title: Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders.
abstract: Previous studies have shown that serum uric acid (UA) modulates outcomes of neurological diseases, although little is known about cerebrospinal fluid (CSF) UA levels in neuromyelitis optica spectrum disorders (NMOSDs).
  
  
  
  Cerebrospinal fluid and serum UA levels were measured in samples from 68 patients, including NMOSDs during relapse (n= 38) and controls with noninflammatory and non-neurodegenerative diseases (CTLs,n= 30). Correlation analysis was performed between CSF UA and clinical characteristics, serum UA, and blood-brain barrier integrity in NMOSDs.
  
  
  
  Cerebrospinal fluid UA levels in NMOSDs were significantly higher than in CTLs (p=.002), while serum UA differences between NMOSDs and CTLs were not statistically significant. In NMOSDs, CSF UA levels were significantly higher in patients with an impaired blood-brain barrier than in patients with an intact one (p<.001), and significantly higher in longer disease duration than in shorter disease duration patients (p=.002). CSF UA levels were also significantly higher in active patients upon MRI than in inactive patients (p<.001), and significantly higher in patients with brain lesions than without brain lesions (p=.024). CSF UA was significantly associated with the serum UA levels (r= .454,p=.002), disease duration (r= .383,p= .018), and blood-brain barrier index (r= .805,p<.001), but did not correlate with age, gender, annualized relapse rate, duration, or severity of NMOSD. Multiple regression analysis demonstrated that CSF UA was independent of the blood-brain barrier index (β = .765,p<.001) and serum UA levels (β = .01,p=.019) in NMOSDs.
  
  
  
  Cerebrospinal fluid UA levels were elevated in NMOSD patients during relapse, and were likely modified by serum UA levels and blood-brain barrier integrity.
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Yaqing
authors.initials: Y
authors.lastname: Shu
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurology The Fifth Affiliated Hospital of Sun Yat-sen University Zhuhai China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Yuge
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China; Department of Neurology Second Affiliated Hospital of Guangzhou Medical University Guangzhou China.
authors.forename: Youming
authors.initials: Y
authors.lastname: Long
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Neurology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China.
authors.forename: Fuhua
authors.initials: F
authors.lastname: Peng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000134:cerebrospinal fluid*; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid*; D009902:Optic Neuritis / Q000097:blood / Q000134:cerebrospinal fluid*; D012008:Recurrence; D014527:Uric Acid / Q000097:blood / Q000134:cerebrospinal fluid*; D055815:Young Adult
chemical_list: D014527:Uric Acid
keywords: excitotoxicity; metabolism; neuroimmunology