Comparative value of purine metabolites in preeclampsia and acute cerebral stroke
Evgeny V. Oreshnikov , Svetlana F. Oreshnikova , Elvira N. Vasilyeva , Tatiana V. Karpova , Olga Yu. Khabarova , Tamara G. Denisova
Bulletin of the Russian Military Medical Academy ›› 2021, Vol. 23 ›› Issue (4) : 129 -138.
Comparative value of purine metabolites in preeclampsia and acute cerebral stroke
The values of the purine metabolites in preeclampsia and acute cerebral stroke were compared. A total of 33 patients with preeclampsia and 350 patients with an acute cerebral stroke were examined. The blood and liquor guanine, hypoxanthine, adenine, xanthine, and uric acid were determined by a direct spectrophotometry, in addition to conventional laboratory parameters. It has been established that there are clinical–pathobiochemical parallels between preeclampsia and the cerebral stroke, including by the features of purine metabolism. It is known that the most pronounced adverse metabolic indicator (marker, predictor) for both preeclampsia and the cerebral stroke is hyperuricemia. It was revealed that the favorable sign for stroke is the high values of oxypurines (hypoxanthine, xanthin, and uric acid) in the cerebrospinal fluid, and for preeclampsia their low levels. It has been shown that cerebrospinal fluid is not only the medium of administration of the drugs for spinal anesthesia, but also a source of valuable diagnostic and prognostic information, including in preeclampsia. Preeclampsia is metabolically like stroke with an unfavorable significance of hyperuricemia and diametrically antagonistic to stroke with a favorable value not increased, but a reduced concentration of hypoxanthine, xanthin, and uric acid in cerebrospinal fluid. The level of uric acid and other purines in patients suffering from a preeclampsia and in patients suffering from a cerebral stroke should be determined not only in the blood serum, but also, as far as possible, in cerebrospinal fluid.
cerebral ischemia / stroke / xanthine / hypoxanthine / uric acid / preeclampsia / oxypurines / blood serum / cerebrospinal fluid
| [1] |
Nihei H. Cerebral uric acid, xanthine, and hypoxanthine after ischemia: the effect of allopurinol. Neurosurgery. 1989;25(4): 613–617. DOI: 10.1097/00006123-198910000-00016 |
| [2] |
Nihei H. Cerebral uric acid, xanthine, and hypoxanthine after ischemia: the effect of allopurinol // Neurosurgery. 1989. Vol. 25, No. 4. P. 613–617. DOI: 10.1097/00006123-198910000-00016 |
| [3] |
Hallgren R. Oxypurines in cerebrospinal fluid as indices of disturbed brain metabolism. Stroke. 1983;14(3):382–388. DOI: 10.1161/01.str.14.3.382 |
| [4] |
Hallgren R. Oxypurines in cerebrospinal fluid as indices of disturbed brain metabolism // Stroke. 1983. Vol. 14, No. 3. P. 382–388. DOI: 10.1161/01.str.14.3.382 |
| [5] |
Amaro S, Renú A, Laredo C, et al. Relevance of Collaterals for the Success of Neuroprotective Therapies in Acute Ischemic Stroke: Insights from the Randomized URICO-ICTUS Trial. Cerebrovasc Dis. 2019;47(3–4):171–177. DOI: 10.1159/000500712 |
| [6] |
Amaro S., Renú A., Laredo C., et al. Relevance of Collaterals for the Success of Neuroprotective Therapies in Acute Ischemic Stroke: Insights from the Randomized URICO-ICTUS Trial // Cerebrovasc Dis. 2019. Vol. 47, No. 3–4. P. 171–177. DOI: 10.1159/000500712 |
| [7] |
Amaro S, Jiménez-Altayó F, Chamorro Á. Uric acid therapy for vasculoprotection in acute ischemic stroke. Brain Circ. 2019;5(2): 55–61. DOI: 10.4103/bc.bc_1_19 |
| [8] |
Amaro S., Jiménez-Altayó F., Chamorro Á. Uric acid therapy for vasculoprotection in acute ischemic stroke // Brain Circ. 2019. Vol. 5, No. 2. P. 55–61. DOI: 10.4103/bc.bc_1_19 |
| [9] |
Newman EJ. Elevated serum urate concentration independently predicts poor outcome following stroke in patients with diabetes. Diabetes Metab Res Rev. 2006;22(1):79–82. DOI: 10.1002/dmrr.585 |
| [10] |
Newman E.J. Elevated serum urate concentration independently predicts poor outcome following stroke in patients with diabetes // Diabetes Metab Res Rev. 2006. Vol. 22, No. 1. P. 79–82. DOI: 10.1002/dmrr.585 |
| [11] |
Chamorro Á, Amaro S, Castellanos M. Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy. Int J Stroke. 2017;12(4):377–382. DOI: 10.1177/1747493016684354 |
| [12] |
Chamorro Á., Amaro S., Castellanos M. Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy // Int J Stroke. 2017. Vol. 12, No. 4. P. 377–382. DOI: 10.1177/1747493016684354 |
| [13] |
Amaro S, Laredo C, Renú A, et al. Uric Acid Therapy Prevents Early Ischemic Stroke Progression: A Tertiary Analysis of the URICO-ICTUS Trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke). Stroke. 2016;47(11):2874–2876. DOI: 10.1161/STROKEAHA.116.014672 |
| [14] |
Amaro S., Laredo C., Renú A., et al. Uric Acid Therapy Prevents Early Ischemic Stroke Progression: A Tertiary Analysis of the URICO-ICTUS Trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) // Stroke. 2016. Vol. 47, No. 11. P. 2874–2876. DOI: 10.1161/STROKEAHA.116.014672 |
| [15] |
Llull L, Laredo C, Renu A, et al. Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke. Stroke. 2015;46(8):2162-2167. DOI: 10.1161/STROKEAHA.115.009960 |
| [16] |
Llull L., Laredo C., Renu A., et al. Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke // Stroke. 2015. Vol. 46, No. 8. P. 2162–2167. DOI: 10.1161/STROKEAHA.115.009960 |
| [17] |
Bainbridge SA, James Roberts JM. Uric Acid as a Pathogenic Factor in Preeclampsia. Placenta. 2008;29(3):67–72. DOI: 10.1016/j.placenta.2007.11.001 |
| [18] |
Bainbridge S.A., James Roberts J.M. Uric Acid as a Pathogenic Factor in Preeclampsia // Placenta. 2008. Vol. 29, No. 3. P. 67–72. DOI: 10.1016/j.placenta.2007.11.001 |
| [19] |
Powers R.W. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. Am J Obstet Gynecol. 2006;194(1):160. DOI: 10.1016/j.ajog.2005.06.066 |
| [20] |
Powers R.W. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery // Am J Obstet Gynecol. 2006. Vol. 194, No. 1. P. 160. DOI: 10.1016/j.ajog.2005.06.066 |
| [21] |
Cnossen JS. Accuracy of serum uric acid determination in predicting pre-eclampsia. Acta Obstet Gynecol Scand. 2006;85(5):519–25. DOI: 10.1080/00016340500342037 |
| [22] |
Cnossen J.S. Accuracy of serum uric acid determination in predicting pre-eclampsia // Acta Obstet Gynecol Scand. 2006. Vol. 85, No. 5. P. 519–25. DOI: 10.1080/00016340500342037 |
| [23] |
Thangaratinam S, Ismail KM, Sharp S, et al. Accuracy of serum uric acid in predicting complications of pre-eclampsia. Brit J Obstet Gynecol. 2006;113(4):369–378. DOI: 10.1111/j.1471-0528.2006.00908.x |
| [24] |
Thangaratinam S., Ismail K.M., Sharp S., et al. Accuracy of serum uric acid in predicting complications of pre-eclampsia // Brit J Obstet Gynecol. 2006. Vol. 113, No. 4. P. 369–378. DOI: 10.1111/j.1471-0528.2006.00908.x |
| [25] |
Lana К. Wagner. Diagnosis and Management of Preeclampsia. Amer Fam Phys. 2004;70(12):2317–2324. |
| [26] |
Lana К. Wagner. Diagnosis and Management of Preeclampsia // Amer Fam Phys. 2004. Vol. 70, No. 12. P. 2317–2324. |
| [27] |
Roberts J.M. Bodnar L.M., Lain K.Y., et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46(6):1263–1269. DOI: 10.1161/01.HYP.0000188703.27002.14 |
| [28] |
Roberts J.M. Bodnar L.M., Lain K.Y., et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension // Hypertension. 2005. Vol. 46, No. 6. P. 1263–1269. DOI: 10.1161/01.HYP.0000188703.27002.14 |
| [29] |
Deruelle P, Coudoux E, Ego A, et al. Risk factors for post-partum complications occurring after preeclampsia and HELLP syndrome. A study in 453 consecutive pregnancies. Eur J Obstet Gynecol Reprod Biol. 2006;125(1):59–65. DOI: 10.1016/j.ejogrb.2005.07.011 |
| [30] |
Deruelle P., Coudoux E., Ego A., et al. Risk factors for post-partum complications occurring after preeclampsia and HELLP syndrome. A study in 453 consecutive pregnancies // Eur J Obstet Gynecol Reprod Biol. 2006. Vol. 125, No. 1. P. 59–65. DOI: 10.1016/j.ejogrb.2005.07.011 |
| [31] |
Marimont JH, London M. Direct determination of uric acid by ultraviolet absorption. Clin Chem. 1964;10:934–941. |
| [32] |
Marimont J.H., London M. Direct determination of uric acid by ultraviolet absorption // Clin Chem. 1964. Vol. 10. P. 934–941. |
| [33] |
Medicinskie laboratornye tehnologii. Karpishhenko AI, editor. Saint Petersburg: Intermedika; 1998. P. 40–56. (In Russ.). |
| [34] |
Медицинские лабораторные технологии / под ред. А.И. Карпищенко. Санкт Петербург: Интермедика, 1998. С. 40–56. |
| [35] |
Sridharan R. Risk factors for ischemic stroke: a case control analysis. Neuroepidemiology. 1992;11(1):24–30. DOI: 10.1159/000110903 |
| [36] |
Sridharan R. Risk factors for ischemic stroke: a case control analysis // Neuroepidemiology. 1992. Vol. 11, No. 1. P. 24–30. DOI: 10.1159/000110903 |
| [37] |
Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114(6):1326–1331. DOI: 10.1097/AOG.0b013e3181c2bde8 |
| [38] |
Abbassi-Ghanavati M., Greer L.G., Cunningham F.G. Pregnancy and laboratory studies: a reference table for clinicians // Obstet Gynecol. 2009. Vol. 114, No. 6. P. 1326–1331. DOI: 10.1097/AOG.0b013e3181c2bde8 |
| [39] |
Hatice P, Gülsen B, Elmas Ö, et al. Nitric Oxide, Lipid Peroxides, and Uric Acid Levels in Pre-Eclampsia and Eclampsia. J Exp Med. 2004;202(2):87–92. DOI: 10.1620/tjem.202.87 |
| [40] |
Hatice P., Gülsen B., Elmas Ö., et al. Nitric Oxide, Lipid Peroxides, and Uric Acid Levels in Pre-Eclampsia and Eclampsia // J Exp Med. 2004. Vol. 202, No. 2. P. 87–92. DOI: 10.1620/tjem.202.87 |
Oreshnikov E.V., Oreshnikova S.F., Vasilyeva E.N., Karpova T.V., Khabarova O.Y., Denisova T.G.
/
| 〈 |
|
〉 |