Study on the diagnosis of gout with xanthine and hypoxanthine

Abstract

Background Hyperuricemia is the only biochemical index in the classification of acute gouty arthritis in American Rheumatism Association 1977 and the main basis of clinical diagnosis for most doctors. However, nearly half of the time gout occurs without hyperuricemia, especially in an acute attack，which leads to an urgent need to find a new substitute diadynamic criteria of gout. Xanthine and hypoxanthine, as precursors of uric acid, have been reported to be high in gout patients with hyperuricemia and presumed to be gout biomarkers. Objectives To further explore the possibility of xanthine and hypoxanthine to be gout biomarkers as substitutes for uric acid. Methods A reversed‐phase HPLC‐UV method was employed for simultaneous quantitative detection of uric acid (UA), xanthine (X), and hypoxanthine (HX) in gout patients’ (with and without hyperuricemia) and healthy persons’ serum. Results The xanthine and hypoxanthine concentrations in gout patients with hyperuricemia and without hyperuricemia are higher than in healthy persons with a P < 0.001. Conclusions This study supplements previous researches by confirming that xanthine and hypoxanthine are significantly elevated in gout patients’ serum especially in patients’ with normouricemia, which supported xanthine and hypoxanthine may have clinical application for the diagnosis of gout.

Identification of Inflammation-Related Biomarker Pro-ADM for Male Patients With Gout by Comprehensive Analysis

“…We analyze the differential genes of gout. GO enrichment analysis ( 24 ) and KEGG pathway enrichment analysis ( 25 ) analyze the biological processes and key pathways that differential genes are mainly involved in. Among them, GO enrichment analysis P<0.01 is the selection criterion, and KEGG pathway analysis is based on P<0.05 for selection criteria.…”

Improved ultra‐high performance liquid chromatographic method for simultaneous determination of five gout‐related metabolites in human serum

“…Mobile phase composition is the most important parameter in RP LC. Initially, different modifiers in the water phase (0.1 % phosphoric acid [34], 10 mM ammonium formate [35], 10 mM ammonium acetate [12], and 50 mM sodium dihydrogen phosphate [29]) were investigated concerning their influence on chromatographic retention and resolution. As seen from Fig.…”

“…Since purines had been analyzed mostly at acidic mobile phase according to the relevant literature [12,29,34,35], pH ranging from 3 to 4.5 were evaluated in this work. Interestingly, it was found in Fig.…”

“…1), hypoxanthine, xanthine, and inosine are the three pivotal precursors of uric acid, which might be involved in the pathogenesis of gout. Recent studies have shown that the levels of hypoxanthine, xanthine, and inosine in gout patients have a significant difference between healthy controls and gout patients [11][12][13][14]. Moreover, previous literature has reported that concentrations of them are remarkably high in the urine of chronic gout patients than acute gout patients [15].…”

An update of genetics, co‐morbidities and management of hyperuricaemia

“…When UA concentrations are greater than 6.8 mg/dL, MSU exceeds its limit of solubility in serum under physiologic conditions. Thus, the precipitation is allowed, and then MSU crystals are formed 65 …”