Absolute Numbers Of Peripheral CD4+T Cells In Patients With Acute Gout

Background: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.Objective:Our present study is to explore whether the absolute numbers of peripheral Th1?Th2?Th17 cells and CD4+CD25+FOXP3 T regulatory(Treg)cells are abnormal in acute gout.Methods: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 1st in 2016 to July 30 th in 2017).Of these,72 patients were categorized as acute gout who had redness,swelling,warmth and pain at the same time(GroupA;n=18)or as acute gout without redness and warmth(GroupB;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 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.The detail medical histories were collected,comprehensive laboratory examinations were performed,and then the differences between the patients and controls were investigated.Results:The duration of their disease was 32.00(102.00)months,of these,24.00(73.50)(GroupA),or 36.00(102.00)(GroupB)months.For all patients and controls:(1)Levels of absolute numbers of total T lymphocyte counts(CD3+CD19-),total B lymphocyte counts(CD3-CD19+)and Helper T cells(CD3+CD4+)were increased in gout patients(all P<0.05).Levels of Th2 and Th17 were higher than controls(P=0.001 vs 0.004).The absolute number of Treg cells were No difference comparing with controls.(2)Levels of percentage of total T lymphocyte counts(CD3+CD19-)were increased in cases(all P=0.002).The percentage of peripheral Th2 in gout was higher than that in healthy controls(P<0.05).Moreover,the percentage of peripheral Th1 and Treg cells was significantly decreased in gout patients(all P<0.05).For GroupA,GroupB and controls:Levels of Total B lymphocyte counts(CD3-CD19+)and Helper T cells(CD3+CD4+)were increased in GroupB(all P<0.05).Nevertheless,there was no difference between GroupA and healthy controls.The absolute number of peripheral Th2 in gout(both GroupA and Group B)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 GroupB(P=0.006)while,in GroupA,the absolute number of Treg cells decreased despite no statistical significance(P=0.357).Conclusion:Detection of the absolute numbers are more meaningful than percentage of the CD4+T cell subsets in gout.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.Moreover,Th17 may contribute to the persistence of the disease.