P422Purine metabolism and multiple sclerosis: pattern variesaccording to disease stage and clinical formG. Salemi, M. Gueli, V. Cusimano, M. Lo Re, V. Lo Re,M.A. Mazzola, S. Realmuto, P. Ragonese, G. SavettieriUniversity (Palermo, IT)Background: Serum concentration of uric acid (sUA) wasvariably associated with Multiple Sclerosis (MS). Many papersreported lower sUA in MS patients respect to healthy controls,expecially in course of relapse. This lower sUA was consideredas a marker of oxidative stress. However, this association was notconfirmed by many other papers. Recently, an increase in the concentrationof sUA, hypoxanthine, xanthine, and sum of oxypurine(sPU) was reported in a population of MS patients by HPLCdetection. The authors suggested that this could be an index ofa sustained purine catabolism, possibly due to imbalance in ATPhomeostasis.Objective: To compare sUA and sPU between MS during stabledisease and healthy controls. To confront sUA and sPU amongdifferent MS subtypes. To search for modification of sUA andsPU during and after a clinical relapse.Materials and Methods: We included MS patients with relapsing-remitting MS (RRMS), secondary-progressive MS (SPMS),and primary-progressive MS (PPMS) during stable disease and agroup of healthy controls comparable for gender and age. Venousblood samples were obtained and the concentration of purinecompounds was determined by HPLC separation. Moreover, subjectswith MS were identified in course of a clinical relapse. Bloodsamples were obtained within two days from the onset, after 30and 60 days and processed by HPLC. Non parametric tests wereused to compare results between the groups.Results: We included 94 MS patients (74 RRMS, 14 SPMS, 6PPMS) and 94 healthy controls. Median serum xanthine (p =0.002), sUA (p = 0.0004) and sPU (p = 0.0002) concentrationswere higher in MS sample. In RRMS median hypoxanthine concentrationwas lower respect to SPMS (0.002) and PPMS (0.01),while median sUA (p = 0.004) and sPU (p = 0.005) concentrationwas higher than in SPMS. Ten patients were included in courseof a clinical relapse. No significant changes in the concentrationof sUA aor sPU were observed comparing the first days after arelapse and the period post-relapse.Conclusion: Our data support the thesis that the changes at sUAand sPU observed in course of MS could be an index of a sustainedpurine catabolism, possibly due to imbalance in ATP homeostasis.
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|Publication status||Published - 2013|