Serum uric acid levels in patients with multiple sclerosis: a meta-analysis

Liu, Bo; Shen, Yongchun; Xiao, Kan; Tang, Yucai; Cen, Luan; Wei, Junjie

doi:10.1179/1743132811y.0000000074

Cited by 61 publications

(44 citation statements)

References 31 publications

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“…It has been observed that MS and gout are mutually exclusive (35). It is now generally accepted that the lower serum UA level in MS patients may be due to the intrinsically reduced antioxidant capacity, as well as the increased consumption of UA in MS (11,12). The mechanisms of CNS injury during infection are complex.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the present study was to investigate whether UA has diagnostic and predictive value for IM, prompted by the fact that a low UA level was found to be associated with pathological conditions such as stroke (8-10), MS (11,12,20) and CNS infections (13,14). Our research group previously investigated UA, but the focus was the association of hyperuricemia with various metabolic disorders (5-7).…”

Section: Discussionmentioning

confidence: 99%

“…Abnormalities in the serum levels of UA have been observed in several diseases. For example, a low UA level has been detected in stroke (8-10), multiple sclerosis (MS) (11,12), infections of the central nervous system (CNS) (13,14) and leprosy reaction episodes (15). As regards IM, the number of previous related studies is limited and the results are conflicting.…”

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confidence: 99%

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Low uric acid level increases the risk of infectious mononucleosis and this effect is more pronounced in women

et al. 2017

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Abstract. Infectious mononucleosis (IM) due to Epstein-Barr virus infection is common. Uric acid (UA) is an important endogenous antioxidant. To the best of our knowledge, the association between UA and IM has not been comprehensively investigated to date. The aim of the present study was to investigate this association in Chinese patients. A total of 95 patients (47 men and 48 women) with IM were recruited, along with 95 healthy controls. Clinical data were classified by patient sex. Receiver operating characteristic (ROC) curve analysis was adopted to determine the cut-off values of UA for IM diagnosis and prediction. Crude and adjusted odds ratios (ORs) of UA for IM were analyzed by binary logistic regression. The UA levels were significantly lower in IM patients compared with those in controls. In addition, UA levels in men were significantly higher compared with those in women. The ROC curve demonstrated good diagnostic and predictive values of UA for IM in both sexes. The UA cut-off values were 326.00 and 243.50 µmol/l for diagnosing IM in men and women, respectively, with a diagnostic accuracy of 76.596 and 80.208%, respectively. Binary logistic regression analysis revealed a significant risk of IM in the low UA quartiles in both sexes. Following adjustments, the ORs even increased. Women with low UA levels appeared to be more susceptible to IM. For example, the crude ORs in quartile 1 were 24.000 and 52.500 for men and women, respectively, and the respective adjusted ORs were 31.437 and 301.746 (all P<0.01). To the best of our knowledge, the present study is the first to demonstrate the inverse association between UA and IM, suggesting a progressive decrease of antioxidant reserve in IM. Moreover, low UA was suggestive of IM, particularly in women. IntroductionInfectious mononucleosis (IM) is an important clinical entity that is associated with Epstein-Barr virus (EBV) infection (1,2). This clinical manifestation was first described in 1889, but the term IM was coined in 1920, when it was discovered that a number of patients with glandular fever had similar blood films (3). In 1968, the then newly discovered EBV was identified as the cause of IM (4). The currently estimated incidence of IM is at ~500 cases per 100,000 persons annually. IM diagnosis is often established with the classical clinical triad of pharyngitis, fever and lymphadenopathy. Serological testing for the identification of EBV antibodies is required for a definitive diagnosis (1,2). The treatment of patients with IM is mainly supportive. Corticosteroids are considered as the standard treatment for severe complications associated with IM (1,2).Uric acid (UA) is a purine degradation metabolite. A high serum level of UA is considered harmful. Hyperuricemia is considered to be closely associated with a number of metabolic disorders (5-7). For example, it was previously demonstrated that UA and metabolic syndrome were closely associated, and young women with hyperuricemia were at the highest risk of developing metabolic syndrome (5). Our rece...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Low uric acid level increases the risk of infectious mononucleosis and this effect is more pronounced in women

et al. 2017

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“…We did not include compounds that were examined in fewer than three studies such as chelation, glucosamine, selenium, and others. We also did not review compounds that had already been subjected to rigorous review and synthesis: uric acid [20][21][22] or PUFAs. 23 The largest body of research examined ALA (12 studies) and G. biloba (5 studies), with the remaining compounds having fewer than four peer-reviewed studies.…”

Section: Discussionmentioning

confidence: 99%

“…Although there were 12 studies examining uric acid, we did not synthesize the findings since there are several recent reviews as well as a clinical trial completed. [20][21][22] Similarly, there is a recent Cochrane review that summarizes the literature regarding polyunsaturated fatty acids (PUFA). 23 Many compounds had fewer than three studies, which were below our threshold for synthesis; for example, chelation, polyamines, selenium, and others ( Figure 1).…”

Section: Data Extraction and Synthesismentioning

confidence: 99%

Over-the-counter anti-oxidant therapies for use in multiple sclerosis: A systematic review

et al. 2015

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Background: Anti-oxidant compounds that are found in over-the-counter (OTC) supplements and foods are gaining interest as treatments for multiple sclerosis (MS). They are widely used by patients, sometimes without a clear evidence base. Objective: We conducted a systematic review of animal and clinical research to determine the evidence for the benefits of OTC anti-oxidants in MS. Methods: Using predefined criteria, we searched key databases. Two authors scrutinized all studies against inclusion/exclusion criteria, assessed study risk-of-bias and extracted results. Results: Of the 3507 titles, 145 met criteria and included compounds, α(alpha)-lipoic acid (ALA), antioxidant vitamins, Ginkgo biloba, quercetin, resveratrol and epigallocatechin-3-gallate (ECGC). The strongest evidence to support OTC anti-oxidants was for compounds EGCG and ALA in animal models; both consistently showed anti-inflammatory/anti-oxidant effects and reduced neurological impairment. Only vitamin E, Ginkgo biloba and ALA were examined for efficacy in pilot clinical trials with either conflicting evidence or evidence of no benefit. Conclusion: OTC anti-oxidants EGCG and ALA show the most consistent benefit, however only in preclinical studies. There is no evidence that they alter MS relapses or progression. Future work should focus on testing more of these therapies for clinical efficacy before recommending them to MS patients. Anti-oxidant drug therapies, diets, and supplements, purported to counteract ROS and RNS cascades, are available as over-the-counter (OTC) remedies yet their benefits have not been proven. Most people with MS reporting using an OTC supplement despite the lack of a clear evidence base. 15 We undertook this study to systematically and rigorously examine current research findings on the effects of OTC anti-oxidant supplements in animal models and clinical trials in MS. Our aim was to translate research findings to MS clinicians and to identify areas for future research. Keywords Methods Search strategyWith the assistance of a librarian expert in systematic reviews and using predefined search terms (Table 1), we searched PubMed, CINAHL, PsychInfo, the Cochrane Library, and the Central Register of Controlled Clinical Trials, including all years up to 1 October 2013 (English language only). Clinical studies were included if the participants had MS or the biological products tested were from people with MS. Animal studies were included if a disease, similar to MS, was induced in animals and included at least behavioral findings. Data extraction and synthesisFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 16 and after duplicates were removed, we merged titles retrieved across search databases. At the title, abstract, and manuscript levels of the search, two authors evaluated inclusion status independently and if the authors disagreed, the article was included. Data extraction and synthesis was conducted on manuscripts that were categorized by compound tested. Referenc...

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Inosine for multiple sclerosis

Niu

Yang

2017

Cochrane Database of Systematic Reviews

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Serum uric acid levels in patients with multiple sclerosis: a meta-analysis

Abstract: Our study suggests that UA is relevant to MS. Future research is needed to determine whether the administration of UA levels by inosine might be considered as a novel treatment strategy for MS.

Cited by 61 publications

References 31 publications

Low uric acid level increases the risk of infectious mononucleosis and this effect is more pronounced in women

Low uric acid level increases the risk of infectious mononucleosis and this effect is more pronounced in women

Over-the-counter anti-oxidant therapies for use in multiple sclerosis: A systematic review

Inosine for multiple sclerosis

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