Purinas y ácido úrico en pre-eclampsia: interacciones fisiopatológicas y proyecciones en investigación / Uric acid and purine plasma levels as plausible markers for placental dysfunction in pre-eclampsia

Uric acid is the final metabolite of purine break down, such as ATP, ADP, AMP, adenosine, inosine and hypoxanthine. The metabolite has been used broadly as a renal failure marker, as well as a risk factor for maternal and neonatal morbidity during pre-eclamptic pregnancies. High purine levels are observed in pre-eclamptic pregnancies, but the sources of these purines are unknown. However, there is evidence that pre-eclampsia (mainly severe pre-eclampsia) is associated with an increased release of cellular fragments (or microparticles) from the placenta to the maternal circulation. These in fact could be the substrate for purine metabolism. Considering this background, we propose that purines and uric acid are part of the same physiopathological phenomenon in pre-eclampsia (i.e., placental dysfunction) and could become biomarkers for placental dysfunction and postnatal adverse events.

Purines and oxypurines in myocardial ischemia

To evaluate the plasma levels of purine nucleosides and oxypurines in the presence of other risk factors as additional markers for the diagnosis of myocardial ischemia and severity of myocardial infarction. A case control study was conducted on 101 patients with ischemic heart disease [stable angina, n=19: unstable angina, n=29: acute myocardial infarction [AMI]; n=53 patients] admitted to the Cardiology Unit at Al-Kadhimyia Teaching Hospital, Baghdad, Iraq from January to November 2007 in addition to 31 healthy controls. Blood samples were aspirated from those with AMI within the first 12 hours of onset of chest pain. Plasma adenosine [ADO], inosine [INO], hypoxanthine [HYP], and xanthine [XAN] were analyzed by high-performance liquid chromatography. The mean plasma ADO, INO, HYP, and XAN levels were raised in unstable angina over the control values. More increase in all nucleosides and oxypurines was reported in the plasma of patients with AMI as compared to the controls and those of stable angina. The INO [p = 0.01] and HYP [p = 0.001] values were increased significantly in diabetic men with AMI and at age of Conclusion: The levels of purines and their catabolites could be used as additional indices for prior or current ischemia. Pretreatment with such nucleosides, or their oxypurine derivatives, is suggested to improve the regional ventricular function after coronary artery occlusion