Altered circadian relationship between serum nitric oxide, carbon dioxide, and uric acid in multiple sclerosis

The free radical nitric oxide (NO^.) is involved in a variety of diverse biological processes from acting as a vasodilator in the cardiovascular system to being the rate-limiting component in the production of peroxynitrite (ONOO^-), a contributor to neurodegenerative disorders such as multiple sclerosis (MS). Uric acid (UA), the end product of purine metabolism in humans and a selective inhibitor of toxic reactions attributed to radicals formed by the interaction of ONOO^- and CO₂, is generally low in MS patients. We investigated the relationship between serum ONOO ^-, CO₂, and UA in MS patients and normal controls by comparing the circadian characteristics of the NO^. metabolites nitrite/ nitrate (NO), CO₂, and UA. In this preliminary study, we found the functional relationship ascribed to the circadian timing of the peak and trough levels of NO, CO₂, and UA in healthy subjects to be clearly altered in MS patients. These findings suggest that alterations in the temporal relationship between the 24 h pattern in serum ONOO^- formation and UA may either contribute to or reflect the disease processes in MS.