What is neuroprotection

The authors supplement the various recommendations (guidelines) that have been published in recent years (1): In addition to those of the European League against Rheumatism (EULAR) and the American College of Rheumatology (ACR), the guidelines of the American College were published in March 2017 of Physicians (ACP) (2). The differences are that the rheumatological guidelines are based on the so-called “treat-to-target” (T2T) principle. The ACP recommendations, on the other hand, favor the principle of “treat-to-avoid symptoms” (T2aS).

To what extent is it possible to lower the serum uric acid concentration without long-term side effects? The well-known antioxidant effects of uric acid are important in neuroprotection. For example, gout rules out multiple sclerosis (3). Even if the severe cutaneous side effects of allopurinol are rare, the question of a possible prophylaxis arises with the widespread therapy with allopurinol. The pharmacogenetic examination of the genotype in the HLA B * 5801 system offers such a possibility at the beginning of the allopurinol dosage (4).

DOI: 10.3238 / arztebl.2017.0506b

Dr. med. Antonis G. Tsamaloukas

Berlin

[email protected]

Engel B, Just J, Bleckwenn M, Weckbecker K: Treatment options for gout. Dtsch Arztebl Int 2017; 114: 215-22 FULL TEXT
Qaseem A, McLean RM, Starkey M, Forciea MA, Clinical Guidelines Committee of the American College of Physicians: Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017; 166: 52-7 CrossRefMEDLINE
Spitsin S, Hooper DC, Mikheeva T, Koprowski H: Uric acid levels in patients with Multiple Sclerosis: analysis in mono-and dizygotic twins. Mult Scler 2001; 7: 165-6 CrossRefCrossRef
Wu R, Cheng YJ, Zhu LL, et al .: Impact of HLA-B * 58: 01 allele and allopurinol-induced cutaneous adverse drug reactions: evidence from 21 pharmacogenetic studies. Oncotarget 2016; 7: 81870-9 CrossRef
1.Engel B, Just J, Bleckwenn M, Weckbecker K: Treatment options for gout. Dtsch Arztebl Int 2017; 114: 215-22 FULL TEXT
2.Qaseem A, McLean RM, Starkey M, Forciea MA, Clinical Guidelines Committee of the American College of Physicians: Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017; 166: 52-7 CrossRefMEDLINE
3.Spitsin S, Hooper DC, Mikheeva T, Koprowski H: Uric acid levels in patients with Multiple Sclerosis: analysis in mono-and dizygotic twins. Mult Scler 2001; 7: 165-6 CrossRefCrossRef
4.Wu R, Cheng YJ, Zhu LL, et al .: Impact of HLA-B * 58: 01 allele and allopurinol-induced cutaneous adverse drug reactions: evidence from 21 pharmacogenetic studies. Oncotarget 2016; 7: 81870-9 CrossRef
Importance in neuroprotection

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