High-dose Methylprednisolone Therapy in Multiple Sclerosis Increases Serum Uric Acid Levels

Tončev, Gordana; Miličić, Biljana; Tončev, Slavčo; Samardžić, Goran

doi:10.1515/cclm.2002.088

Cited by 25 publications

(15 citation statements)

References 32 publications

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“…This study favored the view that reduced UA in MS acts as a primary, constitutive loss of protection against oxidative agents. This reduction has been confirmed in other studies that showed also an inverse correlation with clinical and neuroradiological disease activity [11], while therapy with steroid boli for clinical relapses was associated with a significant increase in the values of UA compared to pre-treatment values [12].…”

Section: Introductionsupporting

confidence: 75%

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

Orefice

Ferraro²,

Barbato³

et al. 2012

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Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) and is characterized by inflammation, demyelination and desctruction of oligodendrocytes and axons. The immunology of MS is complex, involving autoreactive Th1 and Th17 lymphocytes, cells of the innate immune system including dedritic, natural killer (NK) and microglia cells, as well as vascular endothelial cells. Multiple Sclerosis (MS) is based by a series of biochemical changes affecting to different extent neuronal functions; great attention has been focused on: liver enzymes, thyroid function tests, autoantibodies, lipid profile and uric acid levels. Following the introduction of therapy with drugs that modify the course of disease, more attention has been paid to the change of biochemical parameters, in particular to evaluate possible adverse effects. Aim of this study was to perform a review of the literature on biochemical alterations in treated and untreated MS patients and to assess laboratory parameters alterations in a cohort of MS patients, before and during treatment. On a total of 624 patients followed at our center, we selected those who practiced for the first time a therapy with IFN beta 1a at various doses, IFN beta 1b and Glatiramer acetate, that were 595 (95%), with baseline biochemical evaluation available in 488 (82%) (307 females, mean age 36.6 years). We considered the evolution of various biochemical parameters during treatment. The following outcome variables were evaluated: laboratory changes, in particular liver function, thyroid function, lipids and blood cell count. Percentages were compared using the chisquare test. ANOVA was performed to evaluate changes of laboratory tests over time between therapy groups. Our finding confirm the presence of biochemical alterations at baseline, in particular regarding liver enzymes, thyroid hormones and lipids. Treatment effects were more evident on liver enzymes elevation, anti thyroid antibodies production and blood cholesterol decrease. These effects were mainly transient and self remitting without suspension of therapy. Biochemical alterations, mainly related to autoimmune pathology and lipid metabolism change were encountered. Treatments increased transient biochemical alterations particulary in patients with baseline changes, suggesting a stricter monitoring of blood exams in this category of patients.

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Section: Introductionsupporting

confidence: 75%

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

Orefice

Ferraro²,

Barbato³

et al. 2012

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“…In addition, the administration of high-dose methylprednisolone for the treatment of MS relapse resulted in an increase in serum UA concentrations in the study by Toncev et al (40).…”

Section: Discussionmentioning

confidence: 93%

Cerebrospinal fluid and serum uric acid levels in patients with multiple sclerosis

Dujmović¹,

Gazibara²,

Obrenović³

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Peroxynitrite was hypothesized to be involved in the pathogenesis of multiple sclerosis (MS) through its various neurotoxic effects. Uric acid (UA) was shown to be a strong peroxynitrite scavenger. Methods: We analyzed cerebrospinal fluid (CSF) and serum UA concentrations in 30 MS patients and 20 controls with non-inflammatory neurological diseases (NIND) and correlated these findings with demographic and clinical characteristics of MS patients. Disease activity was assessed by brain magnetic resonance imaging (MRI) and the CSF/serum albumin quotient as an indicator of the state of blood-brainbarrier (BBB). Results: Serum UA concentrations were found to be significantly lower in MS patients compared with controls (ps0.019). CSF UA concentrations were lower in MS patients as compared to controls, as well as in patients with active MS (clinical and/or MRI activity) in comparison to patients with inactive MS or controls, but these differences were not statistically significant. Significant correlation was found between CSF and serum UA concentrations (ps0.016) in MS patients, but not in controls; and between CSF UA concentrations and the CSF/serum albumin quotient in MS patients (ps0.043), but not in controls. Conclusions: Our results support the significance of UA in the pathogenesis of MS. Decreased serum UA concentrations in MS patients might be due to both intrinsically reduced antioxidant capacity and increased UA consumption in MS. CSF UA concentrations may not be a reliable marker of disease activity in MS since its concentration is dependent on leakage

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“…Consequently, treatment attempts in human MS with a precursor of uric acid have been reported (26,27). A few studies have demonstrated elevated serum uric acid levels after the administration of some drugs, such as glatiramer acetate (28) and high-dose methylprednisolone (29), indicating that some beneficial effects of these drugs might be due to the elevation of serum uric acid levels.…”

Section: Discussionmentioning

confidence: 99%

Higher Serum Uric Acid Levels in Multiple Sclerosis Patients After Longterm Interferon Beta Treatment

Toncev

Vesić

Aleksić

et al. 2017

Serbian Journal of Experimental and Clinical Research

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Interferon beta is a safe and effi cacious treatment for relapsing multiple sclerosis (MS). However, there is some evidence that uric acid, a scavenger of peroxynitrite, is involved in MS pathology and that increasing serum uric acid levels might have benefi cial therapeutic eff ects. Th e aim of this study is to investigate serum uric acid levels in MS patients (272,31±78,21 μmol/l vs. 210,17±53,65 μmol/l; p=0,019, SAŽETAK Interferon beta je bezbedan i efi kasan lek kod relapsno-remitentnog tipa multiple skleroze (MS (272,31 ± 78,21 μmol/l vs. 210,17 ± 53,65 μmol/l; p=0,019,. Nismo utvrdili značajnu razliku u nivoima mokraćne kiseline između grupa pacijenata sa terapijom interferon beta-1a pacijenata sa terapijom interferon beta-1b (p=0.98). Naši rezultati pokazuju da se jedan od korisnih efekata terapije interferonom beta kod MS može bazirati na povišenom nivou mokraćne kiseline koji prirodno uklanja peroksinitrit.

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High-dose Methylprednisolone Therapy in Multiple Sclerosis Increases Serum Uric Acid Levels

Cited by 25 publications

References 32 publications

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

Cerebrospinal fluid and serum uric acid levels in patients with multiple sclerosis

Higher Serum Uric Acid Levels in Multiple Sclerosis Patients After Longterm Interferon Beta Treatment

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