Study On Peripheral Blood Immune Function And Serum Uric Acid Level In Patients With Gout Arthritis

Objective:1.To investigate the changes and significance of peripheral blood immune function and CD4+T lymphoid subgroup in patients with gout arthritis.2.To explore the effect of peripheral blood uric acid level on immune function and CD4+T lymphoid subgroup status in patients with gout.Methods:A total of 258 patients with gout were recruited from the Second Hospital of Shanxi Medical University from May in in 2016 to October in 2019.All patients fulfilled 2015 Gout classification criteria developed by the American College of Rheumatology(ACR)and patients with infections,tumors and other autoimmune diseases,as well as pregnant or lactating women,were excluded.At the same time,41 healthy physical examinees from the physical examination center of our hospital were collected as the control group.The research content is divided into two parts:1?258 gout patients and 41 healthy subjects were selected as the case group and the healthy control group,then compare the differences of peripheral blood immune function and CD4+T lymphocyte subsets between the two groups;2.258 patients with gout were divided into elevated uric acid group and normal uric acid group according to their uric acid level,and then the differences of peripheral blood immune function and CD4+T lymphocyte subsets between the two groups were compared.Results:1.Compared with the healthy control group,the case group,the absolute value of total B cells,Th cells,T+B+NK and the ratio of Th/Ts in peripheral blood immune function all increased,with statistical significance(all P values < 0.05).2.Compared with the healthy control group,the peripheral blood CD4+T cell subsets of the gout group showed significantly increased of Th2,Th17,and Th17/Treg,while significantly decreased of Treg %,Treg,and the differences were statistically significant(P < 0.05).3.Compared with the normal uric acid group,there was no statistically significant difference in peripheral blood immune function between the two groups,including absolute values of T cells,Th cells and Ts cells(all P values were > 0.05),but there was a decreasing trend in the group with elevated uric acid.The value of B cells,NK cells and the ratio of Th/Ts were not statistically significant(all P values were > 0.05),but there was an increasing trend in the group with elevated uric acid..4.Compared with CD4+T cell subsets in the normal uric acid group:(1)The increase of Th17% in the group with elevated uric acid was statistically significant(P < 0.05).(2)Both Treg % and Treg were significantly decreased in the group with elevated uric acid,and the difference was statistically significant(all P values < 0.05).(3)In the CD4+T cell subsets of the group with elevated uric acid compared with the normal uric acid group,there was no statistically significant difference in Th1 and Th2 between the two groups(all P values were>0.05).Conclusion:1.The increase of total B cells,the increase of Th17 and the decrease of Treg in peripheral blood of patients with gout arthritis suggest that the immune mechanism plays an important role in the pathogenesis of gout.2.The absolute number of Treg cells in the group with elevated uric acid in patients with gout was significantly reduced,indicating that,to a certain extent,blood uric acid may affect the occurrence and development of the disease through its regulatory effect on Treg cells.