FRI0239 Absolute numbers of peripheral th17 and th2 cells increased in patients with gout
Authors: J. Yuan, L. Zhao, J. Luo, C. Gao, X. Li, H. Gao, L. Shang, Q. Li
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Gout is generally considered as an acute or chronic inflammatory disease of the joints due to deposition of crystals of monosodium urate (MSU). However, crystals of MSU do not always elicit inflammation in joints, suggesting that the immunological basis is required for the development of gouty arthritis. Although T helper 17 (Th17) and regulatory T cell subsets in CD4 +T cells have been reported to play a key role in autoimmune diseases, their status in peripheral blood of gout patients are rare studied. <h3>Objectives</h3> Our present study is to explore whether the absolute numbers of peripheral CD4 +T subsets, especially Th17 cells and CD4 +CD25+FOXP3T regulatory (Treg) cells, is abnormal in gout. <h3>Methods</h3> A total of 72 patients with gout (70 male/2 female) and 41 age-sexual-matched controls were recruited from the Second Hospital of Shanxi Medical University (from March 1 st in 2016 to July 30th in 2017). Of these, 72 patients were categorised as acute gout who had redness, swelling, warmth and pain at the same time (Group1; n=18) or as acute gout without redness and warmth (Group2; n=52). All patients fulfilled 2015 Gout classification criteria developed by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR). Patients with a history of other autoimmune diseases, nephropathy, cancer, infectious processes, or hematopathy were excluded. The detail medical histories were collected, comprehensive laboratory examinations were performed, and then the differences between the patients and controls were investigated. The concentrations of CD4 +T cell subsets (the absolute numbers of Th1, Th2, Th17 and Treg cells) in peripheral blood were measured by flow cytometry combined with internal standard beads and then the ratios of Th1/Th2 and Th17/Treg were calculated. <h3>Results</h3> The duration of their disease was 46.73±54.92 (Group1), or 61.54±70.51 (Group2) months. The white blood cells (WBCs) and neutrophils in gout blood were significantly higher than those in controls (P&lt;0.01) and ESR in Group1 was obviously increased (p=0.033). Levels of Total T lymphocyte counts (CD3 +CD19-), Total B lymphocyte counts (CD3-CD19+) and Helper T cells (CD3 +CD4+) were increased in Group2 (all p&lt;0.05). Nevertheless, there was no difference between Group1and healthy controls. The absolute number of peripheral Th2 in gout (both Group1 and Group2) was higher than that in healthy controls (p=0.001). Most importantly, the absolute number of peripheral Th17 cells was significantly increased in gout patients in Group2 (p=0.006) while, in Group1, the absolute number of Treg cells decreased despite no statistical significance (P&gt;0.05). <h3>Conclusions</h3> The increase of peripheral Th2 and Th17 cells led to an imbalance of CD4 +T cell subsets may correlate with gouty inflammation in an undefined way. The elevation of Th2 and Th17 cells may serve as important reference indices for gout attack and a target of gout treatment. Moreover, Th17 may contribute to the persistence of the disease. <h3>Reference</h3> [1] Zhou Z, Li X, Li H, Guo M, Liu S, Li C. Genetic Analysis of IL-17 Gene Polymorphisms in Gout in a Male Chinese Han Population. PLoS One [Internet]2016;11(2):e0148082. <h3>Disclosure of Interest</h3> None declared