| Objective:1.To summarize the experience of Professor Wu Shengyuan in treating gouty arthritis and analyze the feasibility of Qingre Tongluo recipe in treating acute gouty arthritis;2.Through experimental study the relationship between TLRs/IL-1β pathway and gout was analyzed,and the role of TLRs/IL-1β pathway in the pathogenesis of gout was discussed;3.The effect of Qingre Tongluo recipe on TLRs/IL-1β pathway was studied by intervention of PBMCs in patients with acute gouty arthritis with the drug serum of Qingre Tongluo prescription,which provided theoretical basis for Qingre Tongluo recipe to treat gout.Methods:1.Review the relevant literature,summarize Professor Wu Shengyuan’s experience in treating gouty arthritis(GA),and analyze the feasibility of Qingre Tongluo recipe in treating acute gouty arthritis(AGA);2.real-time quantitative polymerase chain reaction(RT-q PCR)was used to detect 40 cases of gout acute group,40 cases of gout non acute group,and 40 cases of healthy controls.The levels of TLR-2、TLR-4 and IL-1 m RNA in peripheral blood mononuclear cells(PBMCs)were 40.Enzyme linked immunosorbent assay(ELISA)for the detection of IL-1β-IL-8、IL-10 and IL-37 in three groups.The correlation between the above indexes and uric acid in patients with gout and control group was analyzed,and Study on the role of TLRs/IL-1β pathway in the pathogenesis of gouty arthritis;3.Five patients with acute gouty arthritis were treated with PBMCs isolated from peripheral blood mononuclear cells,induced by sodium uric acid(MSU),cultured in vitro,and treated with serum TAK-242(TLR-4 inhibitor),To investigate the effect of Qingre Tongluo recipe on the expression of IL-1β、IL-10、IL-10 and IL-37 in PBMCs supernatant of patients with acute gouty arthritis.Results:1.Prof.Wu Shengyuan divides gout into three phases,six types for treatment,Qingre Tongluo prescription for treating acute gouty arthritis for many years,the effect is obvious;2.The expression of TLR-4 and IL-1β m RNA in PBMCsin AGA group was significantly higher than that in NAGA group and HC group(P <0.01).The expression of TLR-4 and IL-1β m RNA in PBMCs of NAGA group was higher than that in HC group(P<0.05),but the expression of TLR-2 m RNA in each group had no significant difference(P>0.05).The levels of IL-1β、IL-8、IL-10 and IL-37 in PBMCs in AGA group and NAGA group were significantly higher than those in HC group(P<0.01),and the levels of IL-1β、IL-8、IL-10 and IL-37 in AGA group and NAGA group were significantly different(P<0.01).The level of serum uric acid in group AGA and group NAGA was significantly higher than that in group HC(P<0.01),and the serum uric acid in group AGA was significantly higher than that in group NAGA,the difference was statistically significant(P<0.01).There was a positive correlation between the level of IL-1β m RNA and serum uric acid level in GA patients(P<0.01),but no correlation between TLR-2 m RNA and serum uric acid level(P>0.05).The levels of TLR4 and IL-1β m RNA in HC group were not correlated with serum uric acid(P>0.05).The level of IL-1 β、IL-8 was positively correlated with serum uric acid level in patients with GA(P<0.01).There was no correlation between IL-10、 IL-37 and serum uric acid level(P>0.05).There was no correlation between the levels of IL-1β 、 IL-8 、 IL-10 、 IL-37 and serum uric acid in HC group(P>0.05);3.Compared with the model group,the expression of IL-1β、IL-8 in the positive control group was significantly lower than that in the control group,and the difference was statistically significant(P<0.01),and the expression level of IL-10、IL-37 was higher than that in the control group(P<0.05).Compared with the model group,the expression of IL-1β、IL-8 and IL-37 in the high dose saline group was significantly lower than that in the model group(P<0.05).There was no significant difference in the expression of IL-37 in the high dose group of saline and IL-1β、IL-8、IL-10 and IL-37 in normal and low saline group(P>0.05).Compared with the model group,the expression level of IL-1β and IL-8 in Qingre Tongluo decoction group was significantly lower than that in the model group,and the difference was statistically significant(P<0.01),but there was no significant difference in the expression level of IL-10、IL-37,but there was no significant difference between the two groups(P>0.05).Compared with the positive control group,the expression level of IL-1β、IL-8 in Qingre Tongluo prescription group was significantly lower than that in the control group(P<0.01),but the difference was not statistically significant(P>0.05).Conclusion:1.Qingre Tongluo recipe is an effective prescription for the treatment of acute gouty arthritis;2.TLRs/IL-1β pathway plays an important role in gout immunity and inflammatory response;3.The therapeutic effect of Qingre Tongluo recipe on gout might be related to the decrease the level of IL-1β and IL-8. |
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