article- uric acid

8/9/2019 Article- Uric Acid

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Article.

URIC ACID A BETTER SCAVENGER OF FREE

RADICALS THAN VITAMIN C IN RHEUMATOIDARTHRITIS.

y Mridula Mahajan, Sukhraj Kaur, Shruti Mahajan, RaviKant.

Departments of Biochemistry and Medicine, Govt. Medical

College, Amritsar. Punjab and E.S.I. Hospital, Amritsar,Punjab.

y Indian Journal of Clinical Biochemistry, 2009.


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INTRODUCTION :

y Rheumatoid Arthritis is a chronic progressivedisorder of unknown etiology.

y Prevalence of rheumatoid arthritis is

approximately 0.8% -1%.

y More common in females than males.

y Most patients fall in the range of 30-60 years ofage.

y Mostly patients present with symmetric erosivesinovitis.


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y Diagnostic criteria :

1. Morning stiffness.

2. Arthritis of 3 or more joint areas.

3. Arthritis of hand joints.4. Symmetric arthritis.

5. Rheumatoid nodules.

6. Sr. rheumatoid factor.7. Radiographic changes.


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y Bood tests like Erythrocyte Sedimentation Rate,C-Reactive Protein and rheumatoid factor that areused to diagnose the disease show that the patientof Rheumatoid Arthritis may be sero-positive or

sero-negative.

y 70% - seropositive.

y 30%- sero-negative.


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y The present study was aimed at finding out theinitial events leading to multisystem involvement

in causation and progression of the disease in sero-positive patients.


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MATERIALS AND METHODS:

yAll the patients with rheumatoid arthritis weresuffering from active disease at the time ofinvestigation, they were,

y Complaining of morning stiffness and pain and

y Synovial swellings and increased sedimentationrate.

y All the patients were of classical rheumatoidarthritis according to American RheumatismAssociation criteria.


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y The individuals having clinical history of diseases

such as Diabetes Mellitus, Cardio vascular Disease,Inflammatory diseases, infectious diseases liketuberculosis etc were excluded.


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y 100 sero-positive patients of rheumatoid arthritisfrom various wards of Government MedicalCollege Amritsar and ESI Hospital Amritsar were

included in the course of study.

y Equal number of age and sex matched normal

individuals asymptomatic of the disease wereincluded as controls.


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yAll the normal individuals and patients weresubjected to the following investigations,

yRheumatoid Factor.

y Erythrocyte Sedimentation Rate.

y C-Reactive Proteins & Uric Acid.

yAdenosine Deaminase and

yVitamin C .


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y Statistical analysis was done using students t test.

y

Patients were divided into three group

y Group I : included patients suffering fromrheumatoid arthritis for a period of 5yearsof suffering.

y Results & Discussion:


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RESULTS ANDDISCUSSION


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y Uric Acid an endogenous aqueous antioxidant inhumans contributes as much as 2/3rd of all free

radical scavenging capacity in plasma.

y Effective in quenching hydroxyl ,superoxide,peroxal and peroxynitrite radical.

yAlso prevent lipid per oxidation.


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y In the present study average uric acid levels ofpatients of rheumatoid arthritis were found to beclose to the normal individuals.

yWhen uric acid levels were analyzed on the basis

of the duration of the disease a unique feature wasobserved.


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The patients who were having longer duration ofthe disease had least uric acid levels as comparedto those who were suffering from the disease for arelatively lesser period.

y A closer look into the levels of antioxidant vitaminC revealed that serum vitamin C levels weresignificantly reduced in rheumatoid arthritispatients (p


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y Further the levels of vitamin C were found to fallwith the increase in duration of the disease

suggesting the consumption of vitamin C formopping up the free radicals neutralizing theoxidative properties of these free radicals.


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y Furthermore antioxidant role of ascorbic acid is aseffective as that of uric acid.

y Since uric acid concentration of plasma in humanbeings is much more than that of plasma ascorbicacid, the uric acid contributes more to the

scavenging action of free radicals than ascorbicacid.


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y It is therefore proposed that the uric acid producedas a result of excessive activity of adenosinedeaminase liberated in response to inflammatoryprocess in rheumatoid arthritis plays a significantrole in scavenging the free radicals produced.


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y Reduction in the levels of vitamin C (Table II;p


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y The message to the clinicians is that, they shouldnot target at too much lowering of uric acid valueskeeping in view the antioxidant effects of uric acid.

yVitamin C should be supplemented in diet to raisethe levels of vitamin C in the blood so that its

antioxidant effects can be potentiated.


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THANKYOU.

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