Successful treatment of diffuse cutaneous leishmaniasis caused by Leishmania amazonensis

Diffuse cutaneous leishmaniasis is a rare universal disease associated with an inadequate host cell immune response, caused by different species: infantum, aethiopica, major, mexicana, and others, which presents the challenge of a poor therapeutic response. In Brazil, it is caused by L. amazonensis. A case confirmed by histopathology with an abundance of vacuolated macrophages full of amastigotes and lymphocyte scarcity, identified by RFLP-ITS1PCR and in vitro decrease and exhaustion of the host cell immune response to L. amazonensis antigen, was treated early (3 months after the onset) with Glucantime (2 months) and allopurinol (29 months) with clinical cure, after a follow-up for 30 months after treatment.     

The possible antianginal effect of allopurinol in vasopressin-induced ischemic model in rats

The anti-anginal effects of allopurinol were assessed in experimental model rats of angina and their effects were evaluated with amlodipine. In the vasopressin-induced angina model, oral administration of allopurinol in dose of 10 mg/kg revealed remarkably analogous effects in comparison with amlodipine such as dose-dependent suppression of vasopressin-triggered time, duration and severity of ST depression. In addition, allopurinol produced dose dependent suppression of plasma Malondialdehyde (MDA) level, systolic blood pressure, cardiac contractility and cardiac oxygen consumption; while in contrast, amlodipine minimally suppressed the elevation of plasma MDA level. Endothelial NO synthase (eNOS) expression, serum nitrate were strikingly increased, however lipid profile was significantly reduced. Seemingly, allopurinol was found to be more potent than amlodipine – a calcium channel antagonist. To conclude, it was explicitly observed and verified that on the ischemic electrocardiography (ECG) changes in angina pectoris model in rats, allopurinol exerts a significant protective effects, reminiscent of enhancement of vascular oxidative stress, function of endothelial cells, improved coronary blood flow in addition to the potential enhancement in myocardial stress. Moreover, our findings were in conformity with several human studies.     

Investigation of the transport of xanthine dehydrogenase inhibitors by the urate transporter ABCG2

Hyperuricemia induces gout and kidney stones and accelerates the progression of renal and cardiovascular diseases. Adenosine 5′-triphosphate-binding cassette subfamily G member 2 (ABCG2) is a urate transporter, and common dysfunctional variants of ABCG2, non-functional Q126X (rs72552713) and semi-functional Q141K (rs2231142), are risk factors for hyperuricemia and gout. A recent genome wide association study suggested that allopurinol, a serum uric acid-lowering drug that inhibits xanthine dehydrogenase, is a potent substrate of ABCG2. In this study, we aimed to examine the transport of xanthine dehydrogenase inhibitors via ABCG2. Our results show that ABCG2 transports oxypurinol, an active metabolite of allopurinol, whereas allopurinol and febuxostat, a new xanthine dehydrogenase inhibitor, are not substrates of ABCG2. The amount of oxypurinol transported by ABCG2 vesicles significantly increased in the presence of ATP, compared to that observed with mock vesicles. Since the half-life of oxypurinol is longer than that of allopurinol, the xanthine dehydrogenase-inhibiting effect of allopurinol mainly depends on its metabolite, oxypurinol. Our results indicate that the serum level of oxypurinol would increase in patients with ABCG2 dysfunction.     

Gout drugs use and risk of cancer: A case-control study

Objective

Firm conclusion about whether short and long-term gout medications use has an impact on cancer risk remain inconclusive. The aim of this study was to investigate the association between gout drugs use and risk of cancer.

别嘌呤醇治疗急性脑梗死伴高尿酸血症的临床效果

目的：探讨别嘌呤醇治疗急性脑梗死伴高尿酸血症的临床效果。方法选取2013年10月~2014年10月本院收治的80例急性脑梗死伴高尿酸血症患者作为研究对象,随机分为对照组和观察组,各40例。对照组给予抗凝、抗血小板聚集等对症治疗,观察组在对照组的基础上给予别嘌呤醇,比较两组治疗前后的血清尿酸水平、神经功能缺损评分以及临床效果。结果两组治疗后的血清尿酸水平与神经功能缺损评分显著低于治疗前,差异有统计学意义(P<0.05)。观察组治疗后的血清尿酸水平与神经功能缺损评分显著低于对照组治疗后,差异有统计学意义(P<0.05)。观察组的总有效率为92.5%,显著高于对照组的75.0%,差异有统计学意义(P<0.05)。结论别嘌呤醇能够明显降低急性脑梗死伴高尿酸血症患者的血清尿酸水平,改善患者的神经功能缺损症状,值得临床推广应用。     

奥曲肽治疗别嘌呤醇所致严重腹泻1例

患者因服用别嘌呤醇所致引发多种严重的药物不良反应,皮疹等不良反应经H1受体拮抗剂、激素等处理后好转,但严重腹泻经常规用药治疗无法得以改善,予以使用奥曲肽注射液以药理作用治疗后即好转,提示奥曲肽可能适用于药物不良反应引起的难治性严重腹泻。     

非布司他治疗慢性肾病伴高尿酸血症的疗效和机制分析

目的 分析非布司他治疗慢性肾病伴高尿酸血症的疗效和机制。方法 回顾2015年10月-2017年10月到河南医学高等专科学校附属医院诊治的慢性肾病伴高尿酸血症的患者共108例,按照随机原则分为两组,观察组54例患者采用非布司他治疗,对照组54例患者采用别嘌醇治疗,疗程均为24周。检测两组患者治疗前后血尿酸（UA）、血肌酐（Scr）、肾小球滤过率估算值（eGFR）、血尿素氮（BUN）、血白蛋白（Alb）和尿微量蛋白尿（u-mAlb）水平,比较两组患者疗效,记录肝功能受损、皮疹、胃肠道反应和血脂升高等不良反应发生情况。结果 治疗前两组患者各项指标无明显差异;治疗后UA、Scr、BUN、u-mAlb、eGFR均较治疗前明显降低,Alb较治疗前明显升高,同组治疗前后比较差异有统计学意义（P<0.05）;且治疗后观察组患者UA、Scr、BUN和u-mAlb明显低于对照组,eGFR和Alb明显高于对照组,差异均有统计学意义（P<0.05）。观察组患者高尿酸血症治疗总有效率为77.78%,明显高于对照组患者的55.56%,差异有统计学意义（P<0.05）;观察组患者肾功能治疗总有效率为83.33%,明显高于对照组患者的62.96%,差异有统计学意义（P<0.05）。观察组肝功能受损、皮疹、胃肠道反应和血脂升高等不良反应发生率明显低于对照组,差异有统计学意义（P<0.05）。结论 非布司他治疗慢性肾病伴高尿酸血症疗效确切,能够有效降低血尿酸水平,保护患者肾功能,不良反应发生率低,建议临床推广应用。     

Excellent response to the clinical treatment of tophaceous gout

Gout continues to be a health problem around the world, and the treatment may turn into a real challenge when the patient presents a certain degree of chronic renal failure (CRF). We discuss a case of tophaceous gout in a 68-year-old male patient without urolithiasis and with uric acid (UA) underexcretion and CRF (creatinine clearance of 42 ml/min). Uricosuric treatment with benzbromarone and urinary alkalinization was administered, and acute gouty attacks improved substantially. Subsequently, allopurinol was added to the treatment to accelerate tophi reduction in the hands, feet, elbows and knees. After 30 months of treatment, serum UA declined from 10 to 3.2 mg/dl. Urinary UA excretion of 0.44 g/24 h in the baseline rose to 0.85 g/24 h, returning to the baseline value after 30 months. UA clearance tripled, rising from 3.05 ml/min before treatment to 9.48 ml/min, and remained at this level. It is worth stressing that even in cases of severe tophaceous gout, the response to clinical treatment may be satisfactory with substantial reduction of tophi and full acute gouty attack remission even in patients presenting a certain degree of CRF.     

Adherence and Outcomes with Urate-Lowering Therapy: A Site-Randomized Trial

Purpose

The purpose of this study was to test a pharmacist-led intervention to improve gout treatment adherence and outcomes.

高尿酸血症大鼠模型的实验研究

以含腺嘌呤的饲料在SD大鼠建立高尿酸血症动物模型 ,以别嘌呤醇治疗能降低高尿酸血症大鼠血尿酸值