Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Acute Gout Results in Increased Plasma Myeloperoxidase: A Potential Mechanism for Increase Cardiovascular Risk?

Stamp1,  Lisa K., Khalilova2,  Irada, Kettle2,  Tony

University of Otago, Christchurch, New Zealand
University of Otago

Background:

Gout is the most common form of inflammatory arthritis in men >40 years age. While the joint manifestations of gout dominate, patients with gout have a substantially increased risk of cardiovascular disease (CVD). However, not all of the increase is explained by traditional cardiovascular risk factors. Myeloperoxidase (MPO), which is released from neutrophils as part of the inflammatory process, has been implicated in the pathogenesis of CVD and is associated with coronary artery disease. The aim of this study was to determine whether MPO concentrations were increased in patients with acute and/or controlled gout.

Methods:

40 patients with gout (20 with acute gout, 20 with inter-critical gout) and 12 healthy controls were recruited. Plasma was assayed for urate, MPO protein and MPO activity. Urate was measured by HPLC and MPO protein and activity by ELISA.

Results:

4/12 healthy controls (HC), 17/20 acute gout and 19/20 inter-critical gout patients were male. The age (mean (range)) was 40.5 years (20–52) HC, 55.5 years (34–91) acute gout, and 63.2 years (42–82) inter-critical gout. As expected plasma urate was significantly higher in the subjects with acute gout (465±101mM) as compared to those with inter-critical gout (357 ± 87.8mM) (p<0.05). Plasma MPO protein was significantly higher in patients with acute gout compared to healthy controls, but not significantly different from those with inter-critical gout. MPO activity was significantly increased in patients with acute gout as compared to those with inter-critical gout and HC (Figure 1).

Conclusions:

MPO is released during the acute inflammatory response associated with gout flare. This increase in MPO provides another mechanism for the increase in cardiovascular disease seen in gout patients. More active MPO in patients with acute gout may contribute to oxidative stress in the vasculature and the increased CVD risk. Further studies are required to determine the association between MPO and CVD in patients with gout.

Figure 1. Plasma MPO protein and activity in 12 healthy controls (HC), 20 patients with inter-critical gout (IC Gt), and 20 patients with acute gout (Ac Gt). Comparisons were made using ANOVA on ranks and Dunn's method for post-hoc analysis.

To cite this abstract, please use the following information:
Stamp, Lisa K., Khalilova, Irada, Kettle, Tony; Acute Gout Results in Increased Plasma Myeloperoxidase: A Potential Mechanism for Increase Cardiovascular Risk? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :870
DOI: 10.1002/art.28638

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