Elevated uric acid correlates with wound severity

Abstract

Chronic venous leg ulcers are a major health issue and represent an often overlooked area of biomedical research. Nevertheless, it is becoming increasingly evident that new approaches to enhance healing outcomes may arise through better understanding the processes involved in the formation of chronic wounds. We have for the first time shown that the terminal purine catabolite uric acid (UA) is elevated in wound fluid (WF) from chronic venous leg ulcers with relative concentrations correlating with wound chronicity. We have also shown a corresponding depletion in UA precursors, including adenosine, with increased wound severity. Further, we have shown that xanthine oxidase, the only enzyme in humans that catalyses the production of UA in conjunction with a burst of free radicals, is active in chronic WF. Taken together, this provides compelling evidence that xanthine oxidase may play a critical role in the formation of chronic wounds by prolonging the inflammatory process.

Validation of predictive factors for infection in adults with chronic leg ulcers: A prospective longitudinal study

“…Such inflammatory mediators play significant roles in inflammatory responses (Rider & Jordan, ; Zhao, Liang, Clarke, Jackson, & Xue, ). Furthermore, a study of 29 patients with CLUs by Fernandez, Upton, Edwards, Finlayson, and Shooter () found an increase in the level of uric acid in wound fluid was associated with increased severity of chronic venous leg ulcers (Fernandez et al, ; Fernandez, Upton, & Shooter, ). Thus, the current finding somewhat supports suggested links found in previous research.…”

New Developments in Smart Bandage Technologies for Wound Diagnostics

“…The electroanalytical performance of these fi lms has been shown to accurately measure pH, having been tested in simulated and whole blood samples. [ 18,19 ] Thus far, urate has been used as an indicator of pH yet it has been established in recent years that its quantifi cation is of considerable interest as Fernandez et al (2012) have shown that its concentration is elevated as a consequence of tissue remodeling within the wound. The cellular trauma and associated healing processes result in the release of adenosine triphosphate (ATP) into the extracellular wound matrix, which is subsequently metabolized into uric acid.…”

“…The cellular trauma and associated healing processes result in the release of adenosine triphosphate (ATP) into the extracellular wound matrix, which is subsequently metabolized into uric acid. [ 24 ] Thus, the ability to electrochemically monitor its concentration could be useful in determining the extent of infl ammation and the subsequent response to treatment -therein providing insights into the healing process. [ 24 ] This can be achieved through a procedurally simpler approach, involving the amperometric oxidation measurement of uric acid, As a biomarker, it has the advantage of being found in relatively high concentrations and there is an extensive amount of literature on its electrochemical detection.…”

“…[ 24 ] Thus, the ability to electrochemically monitor its concentration could be useful in determining the extent of infl ammation and the subsequent response to treatment -therein providing insights into the healing process. [ 24 ] This can be achieved through a procedurally simpler approach, involving the amperometric oxidation measurement of uric acid, As a biomarker, it has the advantage of being found in relatively high concentrations and there is an extensive amount of literature on its electrochemical detection. [ 27 ] It is somewhat ironic to note that whilst the ease with which it can be electrochemically oxidized is often considered to be an interference in electroanalytical methods, it is this same property that has made it attractive as a biomarker in the present context.…”

“…The latter include: pH, [16][17][18][19][20] bacterial metabolites, [21][22][23] endogenous wound biomarkers, [ 24 ] volatile organic emissions [ 25,26 ] and temperature. [ 27 ] Many of these have been investigated with the intention of implementation within a clinic setting, but acquiring suffi cient selectivity with minimal sample preparation is a severe challenge, especially when considering the limited time available during a patient consultation.…”