Study On The Expression And Significance Of Th17/Treg Cells In The Peripheral Blood Of Patients With Primary Gouty Arthritis

Objective: This study is aimed to investigate the possible role of Th17/Treg cell in the pathogenesis of primary gout arthritis.Methods: The peripheral blood of 35 acute gout patients(AG group),36 interval gout patients(IG group)and 32 healthy controls(HC group)were collected.The clinical data and laboratory indicators of them were enrolled.The percentages of Th17 and Treg cells were detected by flow cytometry(FCM).The expression of Foxp3 and ROR-?t mRNA in PBMCs were measured using Real time quantitative PCR.The peripheral blood of IG and HC were stimulated with Phosphate Buffered Saline(PBS),100?g/ml monosodium urate(MSU)for 6 hours,then the expression of Foxp3 and ROR-?t mRNA were measured.ELISA was used to detect the level of IL-17?IL-6?TGF-?1?IL-23 from AG,IG,HC,and to measure IL-17?IL-6 of the peripheral blood of IG and HC stimulated with PBS and MSU for 6 hours.The measurement data were compared by one factor analysis of variance test.The correlation between variables was used by Spearman correlation analysis.SPSS21.0 statistical software was used for analysis.Results: The percentage of Th17 cells in peripheral blood of AG group was(2.8±0.9)%,and compared with that of IG group(1.4±0.6)% and HC group(1.2±0.5)% was significantly increased(P<0.05).However,there was no significant difference between IG group and HC group(P>0.05).The proportion of Treg cells in the peripheral blood of AG group(3.4±1.3)% and IG group(4.0±1.2)%,were significantly lower(P<0.05)than the percentage of HC group(5.6±1.7)%.There was no significant difference between the IG group and the AG group(P>0.05).The proportion of TH17/Treg cells in the AG group was higher than that of IG and HC group.The expression of ROR-?t mRNA in AG group was higher(P<0.05)than that of IG and HC group.However,there was no significant difference between IG and HC group(P>0.05).The expression of Foxp3 mRNA were significantly lower(P<0.05)in AG and IG group compared to HC group.And there was no significant difference between the AG and the IG(P>0.05).The IL-17?IL-6?TGF-?1?IL-23 levels increased in AG group compared to HC and IG group.Compared to the the PBS stimulated group,the Foxp3 mRNA level of MSU stimulated group were decreased in HC and IG group.And the ROR?t mRNA level was significantly increased in MSU group compared to PBS stimulated group in HC and IG group.The IL-17,IL-6 level was significantly increased in MSU stimulated group compared to PBS stimulated group in HC and IG group.Spearman correlation analysis found that the Th17 and Treg,ROR?t mRNA and Foxp3 mRNA were negatively correlated.Conclusion: Th17 cells in peripheral blood of patients with GA were increased and accompanied with the decrease of Treg cells,indicating that the imbalance of Th17/Treg cells in the inflammatory and immune response plays a critical role in the pathogenesis of GA.