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Review
. 2012;22(1):63-75.
doi: 10.11613/bm.2012.007.

Uric acid as one of the important factors in multifactorial disorders--facts and controversies

Daria Pasalic  1 , Natalija Marinkovic, Lana Feher-Turkovic
Affiliations
Review

Uric acid as one of the important factors in multifactorial disorders--facts and controversies

Daria Pasalic et al. Biochem Med (Zagreb). 2012.

Abstract
in English, Croatian

With considering serum concentration of the uric acid in humans we are observing hyperuricemia and possible gout development. Many epidemiological studies have shown the relationship between the uric acid and different disorders such are obesity, metabolic syndrome, hypertension and coronary artery disease. Clinicians and investigators recognized serum uric acid concentration as very important diagnostic and prognostic factor of many multifactorial disorders. This review presented few clinical conditions which are not directly related to uric acid, but the concentrations of uric acid might have a great impact in observing, monitoring, prognosis and therapy of such disorders. Uric acid is recognized as a marker of oxidative stress. Production of the uric acid includes enzyme xanthine oxidase which is involved in producing of radical-oxigen species (ROS). As by-products ROS have a significant role in the increased vascular oxidative stress and might be involved in atherogenesis. Uric acid may inhibit endothelial function by inhibition of nitric oxide-function under conditions of oxidative stress. Down regulation of nitric oxide and induction of endothelial dysfunction might also be involved in pathogenesis of hypertension. The most important and well evidenced is possible predictive role of uric acid in predicting short-term outcome (mortality) in acute myocardial infarction (AMI) patients and stroke. Nephrolithiasis of uric acid origin is significantly more common among patients with the metabolic syndrome and obesity. On contrary to this, uric acid also acts is an "antioxidant", a free radical scavenger and a chelator of transitional metal ions which are converted to poorly reactive forms.

Određujući koncentraciju mokraćne kiseline u serumu kod humanih uzoraka možemo primijetiti hiperuricemiju i moguć razvoj gihta. Mnoga su epidemiološka istraživanja pokazala povezanost između mokraćne kiseline i različitih poremećaja kao što su pretilost, metabolički sindrom, povišeni tlak i koronarna arterijska bolest. Kliničari i znanstvenici prepoznali su koncentraciju mokraćne kiseline u serumu kao važan dijagnostički i prognostički čimbenik mnogih multifaktorijelnih poremećaja. Ovaj pregled predstavlja nekoliko kliničkih stanja koja nisu izravno povezana s mokraćnom kiselinom, no na čije promatranje, praćenje, prognostiku i dijagnostiku određivanje koncentracije mokraćne kiseline može imati velik utjecaj. Mokraćna kiselina prepoznata je kao biljeg oksidativnog stresa. U stvaranje mokraćne kiseline uključen je enzim ksantin-oksidaza koji je prisutan i pri stvaranju reaktivnih kisikovih spojeva (engl. radical-oxigen species, ROS). Kao nusproizvodi, ROS imaju značajnu ulogu kod povišenog rizika od vaskularnog oksidacijskog stresa te su možda uključeni i u aterogenezu. Mokraćna bi kiselina mogla inhibirati endotelnu funkciju inhibirajući funkciju dušikovog oksida kod oksidativnog stresa. Moguće je da inhibicija dušikovog oksida i indukcija endotelne disfunkcije sudjeluju u patogenezi hipertenzije. Najvažnija i potkrijepljena s dovoljno dokaza je potencijalna prediktivna uloga mokraćne kiseline pri predviđanju kratkotrajnih ishoda (smrtnost) kod bolesnika nakon akutnog infarkta miokarda i moždanog udara. Nefrolitijaza uzrokovana mokraćnom kiselinom češće se pojavljuje među bolesnicima s metaboličkim sindromom i pretilošću. Suprotno tome mokraćna kiselina također djeluje kao antioksidans, čistač slobodnih radikala i kao kelator iona tranzicijskih metala koji prelaze u slabo reaktivne oblike.

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Figures

Figure 1.
Figure 1.
Degradation of purine nucleotides and formation of uric acid. 1 - Nucleotidase; 2 - Adenosine deaminase; 3 - Inosine phosphorilase; 4 - Xsanthine oxidase; 5 - Purine nucleosidase phosphorilase; 6 - Guanine deaminase.
See this image and copyright information in PMC

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