РОЛЬ МОЧЕВОЙ КИСЛОТЫ В НОРМЕ И ПРИ ПАТОЛОГИИ
Аннотация
Ураты — конечный продукт метаболизма пуринов в организме человека. Доминирующим источником уратов являются эндогенные пурины, в то время как остальные поступают с пищей. Приблизительно две трети уратов выводятся почками, остальная часть — кишечником. Почечная элиминация уратов существенно зависит от конкретных транспортеров, включая URAT1, GLUT9 и BCRP. Исследования, в которых оценивались биологические эффекты уратов, показали очень разные результаты. Ураты обладают как антиоксидантными, так и провоспалительными свойствами. Гиперурикемия может привести к образованию кристаллов моноурата натрия, которые распознаются иммунной системой как сигналы опасности. Этот иммунный ответ приводит к активации инфламмасомы NLRP3 и, в конечном счете, к продукции и высвобождению интерлейкина-1b (IL-1b) и IL-18, которые через воспаление инициируют гибель клеток и некровоспаление. Было также продемонстрировано, что растворимые ураты опосредованно действуют на почки, вызывая гипертензию, и могут вызывать длительное перепрограммирование миелоидных клеток. Считается, что ураты опосредуют большинство физиологических эффектов гиперурикемии и подагры, что свидетельствует о том, что эта биологически активная молекула более эффективна, чем просто «конечный продукт» метаболизма пуринов.
Литература
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