High Purine Research Articles

The flavonoid-rich fraction from rhizomes of Smilax glabra Roxb. ameliorates renal oxidative stress and inflammation in uric acid nephropathy rats through promoting uric acid excretion

Uric acid metabolic disorder is considered to be the main pathogenesis of uric acid nephropathy (UN). Smilax glabra Roxb. is a traditional Chinese herb which has been used in the treatment of gout, but the mechanism was unclear. In this study, we investigated the protective effects of the flavonoid-rich fraction from rhizomes of Smilax glabra Roxb. (SGF) on uric acid nephropathy rats and its underlying mechanisms of promoting uric acid excretion. Sprague Dawley (SD) rats were induced by high purine diet (yeast pellets + adenine) for 5 weeks. Rats were orally treated with SGF or allopurinol daily. The biochemical parameters and enzymes in different treated rats were determined by commercial kits. Kidney pathology was visualized using optical microscopy and electron microscopy. Renal inflammatory factors were detected by ELISA. Renal fibrosis factors and uric acid transporters were analyzed by real time RT-PCR and western blot. The results showed that SGF significantly improved kidney function. Histopathologic examination revealed that urate-induced renal damage was markedly reversed by SGF. Meanwhile, SGF treatment was also found to significantly inhibit renal oxidative stress. SGF treatment obviously suppressed the inflammatory factors of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), cyclooxygenase-2 (COX-2) and the profibrotic factors of basic fibroblast growth factor (bFGF), transforming growth factor-β1 (TGF-β1) expression in UN rats. Moreover, SGF either significantly inhibited uric acid production or promoted uric acid excretion in UN rats. The mechanism of SGF promoting uric acid excretion was related to its increase of ATP-binding cassette transporter G2 (ABCG2), organic anion transporter 1 (OAT1), organic anion transporters 2 (OCT2) and organic cation/carnitine transporters 2 (OCTN2) expression. In conclusion, SGF could ameliorate renal oxidative stress and inflammation in UN rats through promoting uric acid excretion.

Adaptive evolution to a high purine and fat diet of carnivorans revealed by gut microbiomes and host genomes

Carnivorous members of the Carnivora reside at the apex of food chains and consume meat-only diets, rich in purine, fats and protein. Here, we aimed to identify potential adaptive evolutionary signatures compatible with high purine and fat metabolism based on analysis of host genomes and symbiotic gut microbial metagenomes. We found that the gut microbiomes of carnivorous Carnivora (e.g., Felidae, Canidae) clustered in the same clade, and other clades comprised omnivorous and herbivorous Carnivora (e.g., badgers, bears and pandas). The relative proportions of genes encoding enzymes involved in uric acid degradation were higher in the gut microbiomes of meat-eating carnivorans than plant-eating species. Adaptive amino acid substitutions in two enzymes, carnitine O-palmitoyltransferase 1 (CPT1A) and lipase F (LIPF), which play a role in fat digestion, were identified in Felidae-Candidae species. Carnivorous carnivorans appear to endure diets high in purines and fats via gut microbiomic and genomic adaptations.

Role of HSP90 in the Regulation of de Novo Purine Biosynthesis.

Despite purines making up one of the largest classes of metabolites in a cell, little is known about the regulatory mechanisms that facilitate efficient purine production. Under conditions resulting in high purine demand, enzymes within the de novo purine biosynthetic pathway cluster into multienzyme assemblies called purinosomes. Purinosome formation has been linked to molecular chaperones HSP70 and HSP90; however, the involvement of these molecular chaperones in purinosome formation remains largely unknown. Here, we present a new-found biochemical mechanism for the regulation of de novo purine biosynthetic enzymes mediated through HSP90. HSP90-client protein interaction assays were employed to identify two enzymes within the de novo purine biosynthetic pathway, PPAT and FGAMS, as client proteins of HSP90. Inhibition of HSP90 by STA9090 abrogated these interactions and resulted in a decrease in the level of available soluble client protein while having no significant effect on their interactions with HSP70. These findings provide a mechanism to explain the dependence of purinosome assembly on HSP90 activity. The combined efforts of molecular chaperones in the maturation of PPAT and FGAMS result in purinosome formation and are likely essential for enhancing the rate of purine production to meet intracellular purine demand.

Associations between Obesity, High Purine Consumptions, and Medications on Uric Acid Level with the Use of Allopurinol in Hyperuricemia Patients

Hiperurisemia adalah kondisi ketika kadar asam urat dalam darah melebihi nilai normal. Terdapat banyak faktor yang memengaruhi peningkatan kadar asam urat, seperti obesitas, konsumsi tinggi purin, dan pengobatan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara obesitas, konsumsi tinggi purin, dan pengobatan terhadap kadar asam urat dengan penggunaan allopurinol pada pasien hiperurisemia. Data diperoleh melalui rekam medis dan kuesioner dari RSUD Dr. Saiful Anwar, Malang, dan dengan studi potong melintang. Pengambilan sampel dilakukan selama satu bulan (April–Mei 2014). Data dianalisis secara deskriptif dan diuji hipotesis. Sampel penelitian ini adalah 45 pasien hiperurisemia yang memperoleh allopurinol sebagai terapinya selama satu bulan dan pasien dipilih dengan metode pengambilan sampel konsekutif. Hasil dari penelitian ini menunjukkan bahwa tidak terdapat hubungan komparasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,193), konsumsi tinggi purin yaitu makanan laut (0,420), daging (0,469), jerohan (0,054), dan polong-polongan (0,398) juga pengobatan yaitu furosemid (0,631), aspirin dosis rendah (0,773), hidroklorotiazid (0,216), dan spironolakton (0,246). Selain itu, tidak pula terdapat korelasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,197), konsumsi tinggi purin yaitu makanan laut (0,426), daging (0,476), jerohan (0,053), dan polong-polongan (0,404) juga pengobatan yaitu furosemid (0,637), aspirin dosis rendah (0,776), hidroklorotiazid (0,220), dan spironolakton (0,250). Kata kunci: Allopurinol, asam urat, penghambat xantin oksidase Associations between Obesity, High Purine Consumptions, and Medications on Uric Acid Level with the Use of Allopurinol in Hyperuricemia Patients Hyperuricemia is a condition when the blood uric acid level exceeds the normal amount. There are many factors that can increase the uric acid level, such as obesity, high purine consumptions, and medications. The aim of this study was to determine the associations between obesity, high purine consumptions, and medications on uric acid level with the use of allopurinol in hyperuricemia patients. Data were collected through medical records and questionnaires from General Hospital of Dr. Saiful Anwar, Malang, and delivered within a cross-sectional study. Sampling was conducted for one month (April–May 2014). Data were analyzed descriptively and tested hypothetically. The samples of this study were 45 hyperuricemia patients who had gotten allopurinol as their therapy for a month and they were choosen by the consecutive sampling method. The results of this study showed that there were no statistically significant comparative association between uric acid level on obesity (0.193), high purine consumptions i.e. seafoods (0.420), meats (0.469), organ meats (0.054), and pods (0.398) also medications i.e. furosemide (0.631), low dose aspirin (0.773), hydrochlorotiazide (0.216), and spironolactone (0.246). In particular, there were no statistically significant correlations between uric acid level on obesity (0.197), high purine consumptions i.e. seafoods (0.426), meats (0.476), organ meats (0.053), and pods (0.404) also medicines i.e. furosemide (0.637), low dose aspirin (0.776), hydrochlorotiazide (0.220), and spironolactone (0.250). Keywords: Allopurinol, uric acid, xanthin oxidase inhibitor

Hiperurisemia Pada Remaja di Wilayah Kerja Puskesmas Arjasa Kabupaten Situbondo Hyperuricemia in Adolescents (16-24 Years Old) in Arjasa Primary Health Center, Situbondo Regency

Abstract
 Hyperuricemia is a condition which there is an elevated of uric acid serum level above normal, whereas gout is a group of diseases caused by deposition of monosodium urate crystals in the tissues, due to metabolism disorders in the form of hyperuricemia. Most commonly experienced by the elderly, but this disease also can be experienced by elderly and young adolescents. The purpose of this study is to describe of hyperuricemia patients in adolescents (16-24 years) in Arjasa Primary Health Center (PHC) area of ​​Situbondo Regency, as many 11 people. The cross-sectional method is used in this study. We measure body mass index (BMI) and consumption pattern using food frequency questions (FFQ) method. Most of hyperurisemia patient in young adolescent are male, have good enough education level ie Senior High School, unemployement, have enough knowledge, have family income > 1,374,000, -, have a history of hyperuricemia in their family, obesity, consumption of high purine food ie offal, food and drink containing alcohol ie tapé, and do not consume of deuretic medicines.
 
 Keywords: Hyperuricemia, Adolescents

Optimization Of Elevating Blood Uric Acid Levels With High Purine Diet

Exploration of the use of medicinal plants to lower uric acid levels has been widely practiced. Stages of new drug development research is a preclinical test using experimental animals, therefore the manufacture of an animal model of hyperuricemia is necessary. This study aims to determine the optimal induction of uric acid to increase blood uric acid levels by administering high purine foods such as cow’s liver, cow’s spleen, Gnetum gnemon , emping and fried peanuts. Eighty male white rats were used individuals to be divided into 4 groups, they were: (I) cow’s liver, (II) cow’s liver and cow’s spleen, (III) cow’s liver, cow’s spleen and boiled gnetum gnemon beans, and (IV) cow’s liver, cow’s spleen, emping and fried peanuts. This study using easy touch GCU to measure blood uric acid level. The result of statistical analysis of uric acid level means with 5 times repetition using One Way ANOVA showed that there was a very significant difference between treatments ( p <0,01). The results concluded that high purine diet in group I, II and III had not been able to increase uric acid levels significantly. High purine diet group IV was able to increase blood uric acid levels significantly to make the rats experiencing hyperuricemia with the level of 6.54 mg/dL on day 7 and 13.79 mg/dL on day 14.

Review Article: URIC ACID HOMEOSTASIS AND DISTURBANCES

This review examined the homeostasis of uric acid in human body and analyzed recent studies of the affecting major variables. Normal uric acid concentration in male is 3.5-7.2 mg/dL and in female is 2.6-6 mg/dL. Daily turnover of normal uric acid ranges from 498-1392 mg/day, miscible pool is 767-1650 mg, reabsorption is 8064 mg/day, renal excretion is 262-620 mg/day and intestine 186-313 mg/day. The dynamics of uric acid is influenced by factors of food, drink, age, history of disease, and genetic. High purine dietary consumption increases blood uric acid by 1-2 mg/dL, 213-290 g/day fructose drinks increases 0.52-1.7 mg/dL, 1.5 g/kgBW sucrose increases 0.61 mg/dL, and 10-20 ml/kgBW beer increases 0.50-0.92 mg/dL. The ABCG2 gene plays a role in bringing uric acid out of the body by 114.31-162.73 mg/dL, SLC2A9 of 5.43-20.17 mg/dL, and SLC22A12 of 5.77-6.71 mg/dL. The data described the homeostasis of uric acid and the magnitude of the impact of environmental (consumption of food, beverages, and lifestyle) and genetic factors. Understanding uric acid homeostasis and its disturbances is important in managing diseases as a consequence of hyperuricemia and hypouryscemia

Nutrition Counseling among Patients with Gout

Hyperuricemia (high levels of uric acid in the blood) can cause a buildup of monosodium urate crystals. Sudden increase may lead to gout attacks. Consumption of an unbalanced diet, intake of proteins containing high purine is one of the factors that affect gout arthritis. Based on data from medical records at the hospital Mohamad Palembang Hoesin and increase in the number of visits patients with gout, the cumulative incidence of gout reached 22 % after 5 years, the uric acid levels &amp;gt; 9 mg / dL. One of the efforts to help clients change behavior and accelerate the healing process that nutritional counseling is conducted face to face using leaflets media. The purpose of this study was to determine the effectiveness of low-purine diet counseling against uric acid levels in gout patients who were treated at the Hospital dr. AK Gani Palembang. Is a quasi-experimental study design, this study indicated that nutrition counseling with low-purine diet will help to change the behavior of people with gout in the diet to accelerate the reduction in uric acid levels. The average reduction in uric acid levels after being given a lowpurine diet counseling that is equal to 1.6 mg/dL and concluded that giving low-purine diet counseling are effective in lowering uric acid levels in patients with gout. Based on these results, low-purine diet counseling should be offered to patients with gout in an effort to motivate behavior change and reduction in uric acid levels. Nutrition counseling with Low-purine diet in patients with gout can change the eating habits of patients who eventually decreased the levels of uric acid.

Determination of the Genome and Primary Transcriptome of Syngas Fermenting Eubacterium limosum ATCC\xa08486

Autotrophic conversion of CO2 to value-added biochemicals has received considerable attention as a sustainable route to replace fossil fuels. Particularly, anaerobic acetogenic bacteria are naturally capable of reducing CO2 or CO to various metabolites. To fully utilize their biosynthetic potential, an understanding of acetogenesis-related genes and their regulatory elements is required. Here, we completed the genome sequence of the syngas fermenting Eubacterium limosum ATCC 8486 and determined its transcription start sites (TSS). We constructed a 4.4 Mb long circular genome with a GC content of 47.2% and 4,090 protein encoding genes. To understand the transcriptional and translational regulation, the primary transcriptome was augmented, identifying 1,458 TSSs containing a high pyrimidine (T/C) and purine nucleotide (A/G) content at the −1 and +1 position, respectively, along with 1,253 5′-untranslated regions, and principal promoter elements such as −10 (TATAAT) and −35 (TTGACA), and Shine-Dalgarno motifs (GGAGR). Further analysis revealed 93 non-coding RNAs, including one for potential transcriptional regulation of the hydrogenase complex via interaction with molybdenum or tungsten cofactors, which in turn controls formate dehydrogenase activity of the initial step of Wood-Ljungdahl pathway. Our results provide comprehensive genomic information for strain engineering to enhance the syngas fermenting capacity of acetogenic bacteria.

Green Tea Extract (Camellia sinensis L.) Effects on Uric Acid Levels on Hyperuricemia Rats (Rattus norvegicus)

Uric acid is the end product of purine degradation. When uric acid levels exceed normal limits, it will build up and cause hyperuricemia. Allopurinol is one of the most effective and common medicine for hyperuricemia, but it brings serious side effects, therefore it is needed alternative therapy for hyperuricemia. One plant that may be expected to low uric acid levels is green tea ( Camellia sinensis L.), that contains many antioxidants polyphenols, especially flavonoids. Flavonoid has strong antioxidant properties, act as free radical and metal scavengers, and also xanthine oxidase (XOD) inhibitors. This study investigates the potential of green tea using various doses of 150 mg/kg, 300 mg/kg, and 600 mg/kg of body weight in 24 white male rats ( Rattus norvegicus ) Wistar strain that has been received high purine diet in 60 consecutive days. This study used DHBSA methods to measure uric acid levels in blood serum and urine that excreted 8 hours before surgery. Green tea extract that contains polyphenol can inhibit XOD activities, therefore, it leads to decrease uric acid level in blood and increase the excretion through urine by modulating urate gene transporter. A therapy with 600 mg/kg body weight of GTE is the most effective dose to decrease uric acid levels in serum and to increase excretion of exceeding uric acid significantly (p < 0.01), from One Way ANOVA and Tukey analysis.

Ribera's depiction of the sense of taste: A case of ‘gouty arthritis’ resulting from overindulgence?

Jusepe de Ribera's seventeenth-century painting devoted to the sense of taste, part of a series on the five senses, depicts a man from one of 'the humbler walks of life' enjoying his meal. The redness of the man's cheeks and nose, and the swollen index finger on his left hand, are discussed in relation to the food and drink shown in the painting. It is suggested that the man's high purine intake combined with a substantial quantity of alcohol supports the hypothesis that the swollen finger is affected by gout, which was traditionally considered a 'patrician disease'. Ribera's portrayal of a well-fed but non-patrician figure with gouty arthritis of the finger may have been intended as a warning against overindulgence and gluttony at all levels of society.

Annals for Educators - 3 January 2017

Annals for Educators - 3 January 2017

Functional and Structural Characterization of Purine Nucleoside Phosphorylase from Kluyveromyces lactis and Its Potential Applications in Reducing Purine Content in Food

Consumption of foods and beverages with high purine content increases the risk of hyperuricemia, which causes gout and can lead to cardiovascular, renal, and other metabolic disorders. As patients often find dietary restrictions challenging, enzymatically lowering purine content in popular foods and beverages offers a safe and attractive strategy to control hyperuricemia. Here, we report structurally and functionally characterized purine nucleoside phosphorylase (PNP) from Kluyveromyces lactis (KlacPNP), a key enzyme involved in the purine degradation pathway. We report a 1.97 Å resolution crystal structure of homotrimeric KlacPNP with an intrinsically bound hypoxanthine in the active site. KlacPNP belongs to the nucleoside phosphorylase-I (NP-I) family, and it specifically utilizes 6-oxopurine substrates in the following order: inosine > guanosine > xanthosine, but is inactive towards adenosine. To engineer enzymes with broad substrate specificity, we created two point variants, KlacPNPN256D and KlacPNPN256E, by replacing the catalytically active Asn256 with Asp and Glu, respectively, based on structural and comparative sequence analysis. KlacPNPN256D not only displayed broad substrate specificity by utilizing both 6-oxopurines and 6-aminopurines in the order adenosine > inosine > xanthosine > guanosine, but also displayed reversal of substrate specificity. In contrast, KlacPNPN256E was highly specific to inosine and could not utilize other tested substrates. Beer consumption is associated with increased risk of developing gout, owing to its high purine content. Here, we demonstrate that KlacPNP and KlacPNPN256D could be used to catalyze a key reaction involved in lowering beer purine content. Biochemical properties of these enzymes such as activity across a wide pH range, optimum activity at about 25°C, and stability for months at about 8°C, make them suitable candidates for food and beverage industries. Since KlacPNPN256D has broad substrate specificity, a combination of engineered KlacPNP and other enzymes involved in purine degradation could effectively lower the purine content in foods and beverages.

Uric acid bladder stones in congenital cyanotic heart disease

A 54-year-old man was admitted with a 4-year history of recurrent urinary tract infections. He had a history of osteoarthritis of the left hip and benign prostatic enlargement. Physical examination showed clubbing with cyanosis (fi gure), and a grade 4/6 systolic murmur throughout the praecordium. Electrocardiogram showed right ventricular hypertrophy with features of pressure overload (appendix). His haemoglobin was raised at 200 g/L, with a haematocrit of 0·53. A CT scan of the genitourinary system showed multiple large urinary bladder stones (fi gure), urinary bladder wall thickening, trabeculations and diverticulae, and bilateral hydroureters and hydronephrosis. Cardiac MRI showed features consistent with unrepaired tetralogy of Fallot, including a large ventricular septal defect with bidirectional shunting. Cardiac catheterisation showed normal coronary arteries and pulmonary vascular resistance. Ten large bladder stones were removed by open surgery, for symptom relief and to decompress the related obstructive uropathy, measuring up to 3·3 cm in diameter (fi gure). Gas chromatography-mass spectrometry showed that the stones were composed of uric acid. Our patient later had corrective surgery for prognostic and symptomatic improvement of his suprasystemic right ventricular systolic pressure and pulmonary stenosis. Patients with cyanotic heart disease have compensatory erythrocytosis as a physiological response to persistent hypoxia, associated with a shortened red blood cell lifespan. This can cause increased red cell turnover leading to high purine metabolism and uric acid production. The most common factors that promote uric acid stone formations are persistently low urinary pH, dehydration leading to low urinary volume, and high uric acid production. Nitrogen atoms from urate interact with free protons to form uric acid that is 20 times less soluble than urate. Low pH promotes urate conversion to uric acid, which is less soluble and so more prone to forming crystals. At persistently low pH uric acid crystals can form and stabilise even with normal urinary urate concentration. Intermittent alkalinisation of urine dissolves crystals that have formed and promotes urinary stone resorption, although patients with hyperuricosuria do not form uric acid stones in the presence of alkaline urine. The underlying physiology that leads to persistently low urinary pH is poorly understood. Oral agents to modify urinary pH are available, but minimally invasive surgery is the treatment of choice for patients with symptomatic urinary bladder stones. Our patient had slightly raised plasma uric acid, with normal 24-h urinary uric acid and plasma creatinine levels. The electronic patient record had recorded a persistently low urinary pH over the last few years. He now has regular urological follow-up. We suggest that hyperuricaemia combined with persistently low urinary pH, which led to bladder stone formation, was caused by appropriate secondary erythrocytosis, turnover, and breakdown in the setting of cyanotic congenital heart disease.

Annals for Educators - 5 April 2016

<i>Annals</i> for Educators - 5 April 2016

Rats hyperuricemia model established by lipid emulsion simulating irregular of diet

Due to the irregular of diet and overfeeding greasy and surfeit flavor closely associated with hyperuricemia disease, the lipid emulsion containing high cholesterol was used to model. To obtain a more stable and sustained animal model for the efficacy evaluation of traditional Chinese herbs, we observed the influence on the serum uric acid of rat induced by the lipid emulsion compared with high purine diet. 36 SD male rats were randomized to the normal control group, high purine diet group and lipid emulsion group respectively. The general behavior, body weight and daily food intake of rats were observed. The orbital blood was taken to separate into the serum and 24 hours urine was collected. The serum indexes such as UA, BUN, Cr, ALT, AST, TC, TG, LDL-c were determined every 2 weeks, and XOD, ADA enzyme activity were determined at the 4th week. The urine indexes such as UA, Cr and Cua/Ccr were determined at the 4th week. After stopping modeling, the serum UA were determined two weeks and four weeks later respectively. At the 2nd week, the body weight and daily food intake of rats in the lipid emulsion group reduced significantly, and the level of serum UA, BUN, Cr, TC, LDL-c, ATL, AST raised significantly meanwhile TG reduced. At the 4th week, the serum UA in high purine diet group did not raise, and the serum XOD raised obviously while ADA did not; the serum UA in lipid emulsion group was higher significantly, and the serum XOD and ADA raised while Cua/Ccr reduced obviously. At the 6th weeks, the serum UA in both the high purine diet group and lipid emulsion group raised obviously. After stopping modeling, the serum UA in lipid emulsion group still maintained a high level at the 2nd week and back to the normal level at the 4th week. Compared with high purine diet, the hyperuricemia model induced by lipid emulsion forms earlierand more stable. It maybe has great value to study the pharmacodynamics of traditional Chinese medicine treatment to hyperuricemia disease. Its mechanism may be related to increasing XOD and ADA enzyme activity which can promote uric acid synthesis, meanwhile inhibiting of uric acid excretion.

XANTHINE OXYDASE INHIBITION OF KOMBUCHA TEA IN HYPERURICEMIA INDUCED WISTAR RAT: decrease of uric acid, malondialdehyde, and 8-hydroxy-2'-deoxyguanosine

Background: Hyperuricemia is a condition of high level of uric acid in the body due to distortion of purine nucleoside metabolism through hipoxanthin, xanthin, and guanin of basic purine. Objective: to find a cure of hyperuricemia base on the utilization of kombucha tea. Methods: This is a true experimental study by applying posttest only control group design to determine whether kombucha tea inhibit xanthine oxidase in hyperuricemic induced rat reveales by decrease of uric acid, malondialdehyde (MDA), and 8-hydroxy-2’-deoxyguanosine (8-OHdG). In this study, hyperuricemia rat was achieved by intake of high purine diet. Rats were fed with a mixture of 4 g/kg BW of Gnetum gnemon with 50 mL/kg BW of chicken liver ad libitum for 9 days. Treatments in this research are combination of fermentation time of Kombucha tea and volume of this tea, i.e fermentation time 4, 8, and 12 days and the volume are 1 mL and 4 mL. Therefore, there would be seven groups of treatment including control group. ANOVA was then applied to determine the treatment effect with p < 0.05 was concidered significant. Results: This study indicates that kombucha tea has an ability to inhibit xanthine oxidase in hyperuricemic induced rat and decrease uric acid, MDA, and 8-OHdG. This ability was achieved with combination treatment of 12 days fermentation and 4 mL of kombucha intake. Xanthine oxidase, uric acid, MDA, and 8-OHdG levels by this treatment were obtained significantly lower compare to control group. Conclusion: This study proved that kombucha tea was potent to cure hyperuricemia of wistar rat via inhibition of xanthine oxidase produced.

Pola makan, obesitas, dan frekuensi serangan pada pasien artritis gout

Background: Trend of gout arthritis prevalence is increasing every year. Obesity, high purine diet, especially from an animal source, are some risk factors for recurrent gout attacks.Objective: To evaluate the relationship between diet, obesity, and frequency of gout flares in gout arthritis patients.Method: This study was a cross-sectional study with patients from RSUP Dr. Sardjito, RSUD Wirosaban, RSUD Panembahan Senopati that ever diagnosed as gout arthritis within February 2010 - February 2012 which can be seen in the medical record and live in Special District of Yogyakarta with the full address provided, as the respondents of this study. The home visit was done for dietary assessment, waist circumference measurement, and interviewing the respondent about gout flares frequency during the last year.Results: Vitamin C consumption in the 1st and 2nd tertiles increase the odds to have any gout flare (OR=5.5; 95% CI: 1.08-27.77 and OR=1.5; 95% CI: 0.29-7.35, respectively). Obesity tends to increase the odds of having any gout flares up to 1.4 times (95% CI: 0,38-5,25).Conclusion: Low consumption of vitamin C significantly increases the odds of having any gout flares. The odds is also higher in patients with obesity, though this relationship is statistically insignificant.

Food, Drink, and Herbs: Alternative Therapies and Gout

Gout was first recognized as a distinct clinical entity in antiquity. Our understanding of the epidemiology and treatment of gout has evolved over millennia intertwined with observations about social class and plant and animal sources of food, beverages and medicines. Investigators have identified various aspects of diet that relate to gout risk and recurrence. Some of our most useful medications for the treatment of gout were developed from herbal precursors. Traditional dietary recommendations for gout patients have included limiting high purine meat and alcohol consumption. More recent work suggests diets leading to weight loss through calorie and carbohydrate reductions may be effective for lowering serum urate levels, as well as the risk of gout.

Purinas y ácido úrico en pre-eclampsia: interacciones fisiopatológicas y proyecciones en investigación

Uric acid is the final metabolite of purine break down, such as ATP, ADP, AMP, adenosine, inosine and hypoxanthine. The metabolite has been used broadly as a renal failure marker, as well as a risk factor for maternal and neonatal morbidity during pre-eclamptic pregnancies. High purine levels are observed in pre-eclamptic pregnancies, but the sources of these purines are unknown. However, there is evidence that pre-eclampsia (mainly severe pre-eclampsia) is associated with an increased release of cellular fragments (or microparticles) from the placenta to the maternal circulation. These in fact could be the substrate for purine metabolism. Considering this background, we propose that purines and uric acid are part of the same physiopathological phenomenon in pre-eclampsia (i.e., placental dysfunction) and could become biomarkers for placental dysfunction and postnatal adverse events.