Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Shu, Yaqing; Li, Haiyan; Zhang, Lei; Wang, Yuge; Long, Youming; Li, Rui; Qiu, Wei; Liu, Zhengqi; Peng, Fuhua

doi:10.1002/brb3.584

Cited by 13 publications

(17 citation statements)

References 33 publications

(35 reference statements)

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“…In this study, the UA levels in CSF were positively correlated with serum UA, indicating that CSF UA may be partially determined by serum UA and the impaired blood-CSF or blood-nerve barrier in GBS, which is consistent with previous studies in MS and NMOSD (16,38). Female GBS patients had lower serum UA levels in the present study, but there was no gender difference in CSF, which is in line with the study of Shu et al in NMOSD (16). Lower serum UA levels in female have been identified in MS, NMOSD, and healthy controls (25,46).…”

Section: Discussionsupporting

confidence: 92%

“…Several studies have shown inconsistent UA concentrations in neurological diseases. The UA levels in MS and other neurological diseases have been reported either increased or decreased when compared with controls in different studies (8,(12)(13)(14)(15)(16)(17). It has been reported that reduced serum UA levels are linked to the development and progression of neurological diseases, including MS, neuromyelitis optica (NMO), Alzheimer's disease, and Parkinson's disease (8,(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…On the one hand, it remains unclear whether the reduced concentration of serum UA is a cause or a consequence of antioxidant in neurological diseases (12). On the other hand, further studies are required to discuss whether the elevation of UA levels in neuroinflammatory diseases is related to oxidative stress and ATP degradation (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, increased levels of UA and purine compounds in cerebrospinal fluid (CSF) and serum of MS patients were reported to be associated with increased purine and adenosine triphosphate (ATP) catabolism and energy imbalance ( 15 ). A study in neuromyelitis optica spectrum disorders (NMOSDs) discovered increased CSF UA levels during relapse, suggesting oxidative stress and excitotoxicity in these patients ( 16 ). Therefore, UA levels may also reflect oxidative stress and ATP metabolism in neurological diseases ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Increased Cerebrospinal Fluid Uric Acid Levels in Guillain–Barré Syndrome

et al. 2020

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Uric acid (UA) is a natural scavenger for peroxynitrite and can reflect antioxidant activity and oxidative stress in several neurological disorders. Changes in serum and cerebrospinal fluid (CSF) levels of UA have been reported in patients with multiple sclerosis and neuromyelitis optica spectrum disorders. The levels of UA in CSF are relatively poorly understood in patients with Guillain–Barré syndrome (GBS). It remains unclear whether UA can play an antioxidant role and reflect oxidative stress in GBS. The purpose of this study is to investigate CSF and serum UA levels in patients with GBS and their relationship with clinical characteristics. The CSF and serum UA levels were detected in 43 patients with GBS, including 14 acute inflammatory demyelinating polyneuropathy (AIDP), 6 acute motor axonal neuropathy (AMAN), 13 with acute motor and sensory axonal neuropathy (AMSAN), 7 Miller Fisher syndrome (MFS), and 3 unclassified, and 25 patients with non-inflammatory neurological disorders (NIND) as controls. Moreover, serum UA levels were also detected in 30 healthy controls. The levels of UA were measured using uricase-based methods with an automatic biochemical analyzer. CSF UA levels were significantly increased in patients with GBS ( p = 0.011), particularly in patients with AIDP ( p = 0.004) when compared with NIND. Among patients with GBS, CSF UA levels were higher in those with demyelination ( p = 0.022), although the difference was not significant after multiple testing correction. CSF UA levels in GBS were positively correlated with serum UA levels ( r = 0.455, p = 0.022) and CSF lactate ( r = 0.499, p = 0.011). However, no significant correlations were found between CSF UA levels and GBS disability scores. There were no significant differences in serum UA levels among GBS, NIND, and healthy controls. These results suggest that CSF UA may be related to the pathogenesis of demyelination in patients with GBS and may be partially determined by serum UA and the impaired blood–nerve barrier.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased Cerebrospinal Fluid Uric Acid Levels in Guillain–Barré Syndrome

et al. 2020

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“…The normal serum reference levels of uric acid are 1.5–6.0 mg/dL (89–357 μM) in women and 2.5–7.0 mg/dL (149–417 μM) in men [ 134 ], whereas the CSF urate concentration is 10- to 20-fold lower than in plasma; however, a positive correlation between plasma and CSF urate levels was reported [ 165 , 166 ]. Urate concentrations in rat CSF (6.13 ± 0.68 μM) [ 167 ] were found to be higher than in the rat brain ISF (approximately 1 μM) [ 168 ].…”

Section: Urate Transporters In Choroid Plexus Epithelial Cellsmentioning

confidence: 99%

Glucose, Fructose, and Urate Transporters in the Choroid Plexus Epithelium

Chiba

Murakami

Matsumoto

et al. 2020

IJMS

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The choroid plexus plays a central role in the regulation of the microenvironment of the central nervous system by secreting the majority of the cerebrospinal fluid and controlling its composition, despite that it only represents approximately 1% of the total brain weight. In addition to a variety of transporter and channel proteins for solutes and water, the choroid plexus epithelial cells are equipped with glucose, fructose, and urate transporters that are used as energy sources or antioxidative neuroprotective substrates. This review focuses on the recent advances in the understanding of the transporters of the SLC2A and SLC5A families (GLUT1, SGLT2, GLUT5, GLUT8, and GLUT9), as well as on the urate-transporting URAT1 and BCRP/ABCG2, which are expressed in choroid plexus epithelial cells. The glucose, fructose, and urate transporters repertoire in the choroid plexus epithelium share similar features with the renal proximal tubular epithelium, although some of these transporters exhibit inversely polarized submembrane localization. Since choroid plexus epithelial cells have high energy demands for proper functioning, a decline in the expression and function of these transporters can contribute to the process of age-associated brain impairment and pathophysiology of neurodegenerative diseases.

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Comparative analysis of clinical and imaging data between patients with myelin oligodendrocyte glycoprotein antibody disease and patients with aquaporin 4 antibody-positive neuromyelitis optica spectrum disorder

Xie

Shao

et al. 2021

J Neurol

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Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Cited by 13 publications

References 33 publications

Increased Cerebrospinal Fluid Uric Acid Levels in Guillain–Barré Syndrome

Increased Cerebrospinal Fluid Uric Acid Levels in Guillain–Barré Syndrome

Glucose, Fructose, and Urate Transporters in the Choroid Plexus Epithelium

Comparative analysis of clinical and imaging data between patients with myelin oligodendrocyte glycoprotein antibody disease and patients with aquaporin 4 antibody-positive neuromyelitis optica spectrum disorder

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