Uric Acid Puzzle: Dual Role as Anti-oxidantand Pro-oxidant.
Uric Acid Puzzle: Dual Role as Anti-oxidantand Pro-oxidant.
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DOI：
10.5049/ebp.2014.12.1.1
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Ha SK
中科院分区：
文献类型：
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作者：
Kang DH;Ha SK
众所周知，高尿酸血症与心血管和代谢综合征的存在有关，与早期肾脏疾病的发展和肾脏进展加速有关。然而，尿酸水平升高通常不被认为是真正的病因或媒介，而是这些疾病的指标。尿酸最近重新引起了临床的兴趣和流行，因为新出现的数据表明高尿酸血症在心血管和肾脏疾病中的致病作用。实验数据表明，氧化应激是暴露于尿酸的血管、肾脏、肝细胞和脂肪细胞中最早观察到的现象之一。由于尿酸是血浆中的主要抗氧化剂之一，作为自由基清除剂和过渡金属离子的螯合剂，尿酸诱导的氧化应激似乎是矛盾的。关于高尿酸血症的临床意义的数据甚至更令人困惑，它将高尿酸血症定义为一个无用的参数，需要从常规随访中消除，或者是作为治疗目标的主要危险因素。通过对实验和流行病学资料的综述，提出了存在分子开关来调节尿酸在人体不同部位作为抗氧化剂或促氧化剂的作用，这可能有助于理解尿酸矛盾的作用和解决“尿酸之争”。
Hyperuricemia is known to be associated with the presence of cardiovascular and metabolic syndrome and with the development of incipient kidney disease and an accelerated renal progression. However, an elevated uric acid level was not generally regarded as a true etiology or mediator, but an indicator of these diseases. Uric acid has recently regained the clinical interest and popularity based on emerging data suggesting the causative role of hyperuricemia in cardiovascular and renal disease. Experimental data demonstrates oxidative stress is one of the earliest phenomena observed in vascular, renal, liver cells and adipocytes exposed to uric acid. Since uric acid is one of the major antioxidants of plasma acting as a free radical scavenger and a chelator of transitional metal ion, uric acid-induced oxidative stress seems paradoxical. Data regarding the clinical implication of hyperuricemia is even more confusing, which defines hyperuricemia as a useless parameter to be eliminated from routine follow-up or a major risk factor to be therapeutic target. With a review of experimental and epidemiologic data, the presence of molecular switch to regulate the role of uric acid as anti- or pro-oxidant in different compartment of our body is suggested, which may shed light on understanding the paradoxical role of uric acid and solving the "uric acid debate".