150 mg daily for a month then 300 mg daily for the rest of the study (5 months)

Musculoskeletal Degeneration

Inflammation

Hyperuricemia

Individuals who meet the inclusion criteria and also have morphostructural changes suggestive of MSU crystal deposits in their MSUS will start treatment with allopurinol at a dosage of 150 mg to be taken daily, orally for a month and then to be increased to 300 mg. The rest of the individuals' medication is not to be altered. If a participant presents hypersensitivity to allopurinol, they are to stop the medication and will be excluded from the investigation.
Three months after starting treatment, the participants will have a physical exam, confirm the continuation of the treatment (adjust dosage if needed) and take a blood sample for laboratory tests. Six months after treatment is started, the participants will be reevaluated by MSUS and have another blood sample taken, Once the study is finished, continuing or ending treatment with allopurinol will be decided by the medical judgment of the physician of each participant.

Allopurinol Pill

Instituto Nacional de Cardiología

National Institute of Cardiology Mexico

Effects of Allopurinol on Inflammation and Ultrasonographic Changes in People With Elevated Uric Acid But no Symptoms

Effects of Allopurinol on Inflammatory Markers and Morphostructural Changes Evidenced by Musculoskeletal Ultrasound in Individuals With Asymptomatic Hyperuricemia. A Proof of Concept

To measure changes in proinflammatory cytokines (Interleukin 1ß (IL-1ß))

To measure changes in proinflammatory cytokines (Tumor Necrosis Factor)

To measure changes in proinflammatory cytokines (Interleukin 6 (IL-6))

To measure changes in proinflammatory cytokines (Interferon-γ)

To measure changes in proinflammatory cytokines (Interleukin 18 (IL-18))

To measure changes in proinflammatory cytokines (Interleukin 17 (IL-17))

To measure changes in chemokines (Interleukin 8 (IL-8))

To measure changes in chemokines (monocyte chemoattractant protein 1 (MCP-1))

To measure changes in microRNAs (miR) (miR-155)

To measure changes in the percentage of Cluster of Differentiation 4 cells that lack the expression of Cluster of Differentiation 28 (CD4+CD28null)

Presence of the ultrasonographic elemental lesions caused by monosodium urate crystals: (Double contour sign is a hyperechoic abnormal band over the superficial margin of articular hyaline cartilage, independent from insonation angle which can be regular or irregular, continuous or intermittent and that distinguishes itself from the cartilage interphase sign)

Presence of the ultrasonographic elemental lesions caused by monosodium urate crystals: (Tophi are described, independent of location, as an heterogenous, circumscript aggregate, hyper- and/or hypoechoic, which can be surrounded by a small anechoic halo and can have a posterior acoustic shadow)

Presence of the ultrasonographic elemental lesions caused by monosodium urate crystals: (Aggregates are described, independent of location, as heterogenous hyperechoic foci which maintain a high degree of reflectivity even when gain is reduced to the minimum or when the insonation angle is changed, also they can sometimes create a posterior acoustic shadow)

Presence of the ultrasonographic elemental lesions caused by monosodium urate crystals: (Erosions are described as a discontinuation of the bone surface, seen in two perpendicular planes)

Luis M Amezcua-Guerra

Head of Immunology Department, Principal Investigator

Instituto Nacional de Cardiologia Ignacio Chavez

Instituto Nacional de Rehabilitacion

Perfusion is measured using PET/CT during intravenous infusion (0.14 mg/kg/min) of adenosine.

Perfusion and A2A receptor density is measured using PET/CT in resting room temperature conditions.

Perfusion and A2A receptor density is measured using PET/CT during controlled cold exposure.

Obesity

Intravenous infusion of adenosine (0.14 mg/kg) is administered for 5 minutes during PET/CT scan.

Adenosine

Controlled cold exposure is performed before and during PET/CT scan.

Cold exposure

Adenosine and A2A Receptors in Human Brown Adipose Tissue

Adenosine and A2a Receptors in Human Brown Adipose Tissue (AdenoBAT)

Density of A2A receptors in BAT measured with [11C]-TMSX PET/CT

Kirsi Virtanen

Adjunct Professor

Turku University Hospital

University of Bonn

Each subject participates in PET/CT scans in room temperature conditions, during cold exposure and during i.v. infusion of adenosine.

Patients with BMI> 30 and metabolic syndrome ( ATP III).

Patient with BMI> 30 without metabolic syndrome.

healthy persons( without renal disease, cardiovascular diseases, diabetes mellitus, BMI < 25;normotensives ).

Patients with CKD stage III (GFR 30-59 ml/min/1,73 m2) and uric acid < 7 mg/dl.
without diabetes mellitus proteinuria < 3,5 g/24 h without immunosuppressives agents, ACEi, ARB, allopurinol treatment well controlled hypertension ( < 140/90 mmHg)

Patients with CKD stage III(GFR 30-59 ml/min/1,73 m2) and uric acid > 7 mg/dl
without diabetes mellitus proteinuria < 3,5 g/24 h without immunosuppressive agents, ACEi, ARB, allopurinol treatment well controlled hypertension ( < 140/90 mmHg)

Patient with asymptomatic hyperuricemia, uric acid > 7 mg/dl with normal renal function

Patient with asymptomatic hyperuricemia, uric acid > 7 mg/dl with normal renal function Hemodialysis patients.
CKD: nondiabetic nephropathy
duration hemodialysis 3-48 months
Hb-11-13 g/dl
well controlled hypertension ( < 140/90 mmHg)
without ACEi, ARB, allopurinol treatment
residual diuresis will be estimated for last 48 hours-between mid and next dialysis

Chronic Kidney Disease

Metabolic Syndrome

FFT, Inflammation, Lipid Metabolism, Blood Pressure and Organ Damage in Patients With Obesity, Chronic Kidney Disease (CKD).

The Oral Fructose Load Test and Inflammation, Lipid Metabolism, Blood Pressure and Organ Damage in Patients With Obesity, Chronic Kidney Disease With Comparison With Healthy Controls.

purine/murtall

Effects of Allopurinol on Inflammation and Ultrasonographic Changes in People With Elevated Uric Acid But no Symptoms

Adenosine and A2A Receptors in Human Brown Adipose Tissue

FFT, Inflammation, Lipid Metabolism, Blood Pressure and Organ Damage in Patients With Obesity, Chronic Kidney Disease (CKD).

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