调节性T细胞在急慢性痛风患者中的变化及意义

The change and significcance of regulatory T cells in peripheral blood in patients with acute and chronic gout

目的探讨调节性T细胞(Treg)在急、慢性痛风患者外周血中的变化及意义。方法采用流式细胞术检测健康对照、急性痛风和慢性痛风患者外周血调节性T细胞的比值,ELISA方法检测血浆中TGF-β、IL-1β浓度,采用F检验、Kruskal-Walls H检验、q检验以及Pearson、Spearman相关分析等方法分析它们在痛风不同阶段的变化及意义。结果①健康对照组外周血CD4+CD25+Foxp+调节性T细胞/CD4+T细胞百分率为(1.22±0.27)%、急性痛风组为(1.51±0.43)%、慢性痛风组为(0.47±0.26)%,3组间差异有统计学意义(F=101.39,P<0.05),急性痛风较健康对照组、慢性痛风组调节性T细胞百分率均升高,慢性痛风较健康对照组降低,差异均有统计学意义(P均<0.01)。②健康对照组血浆TGF-β浓度为(170±12)ng/L、急性痛风组为(214±77)ng/L、慢性痛风组为(179±21)ng/L,3组间差异有统计学意义(F=6.20,P<0.05)。急性痛风较健康对照组、慢性痛风组均升高,差异有统计学意义(P=0.003,P<0.05),慢性痛风组与健康对照组间差异无统计学意义(P>0.05)。③健康对照组血清IL-1β浓度为(4.8±1.3)ng/L、急性痛风组为(10.1±8.5)ng/L、慢性痛风组为(11.5±12.6)ng/L,3组间差异有统计学意义(χ^2=7.54,P<0.05)。急性痛风、慢性痛风较健康对照组均升高,差异有统计学意义(Z=2.76,P<0.05;Z=2.29,P<0.05),急性痛风与慢性痛风组间差异无统计学意义(Z=0.54,P>0.05)。④痛风患者外周血调节性T细胞百分率与病程、6个月内发病次数均呈负相关(病程:r=-0.381,P<0.05;发病次数:r=-0.518,P<0.01),与血浆TGF-β、IL-1β浓度均无相关。结论调节性T细胞在急性痛风中升高,参与了痛风炎症缓解;在慢性痛风中降低,可能与痛风迁延不愈有关。调节性T细胞在急、慢性痛风转换中起重要调控作用。

Objective To investigate the change and significance of regulatory T cells (Tregs) in peripheral blood in patients with acute and chronic gout. Methods Flow cytometry was used to detect the ratio of Tregs in peripheral blood of healthy controls, patients with acute gout and patients with chronic gout. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of transforming growth factor (TGF)-β and interleukin (IL)-1β in plasma. Then, statistical analysis was conducted to analyze the changes and significance in different stages of gout, such as F test, Kruskal-Walls H test, q test and Pearson and Spearman correlation analysis. Results ① The percentage of CD4^+CD25^+Foxp^+ Treg/CD4^+ T cells in peripheral blood was (1.22±0.27)% in control group. While in patients with acute gout, it was (1.51±0.43)%, and (0.47±0.26)% in patients with chronic gout. There were statistical significant difference among the three groups (F=101.39, P<0.05). The percentage of Tregs in acute gout group was significantly higher than that in control group and chronic gout group, while it was significantly lower in chronic gout group than in control group (P<0.05).② The concentration of TGF-β in plasma was (170±12) ng/L in control group,(214±77) ng/L in patients with acute gout and (179±21) ng/L in patients with chronic gout, the difference was statistically-significant (F=6.20, P<0.05). The concentration of TGF-β in plasma in acute gout group was significantly higher than the control group and chronic gout group, the difference was statistically significant (P<0.05), while the difference between chronic gout group and the control group was not statistically significant (P>0.05).③ The con-centration of IL-1β in plasma in the control group was (4.8±1.3) ng/L, while that in patients with acute and chronic gout was (10.1±8.5) ng/L and (11.50±12.57) ng/L respectively, the difference between these three groupswas stati-sticallysignificant (P<0.05). The concentration of IL-1β in plasma in acute gout group and chronic gout group wassignificantly higher than that in the control group, the difference was statistical significant (P<0.05). There was no significant difference between acute gout and chronic gout (P>0.05) patients.④ The percentage of Tregs in peripheral blood of gout patients was negatively correlated with the duration of disease and the number of gout attacks within six months (duration of disease: r=-0.381, P<0.01;number of gout attacks: r=-0.518, P<0.01). But there wasno significant correlation to the concentration of TGF-β and IL-1β. Conclusion Tregsincreasesin acute gout and participate in the alleviation of gout inflammation, while the persistence of chronic gout may be related to the decrease of Tregs. Therefore, Tregs play an important regulatory role in the transformation of acute and chronic gout.