Oxidized low-density lipoprotein autoantibodies in patients with primary gout: effect of urate-lowering therapy.
BACKGROUND
Uric acid is a strong scavenger of reactive oxygen species, which are known to contribute to the development of atherosclerosis, while the incidence of atherosclerotic diseases is rather high in patients with gout. Among the established risk factors for atherosclerosis, oxidized LDL is believed to play a major role in its development and progression. Allopurinol and its active metabolite, oxypurinol, have been suggested to possess an antioxidant ability to scavenge the hydroxyl radical. Therefore, allopurinol may be beneficial in the prevention of LDL oxidation, as well as in the treatment of hyperuricemia. The objective of this work was to determine the degree of LDL oxidation in gout and the effect of allopurinol on LDL oxidation.


METHODS
Age-matched male patients with primary intercritical gout and healthy male adults were included in the study. The serum concentrations of oxidized LDL autoantibodies and total antioxidant status were measured using an enzyme immunoassay.


RESULTS
Serum concentrations of oxidized LDL autoantibodies were significantly higher in patients with gout than the control subjects (p < 0.05) and were significantly decreased after allopurinol treatment (p < 0.05), but not by benzbromarone treatment, in spite of the similar concentrations of uric acid and total antioxidant status in serum following their separate administration.


CONCLUSIONS
Although the exact mechanism remains unclear, increased serum concentrations of oxidized LDL may play a role in the high incidence of coronary artery disease in gout. In addition, allopurinol may be more preferable to benzbromarone for treatment of gout in light of its inhibitory action toward LDL oxidation.
Tsutsumi
Zenta
Z
Division of Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan.
Moriwaki
Yuji
Y
Takahashi
Sumio
S
Ka
Tsuneyoshi
T
Yamamoto
Tetsuya
T
D000493:Allopurinol / Q000494:pharmacology / Q000627:therapeutic use*; D000975:Antioxidants / Q000032:analysis / Q000378:metabolism; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001835:Body Weight; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood / Q000737:chemistry; D006073:Gout / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012907:Smoking; D014280:Triglycerides / Q000097:blood / Q000378:metabolism; D014527:Uric Acid / Q000037:antagonists & inhibitors / Q000378:metabolism*
D000975:Antioxidants; D001323:Autoantibodies; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; C099252:oxidized low density lipoprotein; D014527:Uric Acid; D000493:Allopurinol