Increase of serum uric acid levels in multiple sclerosis during treatment with natalizumab

• Published in: Multiple sclerosis Vol. 14; p. S281
• Main Authors: Handouk, Y, Angeleri, V A, Danni, M, De Riso, S, Provinciali, L
• Format: Journal Article
• Language: English
• Published: 01.09.2008
• ISSN: 1352-4585

Background: Uric acid (UA), a product of purine metabolism, is an endogenous peroxynitrite scavenger. Several pieces of evidence have demonstrated that the mean serum UA level in clinically active multiple sclerosis (MS) patients was significantly lower than in clinically inactive MS patients or controls. Objective: To propose UA as a marker of disease activity. Methods: UA serum level were measured in 12 relapsing-remitting MS patients, who underwent Expanded Disability Status Scale (EDSS) evaluation and brain magnetic resonance imaging (MRI), and in nine healthy age and sex-matched controls. In all subjects the blood samples were taken after 5 days of the same diet. The Student t test was used to compare the groups. The linear regression analysis was used to determine the correlation between UA levels, EDSS (mean: 3; SD: 1.1), annualized relapse rate (ARR: mean: 1; SD: 0.4) and number of MRI enhancing lesions (mean: 1.8; SD: 1.7). Eight of the MS patients underwent natalizumab treatment (300 mg endovenously, every month). The T-paired test was used to compared UA levels before and after 6 months of therapy. Results: There was a significant difference between mean UA serum level in MS patients (mean: 3.6 mg/dl; SD: 0.8) and controls (mean: 4.6 mg/dl; SD: 0.9) (p=0.01). A significantly inverse correlation between UA levels and EDSS were found (r=0.57; p=0.05), while the statistical analysis showed no considerable correlation with ARR (r=-0.1, p=0.64) and MRI activity (r=-0.08; p=0.8). Finally mean serum UA level was significantly increased after 6 months therapy with natalizumab (p=0.003). Conclusions: Although the role of UA in MS pathogenesis is unknown, it might reflect the disability degree and the response to the treatment.