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Higher Urate Levels May Slow Progression of Parkinson's

Individuals with Parkinson's disease who have higher levels of the antioxidant urate in their blood and cerebrospinal fluid appear to have a slower rate of disease progression, according to results of a new study funded, in part, by the National Institutes of Health. The results support similar findings of an earlier, 2008 study. Urate is a chemical that at very high levels is associated with gout. A clinical trial is under way to examine the safety and potential benefits of supplemental urate elevation for recently diagnosed Parkinson's patients who have low urate levels. Experts emphasize there is no proof that elevating urate levels will help against Parkinson's disease, and that it should not be attempted outside of a clinical trial, where physicians can closely monitor possible benefits and risks, such as gout and heart disease. In the new study, investigators demonstrated the link with urate by mining a repository of clinical data and tissue samples collected from Parkinson's patients more than 20 years ago as part of a pioneering study called DATATOP, funded by the NIH's National Institute of Neurological Disorders and Stroke (NINDS). The new study was funded primarily by the NINDS, with additional support from the Department of Defense and private organizations. "This study speaks to the value of saving data and biospecimens from large clinical studies, and making them available to the research community to pursue new, unanticipated ideas," said Dr. Michael Schwarzschild, of Massachusetts General Hospital in Boston, senior author of the study. "These results were critically important. Only now we can be reasonably sure that the slower rate of progression in patients with higher concentrations of urate is real and not a chance occurrence," said Dr. Alberto Ascherio of the Harvard School of Public Health and lead author of the study. "Because elevated urate levels have known health risks, including gout and kidney stones," Dr. Schwarzschild stressed, "urate elevation should only be attempted in the context of a closely monitored clinical trial in which potential benefits and risks are carefully balanced." The new report will appear in the December 2009 issue of Archives of Neurology and is now available online. [NIH release] [U. Rochester release] [Mass General release] [AoN abstract]