Acta Neurologica Belgica

, Volume 116, Issue 3, pp 303–308 | Cite as

Serum uric acid levels in patients with infections of central nervous system

  • Jia Liu
  • Min Li
  • Xuan Wang
  • Huan Yi
  • Li Xu
  • Xiu-feng Zhong
  • Fu-hua Peng
Original Article


The lower levels of serum uric acid (UA) correlated with meningitis have been reported. However, comparison of UA levels among different kinds of infections of central nervous system (CNS) and changes of UA levels before and after treatment are unknown. Our study aimed to investigate the antioxidant status of serum UA in five common types of CNS infections. We retrospectively evaluated serum UA levels of 399 patients with different types of CNS infections including viral meningitis or meningoencephalitis (VM), brain cysticercosis (BC), tuberculous meningitis or meningoencephalitis (TM), cryptococcus meningitis or meningoencephalitis (CM) and bacterial meningitis or meningoencephalitis (BM), and 119 healthy controls. The changes of serum UA were examined and analyzed. The serum levels of UA in patients with CNS infections were significantly lower than those in normal subjects and among in TM, CM and BM groups were apparently lower when compared with VM and BC groups; otherwise, after effective therapy, serum UA levels were obviously higher than before. Our findings showed that patients with CNS infections had lower serum UA levels, which was independent of the classification and the serum UA levels increased obviously after valid treatment, the variation of UA levels might be considered as an indicator of clinical curative effect in patients with CNS infections.


Meningitis Meningoencephalitis Uric acid Antioxidant Oxidant 



The study was supported by National Science Foundation (No. 81271327) and Technology Project of Guangdong Province (No. 2011B031800015).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving the patient included the case report were in accordance with the ethical standards of the institutional board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Riddell J 4th, Shuman EK (2012) Epidemiology of central nervous system infection. Neuroimaging Clin N Am 22:543–556CrossRefPubMedGoogle Scholar
  2. 2.
    Chong HT, Tan CT (2005) Epidemiology of central nervous system infections in Asia, recent trends. Neurol Asia 10:7–11Google Scholar
  3. 3.
    Leib SL, Täuber MG (1999) Pathogenesis of bacterial meningitis. Infect Dis Clin North Am 13:527–548CrossRefPubMedGoogle Scholar
  4. 4.
    Leib SL, Kim YS, Chow LL, Sheldon RA, Täuber MG (1996) Reactive oxygen intermediates contribute to necrotic and apoptotic neuronal injury in an infant rat model of bacterial meningitis due to group B streptococci. J Clin Invest 98:2632–2639CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Hooper DC, Scott GS, Zborek A, Mikheeva T, Kean RB, Koprowski H, Spitsin SV (2000) Uric acid, a peroxynitrite scavenger, inhibits CNS inflammation, blood-CNS barrier permeability changes, and tissue damage in a mouse model of multiple sclerosis. FASEB J 14:691–698PubMedGoogle Scholar
  6. 6.
    Hooper DC, Kean RB, Scott GS, Spitsin SV, Mikheeva T, Morimoto K, Bette M, Röhrenbeck AM, Dietzschold B, Weihe E (2001) The central nervous system inflammatory response to neurotropic virus infection is peroxynitrite dependent. J Immunol 167:3470–3477CrossRefPubMedGoogle Scholar
  7. 7.
    Klein M, Koedel U, Pfister HW (2006) Oxidative stress in pneumococcal meningitis: a future target for adjunctive therapy? Prog Neurobiol 80:269–280CrossRefPubMedGoogle Scholar
  8. 8.
    Liu Y, Jiang Y, Wu A, Chen S, Zhang Y, Liu M, Ma X, Ma L, Chen X (2012) Prognostic significance of serum antioxidant parameters in immunocompetent patients with cryptococcal meningitis. Eur J Clin Microbiol Infect Dis 31:2359–2367CrossRefPubMedGoogle Scholar
  9. 9.
    Kurien BT, Scofield RH (2008) Autoimmunity and oxidatively modified. Autoimmun Rev 7:567–573CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Toncev G, Milicic B, Toncev S, Samardzic G (2002) Serum uric acid levels in multiple sclerosis patients correlate with activity of disease and blood–brain barrier dysfunction. Eur J Neurol 9:221–226CrossRefPubMedGoogle Scholar
  11. 11.
    Peng F, Yang Y, Liu J, Jiang Y, Zhu C, Deng X, Hu X, Chen X, Zhong X (2012) Low antioxidant status of serum uric acid, bilirubin and albumin in patients with neuromyelitis optica. Eur J Neurol 19:277–283CrossRefPubMedGoogle Scholar
  12. 12.
    Jesús S, Pérez I, Cáceres-Redondo MT, Carrillo F, Carballo M, Gómez-Garre P, Mir P (2013) Low serum uric acid concentration in Parkinson’s disease in southern Spain. Eur J Neurol 20:208–210CrossRefPubMedGoogle Scholar
  13. 13.
    Bahr NC, Boulware DR (2014) Methods of rapid diagnosis for the etiology of meningitis in adults. Biomarkers Med 8:1085–1103CrossRefGoogle Scholar
  14. 14.
    Garcia HH, Nash TE, Del Brutto OH (2014) Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13:1202–1215CrossRefPubMedGoogle Scholar
  15. 15.
    Aycicek A, Iscan A, Erel O, Akcali M, Ocak AR (2007) Oxidant and antioxidant parameters in the treatment of meningitis. Pediatr Neurol 37:117–120CrossRefPubMedGoogle Scholar
  16. 16.
    Gutteridge JM, Halliwell B (2000) Free radicals and antioxidants in the year 2000. A historical look to the future. Ann N Y Acad Sci 899:136–147CrossRefPubMedGoogle Scholar
  17. 17.
    Bonnefoy M, Drai J, Kostka T (2002) Antioxidants to slow aging, facts and perspectives. Presse Med 31:1174–1184PubMedGoogle Scholar
  18. 18.
    Tsukahara H (2002) Oxidative and nitrosative stress in childhood meningitis. Infect Immun Child 14:31–39Google Scholar
  19. 19.
    Tsukahara H, Haruta T, Hata I, Mayumi M (1998) Nitric oxide in septic and aseptic meningitis in children. Scand J Clin Lab Invest 58:73–79CrossRefPubMedGoogle Scholar
  20. 20.
    Beckman JS, Koppenol WH (1996) Nitric oxide, superoxide, and peroxynitrite: the good, the bad, and ugly. Am J Physiol 271:1424–1437Google Scholar
  21. 21.
    Kastenbauer S, Koedel U, Becker BF, Pfister HW (2002) Oxidative stress in bacterial meningitis in humans. Neurology 58:186–191CrossRefPubMedGoogle Scholar
  22. 22.
    Becker BF (1993) Towards the physiological function of uric acid. Free Radic Biol Med 14:615–631CrossRefPubMedGoogle Scholar
  23. 23.
    Sevanian A, Davies KJ, Hochstein P (1991) Serum urate as an antioxidant for ascorbic acid. Am J Clin Nutr 54:1129S–1134SPubMedGoogle Scholar
  24. 24.
    Benzie IF (2000) Evolution of antioxidant defence mechanisms. Eur J Nutr 39:53–61CrossRefPubMedGoogle Scholar
  25. 25.
    Ames BN, Cathcart R, Schwiers E, Hochstein P (1981) Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 78:6858–6862CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Kastenbauer S, Koedel U, Pfister H-W (1999) Role of peroxynitrite as a mediator of pathophysiological alterations in experimental pneumococcal meningitis. J Infect Dis 180:1164–1170CrossRefPubMedGoogle Scholar
  27. 27.
    Aycicek A, Iscan A, Erel O, Akcali M, Selek S (2006) Total antioxidant/oxidant status in meningism and meningitis. Pediatr Neurol 35:382–386CrossRefPubMedGoogle Scholar
  28. 28.
    Nakazato Y, Shimazu K, Tamura N, Shimazu T, Hamaguchi K (1998) Hypouricemia in patients with meningitis. Rinsho Shinkeigaku 38:336–338PubMedGoogle Scholar
  29. 29.
    Koedel U, Pfister HW (1999) Oxidative stress in bacterial meningitis. Brain Pathol 9:57–67CrossRefPubMedGoogle Scholar
  30. 30.
    Hamed SA, Hamed EA (2009) Zakary MM (2009) Oxidative stress and S-100B protein in children with bacterial meningitis. BMC Neurol 9:51CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Spitsin S, Hooper DC, Leist T, Streletz LJ, Mikheeva T, Koprowski H (2001) Inactivation of peroxynitrite in multiple sclerosis patients after oral administration of inosine may suggest possible approaches to therapy of the disease. Mult Scler 7:313–319CrossRefPubMedGoogle Scholar
  32. 32.
    Scott GS, Hooper DC (2001) The role of uric acid in protection against peroxynitrite mediated pathology. Med Hypotheses 56:95–100CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2015

Authors and Affiliations

  • Jia Liu
    • 1
  • Min Li
    • 1
  • Xuan Wang
    • 1
  • Huan Yi
    • 1
  • Li Xu
    • 1
  • Xiu-feng Zhong
    • 2
  • Fu-hua Peng
    • 1
  1. 1.Department of NeurologyThe Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  2. 2.Ophthalmology State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangzhouChina

Personalised recommendations