Мочевая кислота, когнитивные расстройства, нейродегенерация

Елисеев М.С., Желябина О.В., Насонов Е.Л. Мочевая кислота, когнитивные расстройства, нейродегенерация. Терапевтический архив. 2024;96(5):447–452. DOI: 10.26442/00403660.2024.05.202698

© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.

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Eliseev MS, Zheliabina OV, Nasonov EL. Uric acid, cognitive disorders, neurodegeneration. Terapevticheskii Arkhiv (Ter. Arkh.). 2024;96(5):447–452. DOI: 10.26442/00403660.2024.05.202698

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Аннотация

В данной статье рассматривается роль мочевой кислоты (МК) в когнитивных изменениях и нейродегенерации, акцентируется внимание на ее функциях как антиоксиданта и прооксиданта. Исследования показывают, что изменения уровней МК в сыворотке крови могут быть связаны с развитием или замедлением когнитивных нарушений, особенно в контексте нейродегенеративных заболеваний, таких как болезнь Альцгеймера. Выявлено, что существует взаимосвязь между уровнем МК и динамикой когнитивных функций, указывая на потенциальные нейропротекторные свойства МК. Особое внимание уделяется балансу между антиоксидантными и прооксидантными свойствами МК, который может играть ключевую роль в защите нейронов от повреждения. Однако результаты работ не являются однозначными, подчеркивая необходимость дальнейших исследований для более полного понимания роли МК в когнитивных процессах. Определение оптимального уровня МК в сыворотке может стать важным шагом в разработке стратегий профилактики и лечения когнитивных нарушений, связанных с нейродегенерацией. В целом данные исследования расширяют понимание механизмов, лежащих в основе взаимодействия между метаболизмом МК и здоровьем мозга.

Ключевые слова: мочевая кислота, нейродегенерация, когнитивные функции, антиоксидант, прооксидант

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This article examines the role of uric acid (UA) in cognitive changes and neurodegeneration, focusing on its functions as an antioxidant and prooxidant. Research suggests that changes in serum UA levels may be associated with the development or delay of cognitive impairment, especially in the context of neurodegenerative diseases such as Alzheimer's disease. It was revealed that there is a relationship between the level of UA and the dynamics of cognitive functions, indicating the potential neuroprotective properties of UA. Particular attention is paid to the balance between the antioxidant and prooxidant properties of UA, which may play a key role in protecting neurons from damage. However, research results are not clear-cut, highlighting the need for further research to more fully understand the role of UA in cognitive processes. Determining the optimal serum UA level may be an important step in developing strategies for the prevention and treatment of cognitive impairment associated with neurodegeneration. Overall, these studies advance the understanding of the mechanisms underlying the interaction between uric acid metabolism and brain health.

Keywords: uric acid, neurodegeneration, cognitive function, antioxidant, prooxidant

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Список литературы

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12. Fumagalli M, Lecca D, Abbracchio MP, Ceruti S. Pathophysiological Role of Purines and Pyrimidines in Neurodevelopment: Unveiling New Pharmacological Approaches to Congenital Brain Diseases. Front Pharmacol. 2017;8:941. DOI:10.3389/fphar.2017.00941
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21. Liu Q, Liao X, Pan Y, et al. Association Between Serum Uric Acid Levels and Cognitive Function in Patients with Ischemic Stroke and Transient Ischemic Attack (TIA): A 3-Month Follow-Up Study. Neuropsychiatr Dis Treat. 2021;17:991-9. DOI:10.2147/NDT.S300893
22. Kawada T. Serum uric acid and dementia subtype. Neurol Sci. 2023;44(8):2951. DOI:10.1007/s10072-023-06798-6
23. Johnson RJ, Tolan DR, Bredesen D, et al. Could Alzheimer's disease be a maladaptation of an evolutionary survival pathway mediated by intracerebral fructose and uric acid metabolism? Am J Clin Nutr. 2023;117(3):455-66. DOI:10.1016/j.ajcnut.2023.01.002
24. Du N, Xu D, Hou X, et al. Inverse Association Between Serum Uric Acid Levels and Alzheimer's Disease Risk. Mol Neurobiol. 2016;53(4):2594-9. DOI:10.1007/s12035-015-9271-6
25. Chen X, Guo X, Huang R, et al. Serum uric acid levels in patients with Alzheimer's disease: a meta-analysis. PLoS One. 2014;9(4):e94084. DOI:10.1371/journal.pone.0094084
26. Cervellati C, Cremonini E, Bosi C, et al. Systemic oxidative stress in older patients with mild cognitive impairment or late onset Alzheimer's disease. Curr Alzheimer Res. 2013;10(4):365-72. DOI:10.2174/1567205011310040003
27. Beydoun MA, Beydoun HA, Gamaldo AA, et al. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014;14:643. DOI:10.1186/1471-2458-14-643
28. Seifar F, Dinasarapu AR, Jinnah HA. Uric Acid in Parkinson's Disease: What Is the Connection? Mov Disord. 2022;37(11):2173-83. DOI:10.1002/mds.29209
29. Tahavvori A, Gargari MK, Yazdani Y, et al. Involvement of antioxidant enzymes in Parkinson's disease. Pathol Res Pract. 2023;249:154757. DOI:10.1016/j.prp.2023.154757
30. Euser SM, Hofman A, Westendorp RG, Breteler MM. Serum uric acid and cognitive function and dementia. Brain. 2009(Pt. 2): 132:377-82. DOI:10.1093/brain/awn316
31. Verhaaren BF, Vernooij MW, Dehghan A, et al. The relation of uric acid to brain atrophy and cognition: The Rotterdam Scan Study. Neuroepidemiology. 2013;41:29-34. DOI:10.1159/000346606
32. Hong JY, Lan TY, Tang GJ, et al. Gout and the risk of dementia: A nationwide population-based cohort study. J Arthritis Res Ther. 2015;17:139. DOI:10.1186/s13075-015-0642-1
33. Li Q, Cen K, Cui Y, et al. Uric acid levels and their association with vascular dementia and Parkinson's disease dementia: a meta-analysis. Neurol Sci. 2023;44(6):2017-24. DOI:10.1007/s10072-023-06620-3
34. Kawada T, Anang JB, Postuma R. Predictors of dementia in Parkinson disease: a prospective cohort study. Neurology. 2015;84(12):1285. DOI:10.1212/WNL.0000000000001408
35. Latourte A, Soumaré A, Bardin T, et al. Uric acid and incident dementia over 12 years of follow-up: a population-based cohort study. Ann Rheum Dis. 2018;77(3):328-35. DOI:10.1136/annrheumdis-2016-210767
36. Scheepers LEJM, Jacobsson LTH, Kern S, et al. Urate and risk of Alzheimer's disease and vascular dementia: A population-based study. Alzheimers Dement. 2019;15(6):754-63. DOI:10.1016/j.jalz.2019.01.014
37. Salam AP, Borsini A, Zunszain PA. Trained innate immunity: a salient factor in the pathogenesis of neuroimmune psychiatric disorders. Mol Psychiatry. 2018;23(2):170-6. DOI:10.1038/mp.2017.186
38. Noz MP, Ter Telgte A, Wiegertjes K, et al. Trained Immunity Characteristics Are Associated With Progressive Cerebral Small Vessel Disease. Stroke. 2018;49(12):2910-7. DOI:10.1161/STROKEAHA.118.023192
39. Sfera A, Gradini R, Cummings M, et al. Rusty Microglia: Trainers of Innate Immunity in Alzheimer's Disease. Front Neurol. 2018;9:1062. DOI:10.3389/fneur.2018.01062
40. Cabău G, Crișan TO, Klück V, et al. Urate-induced immune programming: Consequences for gouty arthritis and hyperuricemia. Immunol Rev. 2020;294(1):92-105. DOI:10.1111/imr.12833
41. Tanaka T, Milaneschi Y, Zhang Y, et al. A double blind placebo controlled randomized trial of the effect of acute uric acid changes on inflammatory markers in humans: a pilot study. PLoS ONE. 2017;12(8):1-19. DOI:10.1371/journal.pone.0181100

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1. Mijailovic NR, Vesic K, Borovcanin MM. The Influence of Serum Uric Acid on the Brain and Cognitive Dysfunction. Front Psychiatr. 2022;13. DOI:10.3389/fpsyt.2022.828476
2. Wang T, Wu Y, Sun Y, et al. A Prospective Study on the Association between Uric Acid and Cognitive Function among Middle-Aged and Older Chinese. J Alzheimers Dis.
2017;58(1):79-86. DOI:10.3233/JAD-161243
3. Chen-Xu M, Yokose C, Rai SK, et al. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007–2016. Arthritis Rheumatol. 2019;71(6):991-9. DOI:10.1002/art.40807
4. Kuwabara M, Fukuuchi T, Aoki Y, et al. Exploring the Multifaceted Nexus of Uric Acid and Health: A Review of Recent Studies on Diverse Diseases. Biomolecules. 2023;13(10):1519. DOI:10.3390/biom13101519
5. Baddeley A. Working memory: theories, models, and controversies. Annu Rev Psychol. 2012;63:1-29. DOI:10.1146/annurev-psych-120710-100422
6. Zhu Z, Zwerling JL, Qi X, et al. Mechanisms of Change in Cognitive Function Domains Among Older Adults in Cognitive Deterioration and Improvement Groups: Evidence From Phenotypic Network Structure. J Am Med Dir Assoc. 2023;24(12):2009-16.e9. DOI:10.1016/j.jamda.2023.08.022
7. Jaeggi SM, Buschkuehl M, Jonides J, et al. Improving fluid intelligence with training on working memory. Proc Natl Acad Sci U S A. 2008;105(19):6829-33. DOI:10.1073/pnas.0801268105
8. Guerreiro S, Privat AL, Bressac L, Toulorge D. CD38 in Neurodegeneration and Neuroinflammation. Cells. 2020;9(2):471. DOI:10.3390/cells9020471
9. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. JAMA. 2019;322(16):1589-99. DOI:10.1001/jama.2019.4782
10. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-46. DOI:10.1016/S0140-6736(20)30367-6
11. Tang X, Song Z-H, Cardoso MA, et al. The relationship between uric acid and brain health from observational studies. Metab Brain Dis. 2022;37(6):1989-2003.
DOI:10.1007/s11011-022-01016-2
12. Fumagalli M, Lecca D, Abbracchio MP, Ceruti S. Pathophysiological Role of Purines and Pyrimidines in Neurodevelopment: Unveiling New Pharmacological Approaches to Congenital Brain Diseases. Front Pharmacol. 2017;8:941. DOI:10.3389/fphar.2017.00941
13. Orowan E. The origin of man. Nature. 1955;175(4459):683-4. DOI:10.1038/175683a0
14. Stetten D Jr, Hearon JZ. Intellectual level measured by army classification battery and serum uric acid concentration. Science. 1959;129(3365):1737. DOI:10.1126/science.129.3365.1737
15. Liu Q, Peng M, Yang T, Si G. Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies. PLoS One. 2023;18(11):e0293832. DOI:10.1371/journal.pone.0293832
16. Huang S, Wang J, Fan DY, et al. The association of serum uric acid with cognitive impairment and ATN biomarkers. Front Aging Neurosci. 2022;14:943380. DOI:10.3389/fnagi.2022.943380
17. Min KH, Kang SO, Oh SJ, et al. Association Between Gout and Dementia in the Elderly: A Nationwide Population-Based Cohort Study. Am J Geriatr Psychiatr. 2021;29(12):1177-85. DOI:10.1016/j.jagp.2021.01.016
18. Merighi S, Nigro M, Travagli A, et al. A2A Adenosine Receptor: A Possible Therapeutic Target for Alzheimer's Disease by Regulating NLRP3 Inflammasome Activity? Int J Mol Sci. 2022;23(9):5056. DOI:10.3390/ijms23095056
19. Nasonov EL, Eliseev MS. Role of interleukin 1 in the development of human diseases. Rheumatology Science and Practice. 2016;54(1):60-77 (in Russian).
DOI:10.14412/1995-4484-2016-60-77
20. Wang J, Jin R, Wu Z, et al. Moderate increase of serum uric acid within a normal range is associated with improved cognitive function in a non-normotensive population: A nationally representative cohort study. Front Aging Neurosci. 2022;14:944341. DOI:10.3389/fnagi.2022.944341
21. Liu Q, Liao X, Pan Y, et al. Association Between Serum Uric Acid Levels and Cognitive Function in Patients with Ischemic Stroke and Transient Ischemic Attack (TIA): A 3-Month Follow-Up Study. Neuropsychiatr Dis Treat. 2021;17:991-9. DOI:10.2147/NDT.S300893
22. Kawada T. Serum uric acid and dementia subtype. Neurol Sci. 2023;44(8):2951. DOI:10.1007/s10072-023-06798-6
23. Johnson RJ, Tolan DR, Bredesen D, et al. Could Alzheimer's disease be a maladaptation of an evolutionary survival pathway mediated by intracerebral fructose and uric acid metabolism? Am J Clin Nutr. 2023;117(3):455-66. DOI:10.1016/j.ajcnut.2023.01.002
24. Du N, Xu D, Hou X, et al. Inverse Association Between Serum Uric Acid Levels and Alzheimer's Disease Risk. Mol Neurobiol. 2016;53(4):2594-9. DOI:10.1007/s12035-015-9271-6
25. Chen X, Guo X, Huang R, et al. Serum uric acid levels in patients with Alzheimer's disease: a meta-analysis. PLoS One. 2014;9(4):e94084. DOI:10.1371/journal.pone.0094084
26. Cervellati C, Cremonini E, Bosi C, et al. Systemic oxidative stress in older patients with mild cognitive impairment or late onset Alzheimer's disease. Curr Alzheimer Res. 2013;10(4):365-72. DOI:10.2174/1567205011310040003
27. Beydoun MA, Beydoun HA, Gamaldo AA, et al. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014;14:643. DOI:10.1186/1471-2458-14-643
28. Seifar F, Dinasarapu AR, Jinnah HA. Uric Acid in Parkinson's Disease: What Is the Connection? Mov Disord. 2022;37(11):2173-83. DOI:10.1002/mds.29209
29. Tahavvori A, Gargari MK, Yazdani Y, et al. Involvement of antioxidant enzymes in Parkinson's disease. Pathol Res Pract. 2023;249:154757. DOI:10.1016/j.prp.2023.154757
30. Euser SM, Hofman A, Westendorp RG, Breteler MM. Serum uric acid and cognitive function and dementia. Brain. 2009(Pt. 2): 132:377-82. DOI:10.1093/brain/awn316
31. Verhaaren BF, Vernooij MW, Dehghan A, et al. The relation of uric acid to brain atrophy and cognition: The Rotterdam Scan Study. Neuroepidemiology. 2013;41:29-34. DOI:10.1159/000346606
32. Hong JY, Lan TY, Tang GJ, et al. Gout and the risk of dementia: A nationwide population-based cohort study. J Arthritis Res Ther. 2015;17:139. DOI:10.1186/s13075-015-0642-1
33. Li Q, Cen K, Cui Y, et al. Uric acid levels and their association with vascular dementia and Parkinson's disease dementia: a meta-analysis. Neurol Sci. 2023;44(6):2017-24. DOI:10.1007/s10072-023-06620-3
34. Kawada T, Anang JB, Postuma R. Predictors of dementia in Parkinson disease: a prospective cohort study. Neurology. 2015;84(12):1285. DOI:10.1212/WNL.0000000000001408
35. Latourte A, Soumaré A, Bardin T, et al. Uric acid and incident dementia over 12 years of follow-up: a population-based cohort study. Ann Rheum Dis. 2018;77(3):328-35. DOI:10.1136/annrheumdis-2016-210767
36. Scheepers LEJM, Jacobsson LTH, Kern S, et al. Urate and risk of Alzheimer's disease and vascular dementia: A population-based study. Alzheimers Dement. 2019;15(6):754-63. DOI:10.1016/j.jalz.2019.01.014
37. Salam AP, Borsini A, Zunszain PA. Trained innate immunity: a salient factor in the pathogenesis of neuroimmune psychiatric disorders. Mol Psychiatry. 2018;23(2):170-6. DOI:10.1038/mp.2017.186
38. Noz MP, Ter Telgte A, Wiegertjes K, et al. Trained Immunity Characteristics Are Associated With Progressive Cerebral Small Vessel Disease. Stroke. 2018;49(12):2910-7. DOI:10.1161/STROKEAHA.118.023192
39. Sfera A, Gradini R, Cummings M, et al. Rusty Microglia: Trainers of Innate Immunity in Alzheimer's Disease. Front Neurol. 2018;9:1062. DOI:10.3389/fneur.2018.01062
40. Cabău G, Crișan TO, Klück V, et al. Urate-induced immune programming: Consequences for gouty arthritis and hyperuricemia. Immunol Rev. 2020;294(1):92-105. DOI:10.1111/imr.12833
41. Tanaka T, Milaneschi Y, Zhang Y, et al. A double blind placebo controlled randomized trial of the effect of acute uric acid changes on inflammatory markers in humans: a pilot study. PLoS ONE. 2017;12(8):1-19. DOI:10.1371/journal.pone.0181100

Авторы

М.С. Елисеев*¹, О.В. Желябина¹, Е.Л. Насонов^1,2

¹ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
²ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*elicmax@rambler.ru

________________________________________________

Maxim S. Eliseev*¹, Olga V. Zheliabina¹, Evgeny L. Nasonov^1,2

¹Nasonova Research Institute of Rheumatology, Moscow, Russia;
²Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*elicmax@rambler.ru

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