January 27, 2023

Dr Rutledge talks about the role of urate, xanthine oxidase and the effects of allopurinol in vascular oxidative stress. Oxidative stress plays an important role in the progression of vascular endothelial dysfunction. The two major systems generating vascular oxidative stress are the NADPH oxidase and the xanthine oxidase pathways. Allopurinol, a xanthine oxidase inhibitor, has been in clinical use for over 40 years in the treatment of chronic gout. Allopurinol has also been shown to improve endothelial dysfunction, reduce oxidative stress burden and improve myocardial efficiency by reducing oxygen consumption in smaller mechanistic studies involving various cohorts at risk of cardiovascular events. This article aims to explain the role of xanthine oxidase in vascular oxidative stress and to explore the mechanisms by which allopurinol is thought to improve vascular and myocardial indices. The Mini-Gastric Bypass

Wild ok start record stuff okay now talk a little bit about gout now gallop a lot of us know a little bit about gout yeah what does go well you eat a rich meal ben franklin had it and it’s got uric acid the uric acid forms crystals in the joints and it hurts and that’s about the limit of what most people know it turns out that uric acid is an endpoint of metabolism

In the body it’s a waste product a leftover product of the metabolism of nucleic and ribonucleic acids the things that make up dna and rna okay all right so what it turns out that the therapy for gout is a couple of medicines but in particular there’s a medicine called allopurinol and allopurinol is effective at decreasing gout because it inhibits an enzyme called

Hypo xanthine oxidase and the reason i mention that is for the oxidase part if you watch tv you can see all kinds of ads for these wacky cleaners that have like oxides and the peroxides and oxy cleans and things like that that’s because the peroxide or the oxygen molecule with a couple of extra electrons on it is a pretty powerful agent as far as a chemical it

Cleans things it torches things that kills bacteria and in your body you make this peroxide through the hypo xanthine oxidase pathway so who cares well recent research has looked at people with gout and they’ve measured in large samples of patients their uric acid level if you have a high uric acid level you’re likely to die recent research shows that high uric

Acid is associated with heart attacks stroke and death and if you get that diagnosed as having high uric acid and you take allopurinol and lower it you decrease your chance of dying and what they’re thinking is is the when the allopurinol blocks this peroxide peroxide creation then the peroxides are less likely to go on to the lining of the blood vessels and cause

The fat plus the blood vessels to harden into rocky stiff bad arteries so they’ve done a lot of studies for example they took kids with high blood pressure children with high blood pressure and didn’t give them high blood pressure medicine they gave them allopurinol not for god but a gout medicine and their blood pressure normalized and they said how could this be

And they think that the body of those high blood pressure kids was metabolizing some of this peroxide stiffening the arteries and making the pressure go up and when they block the hypo xanthine oxidase less peroxide less stiffening of the arteries so one of the new theories is that we die as people as our own inflammatory clearance system hurts us we have a civil

Defense system and it’s busy sometimes overreacting and harming us internally it’s as if our own police force started killing this own citizens and if we can turn that down a bit with allopurinol we may be able to help now it turns out weight loss surgery is a tremendous causes a tremendous decrease in uric acid and hypo xanthine oxidase and c-reactive protein and

Things like that so there’s real exciting new news that gout is a indicator of lots of uric acid which is an indicator of lots of hypo xanthine oxidase which may be an indicator of an upcoming stroke heart attack and death so appropriately treating it with your allopurinol that you’re on is important there may be other things can be done like the supplement queer

Seat which comes from the walls of oranges and other bioflavonoids may help also protect this but also weight loss surgery may make a big difference so there’s a hot new area of research gao it used to be just gowdy is arthritis i’ll appear at all now it may be a central part of the damage that leads to heart attack and stroke and get your uric acid down treat

That treat the blood pressure may be a central pathway that leads to problems now that we see with heart attacks stroke and death in the united states so very in

Transcribed from video
Dr Rutledge talks about Uric Acid and Death By DrRRutledge