Published online before print November 29, 2007, doi: 10.1161/STROKEAHA.107.503532
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(Stroke. 2008;39:e10.)
© 2008 American Heart Association, Inc.
Letters to the Editor |
Response to Letter by Dawson et al
Institute of Neurosciences, IDIBAPS, Hospital Clinic Barcelona, Barcelona, Spain
Institute for Biomedical Research (IIBB)-Spanish Research Council (CSIC), IDIBAPS, Barcelona, Spain
Institute of Neurosciences, IDIBAPS, Hospital Clinic Barcelona, Barcelona, Spain
Response:
We appreciate the interest generated by our recent report describing that the dual treatment with tPA and uric acid (UA) is feasible, safe and able to decrease lipid peroxidation in patients with acute ischemic stroke.1 In our view, this research effort complies well with the thorough and thoughtful debate requested by Dawson and colleagues, although these investigators reproduce previous worries expressed in this section of the journal.2 Our current encouraging results, together with the experimental data that we have gathered in the ischemic rat brain,3 pave the way to further clinical evaluation in a larger efficacy trial, as we have supported.4 Our methods adhere to current recommendations on good experimental research and clinical trial design. However, only further study will unveil whether the transient elevation of UA levels is harmful5 or beneficial in patients with acute stroke.6 As we have cautioned,7 this approach is independent of the (unsettled) potential relationship between chronic elevation of UA and cardiovascular disease.
Acknowledgments
Disclosures
None.
References
1. Amaro S, Soy D, Obach V, Cervera A, Planas AM, Chamorro A. A pilot study of dual treatment with recombinant tissue plasminogen activator and uric acid in acute ischemic stroke. Stroke. 2007; 38: 2173–2175.
2. Weir CJ, Muir SW, Walters MR, Lees KR. Yin and Yang of uric acid in patients with stroke. Stroke. 2004; 35: e11–e20.[CrossRef][Medline] [Order article via Infotrieve]
3. Romanos E, Planas AM, Amaro S, Chamorro A. Uric acid reduces brain damage and improves the benefits of rt-PA in a rat model of thromboembolic stroke. J Cereb Blood Flow Metab. 2007; 27: 14–20.[CrossRef][Medline] [Order article via Infotrieve]
4. Chamorro A, Planas AM, Muner DS, Deulofeu R. Uric acid administration for neuroprotection in patients with acute brain ischemia. Med Hypotheses. 2004; 62: 173–176.[CrossRef][Medline] [Order article via Infotrieve]
5. Weir CJ, Muir SW, Walters MR, Lees KR. Serum urate as an independent predictor of poor outcome and vascular events after acute stroke. Stroke. 2003; 34: 1951–1957.
6. Chamorro A, Obach V, Cervera A, Revilla M, Deulofeu R, Aponte JH. Prognostic significance of uric acid serum concentration in patients with acute ischaemic stroke. Stroke. 2002; 33: 1048–1052.
7. Chamorro A, Planas AM. Yin and yang of uric acid in patients with stroke. Response. Stroke. 2004; 35: e11–e12.[CrossRef][Medline] [Order article via Infotrieve]
Related Article:
Stroke 2008 39: e9.
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