School of Medicine, Boston, Massachusetts
- Boston Medical Center, Boston, Massachusetts
| | - Anthony Lang
- University of Toronto, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
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22
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Nascimento FP, Macedo-Júnior SJ, Lapa-Costa FR, Cezar-Dos-Santos F, Santos ARS. Inosine as a Tool to Understand and Treat Central Nervous System Disorders: A Neglected Actor? Front Neurosci 2021; 15:703783. [PMID: 34504414 PMCID: PMC8421806 DOI: 10.3389/fnins.2021.703783] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Since the 1970s, when ATP was identified as a co-transmitter in sympathetic and parasympathetic nerves, it and its active metabolite adenosine have been considered relevant signaling molecules in biological and pathological processes in the central nervous system (CNS). Meanwhile, inosine, a naturally occurring purine nucleoside formed by adenosine breakdown, was considered an inert adenosine metabolite and remained a neglected actor on the purinergic signaling scene in the CNS. However, this scenario began to change in the 1980s. In the last four decades, an extensive group of shreds of evidence has supported the importance of mediated effects by inosine in the CNS. Also, inosine was identified as a natural trigger of adenosine receptors. This evidence has shed light on the therapeutic potential of inosine on disease processes involved in neurological and psychiatric disorders. Here, we highlight the clinical and preclinical studies investigating the involvement of inosine in chronic pain, schizophrenia, epilepsy, depression, anxiety, and in neural regeneration and neurodegenerative diseases, such as Parkinson and Alzheimer. Thus, we hope that this review will strengthen the knowledge and stimulate more studies about the effects promoted by inosine in neurological and psychiatric disorders.
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Affiliation(s)
- Francisney Pinto Nascimento
- Programa de Pós-Graduação em Biociências, Laboratório de Neurofarmacologia Clínica, Faculdade de Medicina, Universidade Federal da Integração Latino-Americana, Foz do Iguaçu, Brazil
| | | | | | - Fernando Cezar-Dos-Santos
- Programa de Pós-Graduação em Biociências, Laboratório de Neurofarmacologia Clínica, Faculdade de Medicina, Universidade Federal da Integração Latino-Americana, Foz do Iguaçu, Brazil
| | - Adair R S Santos
- Programa de Pós-Graduação em Neurociências, Laboratório de Neurobiologia da Dor e Inflamação, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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23
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Coneys R, Storm CS, Kia DA, Almramhi M, Wood N. Mendelian Randomisation Finds No Causal Association between Urate and Parkinson's Disease Progression. Mov Disord 2021; 36:2182-2187. [PMID: 34056740 DOI: 10.1002/mds.28662] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/20/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative movement disorder. Observational studies suggest higher levels of plasma urate may protect against Parkinson's risk and progression; however, causality cannot be established. OBJECTIVES This study set out to determine whether there is a true causal association between urate levels and PD age at onset (AAO) and progression severity using recently released PD AAO and progression genome-wide association study (GWAS) data. METHODS A large two-sample Mendelian randomization design was employed, using genetic variants underlying urate levels and the latest GWAS data for PD outcomes. RESULTS This study found no causal association between urate levels and Parkinson's risk, AAO, or progression severity. CONCLUSIONS Our results predict increasing urate levels as a therapeutic strategy is unlikely to benefit PD patients. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rachel Coneys
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Catherine S Storm
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Demis A Kia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Mona Almramhi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - NicholasW Wood
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
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24
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Antioxidant Therapeutics in Parkinson's Disease: Current Challenges and Opportunities. Antioxidants (Basel) 2021; 10:antiox10030453. [PMID: 33803945 PMCID: PMC7998929 DOI: 10.3390/antiox10030453] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress is considered one of the pathological mechanisms that cause Parkinson’s disease (PD), which has led to the investigation of several antioxidants molecules as a potential therapeutic treatment against the disease. Although preclinical studies have demonstrated the efficacy of these compounds to maintain neuronal survival and activity in PD models, these results have not been reflected in clinical trials, antioxidants have not been able to act as disease modifiers in terms of clinical symptoms. Translational medicine currently faces the challenge of redesigning clinical trials to standardize criteria when testing molecules to reduce responses’ variability. Herein, we discuss current challenges and opportunities regarding several non-enzymatic antioxidants’ therapeutic molecules for PD patients’ potential treatment.
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25
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Saltzman RG, Jayaweera DT, Caceres LV, Tovar JA, Vidro-Casiano M, Karakeshishyan V, Soto J, Khan A, Mitrani RD, Schulman IH, Hare JM. Demographic representation in clinical trials for cell-based therapy. Contemp Clin Trials Commun 2021; 21:100702. [PMID: 33511300 PMCID: PMC7817424 DOI: 10.1016/j.conctc.2021.100702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Accepted: 01/01/2021] [Indexed: 01/22/2023] Open
Abstract
Inclusion of women and minorities in clinical research is critical to fully assess the safety and efficacy of innovative therapies. With inadequate representation of demography, generalizability is impaired since pharmacokinetics and pharmacodynamics differ in these patient populations. This study was designed to analyze the voluntary participation rates of different demographic groups in cell-based therapy clinical trials conducted by the Interdisciplinary Stem Cell Institute (ISCI) at the University of Miami, Miller School of Medicine. ISCI conducted eight clinical trials between 2007 and 2017. The trials enrolled patients with ischemic and non-ischemic cardiomyopathy, idiopathic pulmonary fibrosis (IPF), aging-frailty, and Type-2 Diabetes. Participants received cell-based therapy (n = 218) or placebo (n = 33). Among the 251 participants, 29.5% were Hispanic and 20% were women. The proportion of individuals participating in each trial was compared to that of the respective disease populations attending University of Miami Health System clinics to calculate the participation to prevalence ratio (PPR). Distribution of women accurately reflected the population attending the University of Miami Health System in trials for dilated cardiomyopathy (DCM) and aging-frailty but was under-represented in others. Similarly, Hispanics and whites were accurately represented in three of the five disease fields, with Hispanics under-represented in frailty and diabetes, and whites over-represented in DCM and IPF. Black patients were accurately represented in the diabetes trial but were under-represented in all others. This study provides insight into challenges of achieving representative inclusion in research. Novel community engagement strategies are necessary to improve inclusion of women and under-represented minorities in clinical research of cell-based therapy.
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Affiliation(s)
- Russell G Saltzman
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Dushyantha T Jayaweera
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lina V Caceres
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jairo A Tovar
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mayra Vidro-Casiano
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Vela Karakeshishyan
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeanette Soto
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Aisha Khan
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Raul D Mitrani
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ivonne H Schulman
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joshua M Hare
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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26
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Thaler A, Omer N, Giladi N, Gurevich T, Bar-Shira A, Gana-Weisz M, Goldstein O, Kestenbaum M, Cedarbaum JM, Orr-Urtreger A, Shenhar-Tsarfaty S, Mirelman A. Biochemical markers for severity and risk in GBA and LRRK2 Parkinson's disease. J Neurol 2021; 268:1517-1525. [PMID: 33388928 DOI: 10.1007/s00415-020-10325-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/10/2020] [Accepted: 11/19/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The phenotype of Parkinson's disease (PD) is variable with mutations in genes such as LRRK2 and GBA explaining part of this heterogeneity. Additional genetic and environmental factors contribute to disease variability. OBJECTIVE To assess the association between biochemical markers, PD severity and probability score for prodromal PD, among GBA and LRRK2 mutation carriers. METHODS Levels of uric acid, vitamin D, C-reactive protein, microalbumin/creatinine ratio (ACR), white blood count (WBC), hemoglobin, platelets, neutrophil/lymphocyte ratio and estimated glomerular filtration rate (eGFR) were assessed from patients with PD and non-manifesting carriers (NMC) of mutations in GBA and LRRK2, together with disease related questionnaires enabling the construction of the MDS prodromal probability score. RESULT A total of 241 patients with PD: 105 idiopathic PD (iPD), 49 LRRK2-PD and 87 GBA-PD and 412 non-manifesting subjects; 74 LRRK2-NMC, 118 GBA-NMC and 220 non-manifesting non-carriers (NMNC), participated in this study. No significant differences in biochemical measures were detected among patients with PD or non-manifesting carriers. Among GBA-PD patients, worse motor performance was associated with ACR (B = 4.68, 95% CI (1.779-7.559); p = 0.002). The probability score for prodromal PD among all non-manifesting participants was associated with eGFR; NMNC (B = - 0.531 95% CI (- 0.879 to - 0.182); p < 0.001, LRRK2-NMC (B = - 1.014 95% CI (- 1.663 to - 0.366); p < 0.001) and GBA-NMC (B = - 0.686 95% CI (1.300 to - 0.071); p = 0.029). CONCLUSION Sub-clinical renal impairment is associated with increased likelihood for prodromal PD regardless of genetic status. While the mechanism behind this finding needs further elucidation, it suggests that kidney function might play a role in PD pathogenesis.
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Affiliation(s)
- Avner Thaler
- Movement Disorder Unit, Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel.
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel.
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Tel Aviv, Israel.
| | - Nurit Omer
- Movement Disorder Unit, Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Nir Giladi
- Movement Disorder Unit, Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
| | - Tanya Gurevich
- Movement Disorder Unit, Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
| | - Anat Bar-Shira
- Genetic Institute, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Mali Gana-Weisz
- Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Orly Goldstein
- Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Meir Kestenbaum
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Neurology Department, Meir Medical Center, Kfar Saba, Israel
| | - Jesse M Cedarbaum
- Biogen Inc., Cambridge, MA, USA
- Coeruleus Clinical Sciences LLC, Woodbridge, CT, USA
| | - Avi Orr-Urtreger
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel Aviv, Israel
| | - Shani Shenhar-Tsarfaty
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Internal Medicine "C", "D", and "E", Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Anat Mirelman
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Tel Aviv, Israel
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27
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Matar E, McCarter SJ, St Louis EK, Lewis SJG. Current Concepts and Controversies in the Management of REM Sleep Behavior Disorder. Neurotherapeutics 2021; 18:107-123. [PMID: 33410105 PMCID: PMC8116413 DOI: 10.1007/s13311-020-00983-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2020] [Indexed: 11/28/2022] Open
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment and the loss of muscle atonia during REM sleep, known as REM sleep without atonia (RSWA). RBD can result in significant injuries, prompting patients to seek medical attention. However, in others, it may present only as non-violent behaviors noted as an incidental finding during polysomnography (PSG). RBD typically occurs in the context of synuclein-based neurodegenerative disorders but can also be seen accompanying brain lesions and be exacerbated by medications, particularly antidepressants. There is also an increasing appreciation regarding isolated or idiopathic RBD (iRBD). Symptomatic treatment of RBD is a priority to prevent injurious complications, with usual choices being melatonin or clonazepam. The discovery that iRBD represents a prodromal stage of incurable synucleinopathies has galvanized the research community into delineating the pathophysiology of RBD and defining biomarkers of neurodegeneration that will facilitate future disease-modifying trials in iRBD. Despite many advances, there has been no progress in available symptomatic or neuroprotective therapies for RBD, with recent negative trials highlighting several challenges that need to be addressed to prepare for definitive therapeutic trials for patients with this disorder. These challenges relate to i) the diagnostic and screening strategies applied to RBD, ii) the limited evidence base for symptomatic therapies, (iii) the existence of possible subtypes of RBD, (iv) the relevance of triggering medications, (v) the absence of objective markers of severity, (vi) the optimal design of disease-modifying trials, and vii) the implications around disclosing the risk of future neurodegeneration in otherwise healthy individuals. Here, we review the current concepts in the therapeutics of RBD as it relates to the above challenges and identify pertinent research questions to be addressed by future work.
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Affiliation(s)
- E Matar
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - S J McCarter
- Mayo Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
- Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - E K St Louis
- Mayo Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
- Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
- Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
| | - S J G Lewis
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia.
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28
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Jung Lee J, Han Yoon J, Jin Kim S, Soo Yoo H, Jong Chung S, Hyun Lee Y, Yun Kang S, Shin HW, Keun Song S, Yong Hong J, Sunwoo M, Eun Lee J, Sam Baik J, Sohn YH, Hyu Lee P. Inosine 5'-Monophosphate to Raise Serum Uric Acid Level in Multiple System Atrophy (IMPROVE-MSA study). Clin Pharmacol Ther 2020; 109:1274-1281. [PMID: 33064299 DOI: 10.1002/cpt.2082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022]
Abstract
The aim of this trial was to investigate the safety, tolerability, and capability of serum uric acid (UA) elevation of inosine 5'-monophosphate (IMP) in multiple system atrophy (MSA). The IMPROVE-MSA trial was a randomized, double-blind, placebo-controlled trial in patients with MSA with no history of hyperuricemia-related disorders. The participants were assigned to placebo (n = 25) or IMP (n = 30) in a 1 to 1 ratio, and then followed up for 24 weeks. The primary end points included safety, tolerability, and alteration of the serum UA level during the follow-up period. The secondary end points were changes in scores of the unified MSA rating scale (UMSARS) and the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The total number of adverse events (AEs) and serious AEs was comparable between the active and placebo groups. Serum UA level (mg/dL) was significantly increased from baseline (active vs. placebo, 4.57 vs. 4.58; P = 0.98) to study end point (6.96 vs. 4.43; P < 0.001) in the active group compared with the placebo group (time × group interaction; P < 0.001). The change in UMSARS scores did not differ between the active and placebo groups. However, the active group showed better alterations in MoCA scores with nominal significance (P < 0.001) and tendency for better alterations in MMSE scores (P = 0.09) than the placebo group. Our data demonstrated that IMP treatment was generally safe and well-tolerated in patients with MSA. A further trial with a long-term follow-up is required to examine whether UA elevation will slow clinical progression in early MSA.
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Affiliation(s)
- Jae Jung Lee
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Suk Yun Kang
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Hae-Won Shin
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sook Keun Song
- Department of Neurology, Jeju National University School of Medicine, Jeju, South Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - MunKyung Sunwoo
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea
| | - Ji Eun Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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Sanchez-Lozada LG, Rodriguez-Iturbe B, Kelley EE, Nakagawa T, Madero M, Feig DI, Borghi C, Piani F, Cara-Fuentes G, Bjornstad P, Lanaspa MA, Johnson RJ. Uric Acid and Hypertension: An Update With Recommendations. Am J Hypertens 2020; 33:583-594. [PMID: 32179896 PMCID: PMC7368167 DOI: 10.1093/ajh/hpaa044] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 12/24/2022] Open
Abstract
The association between increased serum urate and hypertension has been a subject of intense controversy. Extracellular uric acid drives uric acid deposition in gout, kidney stones, and possibly vascular calcification. Mendelian randomization studies, however, indicate that serum urate is likely not the causal factor in hypertension although it does increase the risk for sudden cardiac death and diabetic vascular disease. Nevertheless, experimental evidence strongly suggests that an increase in intracellular urate is a key factor in the pathogenesis of primary hypertension. Pilot clinical trials show beneficial effect of lowering serum urate in hyperuricemic individuals who are young, hypertensive, and have preserved kidney function. Some evidence suggest that activation of the renin-angiotensin system (RAS) occurs in hyperuricemia and blocking the RAS may mimic the effects of xanthine oxidase inhibitors. A reduction in intracellular urate may be achieved by lowering serum urate concentration or by suppressing intracellular urate production with dietary measures that include reducing sugar, fructose, and salt intake. We suggest that these elements in the western diet may play a major role in the pathogenesis of primary hypertension. Studies are necessary to better define the interrelation between uric acid concentrations inside and outside the cell. In addition, large-scale clinical trials are needed to determine if extracellular and intracellular urate reduction can provide benefit hypertension and cardiometabolic disease.
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Affiliation(s)
- Laura G Sanchez-Lozada
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | - Bernardo Rodriguez-Iturbe
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
- Department of Nephrology, Instituto Nacional de Ciencias Médicas Y Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Eric E Kelley
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, WV, USA
| | | | - Magdalena Madero
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | - Dan I Feig
- Division of Pediatric Nephrology, University of Alabama, Birmingham, Alabama, USA
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federica Piani
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Gabriel Cara-Fuentes
- Department of Pediatrics, Division of Pediatric Nephrology, University of Colorado, Aurora, Colorado, USA
| | - Petter Bjornstad
- Division of Pediatric Endocrinology, University of Colorado, Aurora, Colorado, USA
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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30
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Von Seggern M, Szarowicz C, Swanson M, Cavotta S, Pike ST, Lamberts JT. Purine molecules in Parkinson's disease: Analytical techniques and clinical implications. Neurochem Int 2020; 139:104793. [PMID: 32650026 DOI: 10.1016/j.neuint.2020.104793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 10/23/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that primarily affects patients over the age of 65. PD is characterized by loss of neurons in the substantia nigra and dopamine deficiency in the striatum. Once PD is clinically diagnosed by the observation of motor dysfunction, the disease is already in its advance stages. Consequently, there is a major push to identify clinical biomarkers that are useful for the earlier detection of PD. Using untargeted metabolomics, several research groups have identified purine molecules, and specifically urate, as important biomarkers related to PD. This review will summarize recent findings in the field of purine metabolomics and biomarker identification for PD, including in the areas of PD pathophysiology, diagnosis, prognosis and treatment. In addition, this article will summarize and examine the primary research techniques that are employed to quantify purine molecules in both experimental systems and human subjects.
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Affiliation(s)
| | - Carlye Szarowicz
- College of Arts & Sciences, Ferris State University, Big Rapids, MI, USA; Shimadzu Core Laboratory for Academic and Research Excellence, Ferris State University, Big Rapids, MI, USA
| | - Matthew Swanson
- College of Arts & Sciences, Ferris State University, Big Rapids, MI, USA; Shimadzu Core Laboratory for Academic and Research Excellence, Ferris State University, Big Rapids, MI, USA
| | - Samantha Cavotta
- College of Pharmacy, Ferris State University, Big Rapids, MI, USA
| | - Schuyler T Pike
- College of Arts & Sciences, Ferris State University, Big Rapids, MI, USA; Shimadzu Core Laboratory for Academic and Research Excellence, Ferris State University, Big Rapids, MI, USA
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31
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Kim WJ, Kim HR, Song JS, Choi ST. Low levels of serum urate are associated with a higher prevalence of depression in older adults: a nationwide cross-sectional study in Korea. Arthritis Res Ther 2020; 22:104. [PMID: 32375903 PMCID: PMC7201976 DOI: 10.1186/s13075-020-02192-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/22/2020] [Indexed: 12/24/2022] Open
Abstract
Background Soluble urate has been shown to serve as an antioxidant, especially in the central nervous system. Although there are intriguing data suggesting that low levels of serum urate are associated with worse outcomes in neurodegenerative diseases, its impact on mental health has not been adequately assessed. Thus, we aimed to investigate the association between serum urate and depression using a large, nationally representative sample. Methods Information on participants’ socio-demographic characteristics as well as physical and mental health conditions were retrieved from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 dataset. The Patient Health Questionnaire (PHQ)-9 was applied to identify depressive symptoms. Analyses were stratified by age: young adults (aged 19–39 years), middle-aged adults (aged 40–59 years), and older adults (aged 60 years and older). Results A total of 5332 participants were included. Serum urate concentrations were divided into sex-specific quartiles based on their distribution: ≤ 4.9 (Q1), 5.0–5.7 (Q2), 5.8–6.6 (Q3), and ≥ 6.7 (Q4) mg/dL in men and ≤ 3.7 (Q1), 3.8–4.3 (Q2), 4.4–4.9 (Q3), and ≥ 5.0 (Q4) mg/dL in women. There was a significant negative linear relationship between serum urate quartiles and PHQ-9 scores in older adults (p for trend = 0.020 in men and p for trend = 0.048 in women). Compared to high levels (Q3 and Q4) of serum urate, low levels (Q1 and Q2) were significantly associated with the overall burden of depression in older women (OR 1.78, 95% CI 1.21, 2.61) and clinically relevant depression in older men (OR 3.35, 95% CI 1.16, 9.70), even after adjustment. Conclusions Based on the KNHANES data, low levels of serum urate are associated with a higher prevalence of depression in older adults. This may have clinical implications for mental health.
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Affiliation(s)
- Woo-Joong Kim
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hye Ri Kim
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung Soo Song
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Sang Tae Choi
- Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
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32
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Franco R, Rivas-Santisteban R, Reyes-Resina I, Navarro G, Martínez-Pinilla E. Microbiota and Other Preventive Strategies and Non-genetic Risk Factors in Parkinson's Disease. Front Aging Neurosci 2020; 12:12. [PMID: 32226375 PMCID: PMC7080700 DOI: 10.3389/fnagi.2020.00012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/15/2020] [Indexed: 12/15/2022] Open
Abstract
The exact cause of Parkinson’s disease (PD), the second most prevalent neurodegenerative disease in modern societies, is still unknown. Many scientists point out that PD is caused by a complex interaction between different factors. Although the main risk factor is age, there are other influences, genetic and environmental, that individually or in combination may trigger neurodegenerative changes leading to PD. Nowadays, research remains focused on better understanding which environmental factors are related to the risk of developing PD and why. In line with the knowledge on evidence on exposures that prevent/delay PD onset or that impact on disease progression, the aims of this review were: (i) to comment on the non-genetic risk factors that mainly affect idiopathic PD; and (ii) to comment on seemingly reliable preventive interventions. We discuss both environmental factors that may affect the central nervous system (CNS) or the intestinal tract, and the likely mechanisms underlying noxious or protective actions. Knowledge on risk, protective factors, and mechanisms may help to envisage why nigral dopaminergic neurons are so vulnerable in PD and, eventually, to design new strategies for PD prevention and/or anti-PD therapy. This article reviews the variety of the known and suspected environmental factors, such as lifestyle, gut microbiota or pesticide exposition, and distinguishes between those that are harmful or beneficial for the PD acquisition or progression. In fact, the review covers one of the most novel players in the whole picture, and we address the role of microbiota on keeping a healthy CNS and/or on preventing the “side-effects” related to aging.
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Affiliation(s)
- Rafael Franco
- Chemistry School, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CiberNed), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Rivas-Santisteban
- Chemistry School, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CiberNed), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Gemma Navarro
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CiberNed), Instituto de Salud Carlos III, Madrid, Spain.,Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Eva Martínez-Pinilla
- Departamento de Morfología y Biología Celular, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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33
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Chamorro A, Mir P. Raising serum urate levels in Parkinson disease: A strategy only for women? Neurology 2019; 93:611-612. [PMID: 31484716 DOI: 10.1212/wnl.0000000000008191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Angel Chamorro
- From the Comprehensive Stroke Center, Department of Neuroscience (A.C.), Hospital Clinic of Barcelona; School of Medicine (A.C.), University of Barcelona; August Pi I Sunyer Biomedical Research Institute (IDIBAPS) (A.C.), Barcelona; Unidad de Trastornos del Movimiento (P.M.), Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla; and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (P.M.), Seville, Spain.
| | - Pablo Mir
- From the Comprehensive Stroke Center, Department of Neuroscience (A.C.), Hospital Clinic of Barcelona; School of Medicine (A.C.), University of Barcelona; August Pi I Sunyer Biomedical Research Institute (IDIBAPS) (A.C.), Barcelona; Unidad de Trastornos del Movimiento (P.M.), Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla; and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (P.M.), Seville, Spain
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