AB0936 CLINICAL STUDY ON PERIPHERAL BLOOD IMMUNE FUNCTION IN PATIENTS WITH GOUTY ARTHRITIS
Authors: H. Wang, H. Gao
Journal: Annals of the Rheumatic Diseases (2020)

Background: Gout is an inflammatory disease characterized by hyperuricemia and recurrent arthritis. In severe cases, joint disability and renal insufficiency may occur [1] . In recent years, many studies have found that immune dysfunction plays an important role in the occurrence and development of gout [2] . Therefore, in-depth study of its internal mechanism is of great significance for the prevention and treatment of gout. Objectives: This paper mainly discussed the expression of peripheral blood immune function in patients with gouty arthritis and the changes and significance of peripheral blood immune function in gout with different uric acid levels. Methods: A retrospective analysis was performed on 258 outpatients and inpatients with gout in shanxi medical university from 2016 to 2019, all of which met the diagnostic criteria of the American college of rheumatology (ACR) in 1997, and 41 healthy controls. Complete clinical data and general laboratory data were collected, and peripheral blood lymphocyte and CD4+T cell counts were completed for all subjects. Results: (1) Total peripheral blood B cells of gout patients [238.00 (171.50,323.07) and 191.04 (149.66,253.14), Z=-2.759, P=0.006], Th cells [814.11 (617.50,1052.89) and 625.84 (562.52,750.15), Z=-3.905, P&lt;0.001], Th/Ts [1.4 (1.04,2.00) and 1.11 (0.89,1.52), Z=-2.862,Th17/Treg [0.36 (0.20,0.60) and 0.24 (0.14,0.34), Z=-3.949, P=0.000] and the absolute counts of Th17 cells [9.06 (5.07,15.57) and 7.48 (4.31,10.18), Z=-2.520, P=0.012] were higher than those of the healthy control group, and the differences were statistically significant.The absolute count of Treg cells [28.82 (17.48,38.04) and 30.22 (22.74,39.46), Z=-2.249, P=0.025] was lower than that of the healthy control group, and the difference was statistically significant. (2) The Th17% [1.05 (0.71,1.42) and 1.27 (0.73,2.00), Z=-1.995, P=0.046] and the Th17/Treg [0.25 (0.14,0.44) and 0.39 (0.23,0.63), Z=-3.147, P=0.002] in peripheral blood of patients with high uric acid in the gout group were higher than those in the normal uric acid group, the difference was statistically significant. The Treg % [3.84 (2.65,5.02) and 3.12 (2.36,4.37), Z=-2.239, P=0.025], and the Treg cells [30.75 (21.97,43.27) and 24.07 (16.84,36.29), Z=-2.522, P=0.012] were lower than those in the uric acid control group, with statistically significant differences. Conclusion: The level of Th17 cells in peripheral blood of patients with gout increased significantly while the level of regulatory T cells decreased significantly. Th17 cell level in peripheral blood of the high uric acid group was significantly increased compared with the normal uric acid group, while the regulatory T cell level was also significantly decreased, and the Th17/Treg ratio was also increased. This suggests that regulatory T cells may play an important role in the pathogenesis of gout and are closely related to uric acid metabolism, so the study of internal mechanism can provide a new target for the treatment of gout. References: [1]Ragab G, Elshahaly M, et al. Gout: An old disease in new perspective - A review[J]. Adv Res. 2017;8(5):495–511. DOI: 10.1016/j.jare.2017.04.008. [2]Dai XJ, Tao JH, et al. Changes of Treg/Th17 Ratio in Spleen of Acute Gouty Arthritis Rat Induced by MSU Crystals. [J]. Inflammation. 2018;41(5):1955-1964. Doi: 10.1007/s10753-018-0839-y. Disclosure of Interests: None declared