Antiepileptic drugs reduce serum uric acid

Uric acid examination in 554 epileptic out-patients under long-term anticonvulsant medication revealed significantly lower serum concentrations compared to a group of normal controls. In patients taking enzyme-inducing drugs, uric acid levels were found to be lower than in those under valproate sodium. In addition, uric acid concentrations showed a negative correlation with duration of therapy in epileptic males. At this time, we can only speculate on the mechanism involved in the reduction of uric acid by enzyme-inducing anticonvulsants as well as on the possible implication of this finding in the treatment of hyperuricemia

Lesinurad, a novel, oral compound for gout, acts to decrease serum uric acid through inhibition of urate transporters in the kidney.

BackgroundExcess body burden of uric acid promotes gout. Diminished renal clearance of uric acid causes hyperuricemia in most patients with gout, and the renal urate transporter (URAT)1 is important for regulation of serum uric acid (sUA) levels. The URAT1 inhibitors probenecid and benzbromarone are used as gout therapies; however, their use is limited by drug-drug interactions and off-target toxicity, respectively. Here, we define the mechanism of action of lesinurad (Zurampic®; RDEA594), a novel URAT1 inhibitor, recently approved in the USA and Europe for treatment of chronic gout.MethodssUA levels, fractional excretion of uric acid (FEUA), lesinurad plasma levels, and urinary excretion of lesinurad were measured in healthy volunteers treated with lesinurad. In addition, lesinurad, probenecid, and benzbromarone were compared in vitro for effects on urate transporters and the organic anion transporters (OAT)1 and OAT3, changes in mitochondrial membrane potential, and human peroxisome proliferator-activated receptor gamma (PPARγ) activity.ResultsAfter 6 hours, a single 200-mg dose of lesinurad elevated FEUA 3.6-fold (p < 0.001) and reduced sUA levels by 33 % (p < 0.001). At concentrations achieved in the clinic, lesinurad inhibited activity of URAT1 and OAT4 in vitro, did not inhibit GLUT9, and had no effect on ABCG2. Lesinurad also showed a low risk for mitochondrial toxicity and PPARγ induction compared to benzbromarone. Unlike probenecid, lesinurad did not inhibit OAT1 or OAT3 in the clinical setting.ConclusionThe pharmacodynamic effects and in vitro activity of lesinurad are consistent with inhibition of URAT1 and OAT4, major apical transporters for uric acid. Lesinurad also has a favorable selectivity and safety profile, consistent with an important role in sUA-lowering therapy for patients with gout

Allopurinol use yields potentially beneficial effects on inflammatory indices in those with recent ischemic stroke: a randomized, double-blind, placebo-controlled trial

<p><b>Background and Purpose</b>: Elevated serum uric acid level is associated with poor outcome and increased risk of recurrent events after stroke. The xanthine oxidase inhibitor allopurinol lowers uric acid but also attenuates expression of inflammatory adhesion molecules in murine models, reduces oxidative stress in the vasculature, and improves endothelial function. We sought to investigate whether allopurinol alters expression of inflammatory markers after acute ischemic stroke.</p> <p><b>Methods</b>: We performed a randomized, double-blind, placebo-controlled trial to investigate the safety, tolerability, and effect of 6 weeks’ treatment with high- (300 mg once a day) or low- (100 mg once a day) dose allopurinol on levels of uric acid and circulating inflammatory markers after ischemic stroke.</p> <p><b>Results</b>: We enrolled 50 patients with acute ischemic stroke (17, 17, and 16 in the high, low, and placebo groups, respectively). Mean (±SD) age was 70 (±13) years. Groups had similar characteristics at baseline. There were no serious adverse events. Uric acid levels were significantly reduced at both 7 days and 6 weeks in the high-dose group (by 0.14 mmol/L at 6 weeks, P=0.002). Intercellular adhesion molecule-1 concentration (ng/mL) rose by 51.2 in the placebo group, rose slightly (by 10.6) in the low-dose allopurinol group, but fell in the high-dose group (by 2.6; difference between groups P=0.012, Kruskal-Wallis test).</p> <p><b>Conclusion</b>: Allopurinol treatment is well tolerated and attenuates the rise in intercellular adhesion molecule-1 levels seen after stroke. Uric acid levels were lowered with high doses. These findings support further evaluation of allopurinol as a preventive measure after stroke.</p&gt

In vitro analysis of urinary stone composition in dual-energy computed tomography

Purpose: Dual energy computed tomography (DECT) is a new method of computed tomography (CT) imaging, allowing the assessment of not only the object's morphology, but also its composition. The aim of the study was to evaluate the potential of in vitro DECT evaluation of urinary stones' chemical composition. Material and methods: Six samples of surgically removed renal stones were scanned using DECT and analyzed by scanner vendor software. Uric acid stones were marked red and calcium stones white by the software. The real composition of the stones was finally verified using physicochemical laboratory analysis. Results: In 5 out of 6 samples, the composition of stones in DECT (3 samples identified as uric acid and 2 samples as calcium) was consistent with the physicochemical analysis (3 samples identified as uric acid, 1 as calcium phosphate, 1 as calcium oxalate). In DECT it was not possible to determine more precisely the type of calcium compounds (calcium phosphate vs. calcium oxalate) as established in the physicochemical analysis. In one stone identified in physicochemical analysis as uric acid, DECT detected a composite layered structure containing both uric acid and calcium compounds. Conclusions: DECT allows uric acid to be distinguished from calcium urinary tract stones, which is crucial in the choice of appropriate therapy. Using the available hardware and software, it was not possible to more accurately distinguish types of calcified stones. Evaluation of the stone type in DECT may be limited in the case of mixed chemical composition

Carbon fibre composites: integrated electrochemical sensors for wound management

The applicability of employing a carbon fibre mesh as an electrochemical sensing substructure for assessing urate transformations within wound exudates is evaluated. Prototype sensor assemblies have been designed and their response characteristics towards uric acid and other common physiological components are detailed. Modification of the carbon fibre sensor through surface anodisation and the application of cellulose acetate permselective barriers have been shown to lead to optimized responses and much greater sensitivity (1440% increase) and specificity. These could enable the accurate periodic monitoring of uric acid in wound fluid. The performance characteristics of the composite sensors in whole blood, serum and blister fluid have been investigated

Hubungan Indeks Massa Tubuh Dengan Kadar Asam Urat Darah Pada Penduduk Desa Banjaranyar Kecamatan Sokaraja Kabupaten Banyumas

Uric acid is a weak acid that distributed throughout the extracellular fluid as a sodium urate . The amount of uric acid on the blood is influenced by dietary intake of purines, uric acid biosynthesis of the body and rate of uric acid excretion. Indonesian had nutrient problems on the globalization, where human lifestyle and meal pattern have canged. The result of body mass index of survey on the 1995-1997 at the 27 of province show that prevalence of obessity is 6,8% on man and 13,5% on woman.The aim this study was to know the correlation between body mass index with blood uric acid levels of the society Banjaranyar Sokaraja of Banyumas. The cross sectional study used to assess body mass index, and blood uric acid in 52 respondent that fulfill in inclution criteria. Sample research taken by simple random sampling.The average of body mass index and blood uric acid were normal cathegory, it was 27 respondent (51,92%), and normal blood uric acid levels cathegory was 41 respondent (78,85%). The correlation between body mass index with blood uric acid levels on man was r=-0,09 with p=0,70>?=0,05 and on woman was r=0,05 with p=0,80>?=0,05. There was no correlation between body mass index with blood uric acid levels of the society Banjaranyar Sokaraja Banyumas

Analisis Faktor - Faktor Yang Mempengaruhi Kadar Asam Urat Pada Pekerja Kantor Di Desa Karang Turi, Kecamatan Bumiayu, Kabupaten Brebes

Hiperuricemia is one of strong predictor to the cardiovascular mortality. Hiperuricemia was caused by high purin synthetic because of not in orderly diet and interference of uric acid excretion process. Several factors are predict associate with uric acid level increased. This research aimed to know several factors that influence uric acid level in office workers in Karang Turi countryside, Bumiayu subdistric, Brebes Regency.The correlation between the factors and uric acid level use analitic method with cross sectional. 50 people were taken as the sample. Conclusion: the purin consumption, alkohol consumption, activity and age were not related with uric acid level in office worker in Karang Turi Countryside, Bumiayu Subdistric, Brebes Regency