Роль мочевой кислоты в развитии сердечно-сосудистых заболеваний: от молекулярных механизмов до клинических проявлений
- Авторы: Куницкая Н.А.1, Арьев А.Л.1, Немировский В.С.1
-
Учреждения:
- Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России
- Выпуск: Том 33, № 6 (2022)
- Страницы: 5-12
- Раздел: Актуальная тема
- URL: https://journals.eco-vector.com/0236-3054/article/view/114628
- DOI: https://doi.org/10.29296/25877305-2022-06-01
- ID: 114628
Цитировать
Полный текст
Доступ предоставлен
Доступ платный или только для подписчиков
Аннотация
Мочевая кислота (МК) является конечным продуктом метаболизма пуриновых нуклеотидов в организме человека. Распространенность гиперурикемии (ГУ) растет во всем мире. Эпидемиологические исследования показали, что уровни МК положительно коррелируют с сердечно-сосудистыми заболеваниями (ССЗ), включая артериальную гипертензию, атеросклероз, мерцательную аритмию и сердечную недостаточность. ГУ способствует возникновению и развитию ССЗ, регулируя молекулярные сигналы, такие как воспалительная реакция, окислительный стресс, инсулинорезистентность и эндотелиальная дисфункция. Несмотря на многочисленные исследования, молекулярные механизмы развития ГУ до сих пор неясны. Известно, что ингибитор ксантиноксидазы (КСО) -аллопуринол - улучшает сердечно-сосудистые исходы у пациентов с сердечной недостаточностью, ИБС, сахарным диабетом типа 2 и гипертрофией миокарда левого желудочка. Может ли другой ингибитор КСО - фебуксостат - положительно влиять на сердечно-сосудистую систему? Кроме того, неясно может ли лечение, снижающее содержание МК, принести пользу пациентам с бессимптомной ГУ. В данном обзоре представлены современные данные о клеточных и молекулярных взаимосвязях ССЗ, связанных с ГУ, а также клинические данные об эффективности уратснижающей терапии у пациентов с ССЗ.
Полный текст
Об авторах
Н. А. Куницкая
Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России
Email: scvssd@yandex.ru
доктор медицинских наук
А. Л. Арьев
Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России
Email: scvssd@yandex.ru
доктор медицинских наук, профессор
В. С. Немировский
Северо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России
Автор, ответственный за переписку.
Email: scvssd@yandex.ru
кандидат медицинских наук
Список литературы
- Alberts B.M., Barber J.S., Sacre S.M. et al. Precipitation of Soluble Uric Acid Is Necessary for In Vitro Activation of the NLRP3 Inflammasome in Primary Human Monocytes. J. Rheumatol. 2019; 46 (9): 1141-50. doi: 10.3899/jrheum.180855
- Battelli M.G., Bortolotti M., Polito L. et al. The role of xanthine oxidoreductase and uric acid in metabolic syndrome. Biochim Biophys Acta Mol Basis Dis. 2018; 1864 (8): 2557-65. doi: 10.1016/j.bbadis.2018.05.003
- Bjornstad P., Laffel L., Lynch J. et al. Elevated Serum Uric Acid Is Associated With Greater Risk for Hypertension and Diabetic Kidney Diseases in Obese Adolescents With Type 2 Diabetes: An Observational Analysis From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study. Diabetes Care. 2019; 42 (6): 1120-8. doi: 10.2337/dc18-2147
- Black-Maier E., Daubert J.P. Editorial Commentary: Prevention and treatment of atrial fibrillation: Is hyperuricemia the next target? Trends Cardiovasc. Med. 2019; 29 (1): 48-9. doi: 10.1016/j.tcm.2018.07.006
- Borgi L., McMullan C., Wohlhueter A. et al. Effect of Uric Acid-Lowering Agents on Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Trial. Hypertension. 2017; 69 (2): 243-8. doi: 10.1161/HYPERTENSIONAHA.116.08488
- Braga F., Pasqualetti S., Ferraro S., et al. Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and metaanalysis. Clin Chem Lab Med. 2016; 54 (1): 7-15. doi: 10.1515/cclm-2015-0523
- Cai W., Duan X.M., Liu Y. et al. Uric Acid Induces Endothelial Dysfunction by Activating the HMGB1/RAGE Signaling Pathway. BioMed Res Int. 2017; 2017: 4391920. doi: 10.1155/2017/4391920
- Canpolat U., Aytemir K., Yorgun H. et al. Usefulness of serum uric acid level to predict atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace. 2014; 16 (12): 1731-7. doi: 10.1093/europace/euu198
- Chen Y., Xia Y., Han X. et al. Association between serum uric acid and atrial fibrillation: a cross-sectional communitybased study in China. BMJ Open. 2017; 7 (12): e019037. doi: 10.1136/bmjopen-2017-019037
- Chen X., Umeh C.C., Tainsh R.E. et al. Dissociation between urate and blood pressure in mice and in people with early Parkinson's disease. EBioMedicine. 2018; 37: 259-68. doi: 10.1016/j.ebiom.2018.10.039
- Chen C.H., Chen C.B., Chang C.J. et al. Hypersensitivity and Cardiovascular Risks Related to Allopurinol and Febuxostat Therapy in Asians: A Population-Based Cohort Study and Meta-Analysis. Clin Pharmacol Ther. 2019; 106 (2): 391-401. doi: 10.1002/cpt.1377
- Dai X.M., Wei L., Ma L.L. et al. Serum uric acid and its relationship with cardiovascular risk profile in Chinese patients with early-onset coronary artery disease. Clin Rheumatol. 2015; 34 (9): 1605-11. doi: 10.1007/s10067-015-2878-1
- Grayson P.C., Kim S.Y., LaValley M. et al. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011; 63 (1): 102-10. doi: 10.1002/acr.20344
- Hao Y., Li H., Cao Y. et al. Uricase and Horseradish Peroxidase Hybrid CaHPO(4) Nanoflower Integrated with Transcutaneous Patches for Treatment of Hyperuricemia. J. BioMed Nanotechnol. 2019; 15 (5): 951-65. doi: 10.1166/jbn.2019.2752
- Huang H., Huang B., Li Y. et al. Uric acid and risk of heart failure: a systematic review and meta-analysis. Eur J. Heart Fail. 2014; 16 (1): 15-24. doi: 10.1093/eurjhf/hft132
- Huang T.T., Hao D.L., Wu B.N. et al. Uric acid demonstrates neuroprotective effect on Parkinson's disease mice through Nrf2- ARE signaling pathway. Biochem Biophys Res Commun. 2017; 493 (4): 1443-9. doi: 10.1016/j.bbrc.2017.10.004
- Jadhav S.N., Radchenko V.G., Seliverstov P.V. et al. Importance of insulin resistance in patients with nonalcoholic fatty liver disease and diastolic dysfunction of the heart. Preventive and clinical medicine. 2019; 2 (71): 52-9.
- Johnson R.J., Bakris G.L., Borghi C. et al. Hyperuricemia, Acute and Chronic Kidney Disease, Hypertension, and Cardiovascular Disease: Report of a Scientific Workshop Organized by the National Kidney Foundation. Am J. Kidney Dis. 2018; 71 (6): 851-65. DOI: 10.1053/j. ajkd.2017.12.009
- Johnson, R.J., Choi H.K., Yeo A.E. et al. Pegloticase Treatment Significantly Decreases Blood Pressure in Patients With Chronic Gout. Hypertension. 2019; 74 (1): 95-101. doi: 10.1161/HYPERTENSIONAHA.119.12727
- Jun J.E., Lee Y.B., Lee S.E. et al. Elevated serum uric acid predicts the development of moderate coronary artery calcification independent of conventional cardiovascular risk factors. Atherosclerosis. 2018; 272: 233-9. doi: 10.1016/j.atherosclerosis.2018.02.014
- Khaliq O.P., Konoshita T., Moodley J. et al. The Role of Uric Acid in Preeclampsia: Is Uric Acid a Causative Factor or a Sign of Preeclampsia? Curr Hypertens Rep. 2018; 20 (9): 80. doi: 10.1007/s11906-018-0878-7
- Kim S.K., Choe J.Y., Park K.Y. Anti-inflammatory effect of artemisinin on uric acid-induced NLRP3 inflammasome activation through blocking interaction between NLRP3 and NEK7. Biochem Biophys Res Commun. 2019; 517 (2): 338-45. doi: 10.1016/j.bbrc.2019.07.087
- Kimura Y., Yanagida T., Onda A. et al. Soluble Uric Acid Promotes Atherosclerosis via AMPK (AMPActivated Protein Kinase)-Mediated Inflammation. Arterioscler Thromb Vasc Biol. 2020; 40 (3): 570-82. doi: 10.1161/ATVBAHA.119.313224
- Klisic A., Kocic G., Kavaric N. et al. Xanthine oxidase and uric acid as independent predictors of albuminuria in patients with diabetes mellitus type 2. Clin Exp Med. 2018; 18 (2): 283-90. doi: 10.1007/s10238-017-0483-0
- Kobayashi N., Asai K., Tsurumi M. et al. Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome. Cardiology. 2018; 141 (4): 190-8. doi: 10.1159/000496053
- Kramer F., Voss S., Roessig L. et al. Evaluation of high-sensitivity C-reactive protein and uric acid in vericiguattreated patients with heart failure with reduced ejection fraction. Eur J. Heart Fail. 2020; 22 (9): 1675-83. doi: 10.1002/ejhf.1787
- Kuwabara M., Borghi C., Cicero A.F.G. et al. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia: A five-year cohort study in Japan. Int J. Cardiol. 2018; 261: 183-8. doi: 10.1016/j.ijcard.2018.03.045
- Kuwabara M., Hisatome I., Niwa K. et al. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension: A 5-Year Japanese Cohort Study. Hypertension. 2018; 71 (1): 78-86. doi: 10.1161/HYPERTENSIONAHA.117.10370
- Li Z., Shen Y., Chen Y. et al. High Uric Acid Inhibits Cardiomyocyte Viability Through the ERK/P38 Pathway via Oxidative Stress. Cell Physiol Biochem. 2018; 45 (3): 1156-64. doi: 10.1159/000487356
- Li H., Qian F., Liu H. et al. Elevated Uric Acid Levels Promote Vascular Smooth Muscle Cells (VSMC) Proliferation via an Nod-Like Receptor Protein 3 (NLRP3)-Inflammasome-Dependent Mechanism. Med Sci Monit. 2019; 25: 8457-64. doi: 10.12659/MSM.916667
- Li M., Hu X., Fan Y. et al. Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis. Sci Rep. 2016; 6: 19520. doi: 10.1038/srep19520
- Lin W.D., Deng H., Guo P. et al. High prevalence of hyperuricaemia and its impact on non-valvular atrial fibrillation: the cross-sectional Guangzhou (China) Heart Study. BMJ Open. 2019; 9 (5), e028007. doi: 10.1136/bmjopen-2018-028007
- Lu J., Sun M., Wu X. et al. Urate-lowering therapy alleviates atherosclerosis inflammatory response factors and neointimal lesions in a mouse model of induced carotid atherosclerosis. FEBS J. 2019; 286 (7): 1346-59. doi: 10.1111/febs.14768
- Lu J., He Y., Cui L. et al. Hyperuricemia Predisposes to the Onset of Diabetes via Promoting Pancreatic beta-Cell Death in Uricase-Deficient Male Mice. Diabetes. 2020; 69 (6): 1149-63. doi: 10.2337/db19-0704
- Mantovani A., Rigolon R., Civettini A. et al. Hyperuricemia is associated with an increased prevalence of paroxysmal atrial fibrillation in patients with type 2 diabetes referred for clinically indicated 24-h Holter monitoring. J. Endocrinol Invest. 2018; 41 (2): 223-31. doi: 10.1007/s40618-017-0729-4
- Maruhashi T., Hisatome I., Kihara Y. et al. Hyperuricemia and endothelial function: From molecular background to clinical perspectives. Atherosclerosis. 2018; 278: 226-31. doi: 10.1016/j.atherosclerosis.2018.10.007
- McMurray J.J.V., Solomon S.D., Inzucchi S.E. et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N. Engl J. Med. 2019; 381 (21): 1995-2008. doi: 10.1056/NEJMoa1911303
- Mortada I. Hyperuricemia, Type 2 Diabetes Mellitus, and Hypertension: an Emerging Association. Curr Hypertens Rep. 2017; 19 (9): 69. doi: 10.1007/s11906-017-0770-x
- Nidorf M., Jelinek M. Serendipity: How the search for meaning of serum uric acid might lead to the repurposing of an old drug in patients with cardiovascular disease. Eur J. Prev Cardiol. 2018; 25 (3): 231-2. doi: 10.1177/2047487317749039
- Pak S., Yatsynovich Y., Valencia D. et al. Serum Uric Acid and Atrial Fibrillation: Metaanalysis. Crit Pathw Cardiol. 2018; 17 (3): 161-6. doi: 10.1097/HPC.0000000000000150
- Palazzuoli A., Ruocco G., De Vivo O. et al. Prevalence of Hyperuricemia in Patients With Acute Heart Failure With Either Reduced or Preserved Ejection Fraction. Am J. Cardiol. 2017; 120 (7): 1146-50. doi: 10.1016/j.amjcard.2017.06.057
- Pavlusova M., Jarkovsky J., Benesova K. et al. Hyperuricemia treatment in acute heart failure patients does not improve their long-term prognosis: A propensity score matched analysis from the AHEAD registry. Clin Cardiol. 2019; 42 (8): 720-7. doi: 10.1002/clc.23197
- Sakr H.I., Khowailed A.A., Al-Fakharany R.S. et al. Serum Uric Acid Level as a Predictive Biomarker of Gestational Hypertension Severity; A Prospective Observational Case-Control Study. Rev Recent Clin Trials. 2020; 15 (3): 227-39. doi: 10.2174/157488711566620 0709142119
- Singh J.A., Cleveland J. Allopurinol and the risk of incident peripheral arterial disease in the elderly: a US Medicare claims data study. Rheumatol (Oxford). 2018; 57 (3): 451-61. doi: 10.1093/rheumatology/kex232
- Singh G., Lingala B., Mithal A. Gout and hyperuricaemia in the USA: prevalence and trends. Rheumatol (Oxford). 2019; 58 (12): 2177-80. doi: 10.1093/rheumatology/kez196
- Sun H.L., Pei D., Lue K.H. et al. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PloS One. 2015; 10 (11): e0143786. doi: 10.1371/journal.pone.0143786
- Taufiq F., Maharani N., Li P. et al. Uric Acid-Induced Enhancements of Kv1.5 Protein Expression and Channel Activity via the Akt-HSF1-Hsp70 Pathway in HL-1 Atrial Myocytes. Circ J. 2019; 83 (4): 718-26. doi: 10.1253/circj.CJ-18-1088
- Tomiyama H., Shiina K., Vlachopoulos C. et al. Involvement of Arterial Stiffness and Inflammation in Hyperuricemia-Related Development of Hypertension. Hypertension. 2018; 72 (3): 739-45. doi: 10.1161/HYPERTENSIONAHA.118.11390
- Vaduganathan M., Greene S.J., Ambrosy A.P. et al. Relation of serum uric acid levels and outcomes among patients hospitalized for worsening heart failure with reduced ejection fraction (from the efficacy of vasopressin antagonism in heart failure outcome study with tolvaptan trial). Am J. Cardiol. 2014; 114 (11): 1713-21. DOI: 10.1016/j. amjcard.2014.09.008
- Virdis A., Masi S., Casiglia E. et al. Identification of the Uric Acid Thresholds Predicting an Increased Total and Cardiovascular Mortality Over 20 Years. Hypertension. 2020; 75 (2): 302-8. doi: 10.1161/HYPERTENSIONAHA.119.13643
- von Lueder T.G., Girerd N., Atar D. et al. Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the High-Risk Myocardial Infarction Database Initiative. Eur J. Heart Fail. 2015; 17 (11): 1144-51. doi: 10.1002/ejhf.419
- Wang G.L., Yuan H.M., Wang Z.F. et al. Soluble Uric Acid Activates NLRP3 Inflammasome in Myocardial Cells Through Down-regulating UCP2. Sichuan Da Xue Xue Bao YiXue Ban. 2018; 49 (4): 512-7.
- Wang I.K., Chen J.H., Muo C.H. et al. Subsequent risk of gout for women with hypertensive disorders in pregnancy: a retrospective cohort study. J. Hypertens. 2016; 34 (5): 914-9. doi: 10.1097/HJH.0000000000000888
- White W.B., Saag K.G., Becker M.A. et al. Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. N. Engl J. Med. 2018; 378 (13): 1200-10. doi: 10.1056/NEJMoa1710895
- Wilcox C.S., Shen W., Boulton D.W. et al. Interaction Between the Sodium-Glucose-Linked Transporter 2 Inhibitor Dapagliflozin and the Loop Diuretic Bumetanide in Normal Human Subjects. J. Am Heart Assoc. 2018; 7 (4): e007046. doi: 10.1161/JAHA.117.007046
- Wiviott S.D., Raz I., Bonaca M.P. et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N. Engl J. Med. 2019; 380 (4): 347-57. doi: 10.1056/NEJMoa1812389
- Xin Y., Guo Y., Li Y. et al. Effects of sodium glucose cotransporter-2 inhibitors on serum uric acid in type 2 diabetes mellitus: A systematic review with an indirect comparison meta-analysis. Saudi J. Biol Sci. 2019; 26 (2): 421-6. doi: 10.1016/j.sjbs.2018.11.013
- Yan M., Chen K., He L. et al. Uric Acid Induces Cardiomyocyte Apoptosis via Activation of Calpain-1 and Endoplasmic Reticulum Stress. Cell Physiol Biochem. 2018; 45 (5): 2122-35. doi: 10.1159/000488048
- Yin W., Zhou Q.L., OuYang S.X. et al. Uric acid regulates NLRP3/IL-1beta signaling pathway and further induces vascular endothelial cells injury in early CKD through ROS activation and K(+) efflux. BMC Nephrol. 2019; 20 (1): 319. doi: 10.1186/s12882-019-1506-8
- Zhang C.H., Huang D.S., Shen D. et al. Association Between Serum Uric Acid Levels and Atrial Fibrillation Risk. Cell Physiol Biochem. 2016; 38 (4): 1589-95. doi: 10.1159/000443099