Letter to the Editor

In response: Hyperuricemia as a risk factor for cardiovascular disease Expert Review of Cardiovascular Therapy Downloaded from informahealthcare.com by Nyu Medical Center on 02/05/15 For personal use only.

Expert Rev. Cardiovasc. Ther. 13(1), 21–22 (2015)

Claudio Borghi Department of Medical and Surgical Science, S. Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni 15–Pad. 2, 40138 Bologna, Italy [email protected]

Arrigo FG Cicero Department of Medical and Surgical Science, S. Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni 15–Pad. 2, 40138 Bologna, Italy

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Response to: Katsiki N, Doumas M, Athyros VG, Karagiannis A. Hyperuricemia as a risk factor for cardiovascular disease. Expert Rev Cardiovasc Ther 2015;13(1):19-20

Dear Editor, We are grateful to Katsiki et al. for their interest for our review focused on the relationship between serum uric acid (SUA) level and risk of cardiovascular disease [1,2]. Of course, we agree with the concept that the positive and negative interaction between largely prescribed drugs and SUA is more complex that previously suggested. We also agree that hyperuricemia is not only directly related to cardiovascular disease risk, but also to pathophysiological conditions associated to increased cardiovascular risk such as nonalcoholic fatty liver disease and chronic kidney disease. All these observations confirm the role of SUA as a marker of systemic oxidative stress, per se involved in the pathogenesis of a large number of clinical conditions. In agreement with this hypothesis, we recently also published data that relates SUA level with the ones of other markers of systemic oxidative stress related to cardiovascular disease, the serum level of oxidized low density lipoproteins (LDL) and dienes, in a relatively large sample of overall healthy adult-elderly men and women [3]. Similar results have been previously observed by Barbosa et al. [4] in a smaller sample of younger subjects and by Ruı´z-Herna´ndezet al. [5]., who limited their study on overweight women. We also observed that SUA was associated with the dienes level, but not with the LDL lag phase and propagation phase length. The formation of conjugated dienes is an early event of lipid peroxidation taking place soon after the initiation of the chain reaction [6], and the oxidation-induced increase of diene

10.1586/14779072.2015.987130

conjugation in LDL lipids is well documented [7]. In vitro, Patterson et al. demonstrated that UA rapidly reduces Cu2+ to Cu+, and the decreased concentration of Cu2+ would inhibit tocopherolmediated peroxidation in native LDL, while the generation of Cu+ would promote the rapid breakdown of lipid hydroperoxides in mildly oxidized LDL into lipid radicals [8]. The explication of our result could be that high SUA level promotes oxidative stress trough the generation of free oxygen radicals, thus inducing an increase in circulating oxLDL, or is more simply an indirect marker of systemic oxidation or exposition to oxidative stress, but probably does not directly affect the LDL resistance to oxidation. Therefore, it could be argued, but it is yet to be proven, that the inhibition of xanthine oxidase could improve the level of systemic oxidative stress and consequently also the level of circulating ox-LDL, with the resulting positive effects on the health of arterial walls and prevention of hypertension development. Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Ó 2015 Informa UK Ltd

ISSN 1477-9072

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Letter to the Editor

Borghi & Cicero

Brisighella Heart Study. Pol Arch Med Wewn 2014. [Epub ahead of print]

References 1.

Expert Review of Cardiovascular Therapy Downloaded from informahealthcare.com by Nyu Medical Center on 02/05/15 For personal use only.

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3.

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Borghi C, Verardi FM, Pareo I, et al. Hyperuricemia and cardiovascular disease risk. Expert Rev Cardiovasc Ther 2014;12: 1219-25 Katsiki N, Doumas M, Athyros VG, Karagiannis A. Letter to the Editor: hyperuricemia as a risk factor for cardiovascular disease. Expert Rev Cardiovasc Ther 2015;13(1):19-20 Cicero AF, Rosticci M, Cagnati M, Brisighella Heart Study Group. Serum uric acid and markers of LDL-oxidation in non-smoker healthy subjects: data from the

4.

5.

Barbosa KB, Volp AC, Hermsdorff HH, et al. Relationship of oxidized low density lipoprotein with lipid profile and oxidative stress markers in healthy young adults: a translational study. Lipids Health Dis 2011;10:61 Ruı´z-Herna´ndez N, Espinoza-Zavala M, Gonza´lez JC, et al. Oxidized LDL and anti-oxidized LDL antibodies according uric acid levels in overweight women. Arch Cardiol Mex 2011;81:188-96

6.

Kappus H. Lipid peroxidation: mechanisms, analysis, enzymology and biological relevance. In: Sies H, Edito Oxidative stress. London: Academic Press; 1985. 273-310

7.

Esterbauer H, Gebicki J, Puhl H, Jurgens G. The role of lipid peroxidation and antioxidants in oxidative modification of LDL Free Rad Biol Med 1992;13:341-90

8.

Patterson RA, Horsley ET, Leake DS. Prooxidant and antioxidant properties of human serum ultrafiltrates toward LDL: important role of uric acid. J Lipid Res 2003;44:512-21

Expert Rev. Cardiovasc. Ther. 13(1), (2015)

In response: hyperuricemia as a risk factor for cardiovascular disease.

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