NLRP3、PYCARD、CASP1在痛风性关节炎患者中的变化特点及其临床意义

Changes of NLRP3,PYCARD and CASP1 in patients with GA and its clinical significance

目的:目的探讨外周血单个核细胞中核苷酸结合寡聚化结构域样受体3(NLRP3)、半胱天冬酶-1(CASP1)、凋亡相关斑点样蛋白(PYCARD)在痛风性关节炎(GA)患者中的变化特点及其意义。方法:选取我院2016年2月至2017年4月确诊的90例GA患者(GA组)、选取健康体检志愿者90例(对照组),采用RT-PCR技术检测两组NLRP3、PYCARD、CASP1 mRNA表达水平,并按照患者病情、治疗前后进行分层分析,分析GA患者NLRP3、PYCARD、CASP1 mRNA与患者血清炎症因子的关系。结果:GA组患者的NLRP3 mRNA表达水平低于对照组(t=-9.263,P<0.001),GA组患者的PYCARD、CASP1 mRNA表达水平高于对照组(t=13.975,t=10.064;P均<0.001);急性GA患者(AGA组)患者的NLRP3、CASP1 mRNA表达水平高于非急性GA患者(NAGA组)(t=8.872,t=12.062;P均<0.001),AGA组和NAGA组的PYCARD mRNA差异无统计学意义(t=0.823,P=0.413);GA组患者的治疗后的NLRP3 mRNA水平显著升高(t=-6.542,P<0.001),CASP1 mRNA、PYCARD mRNA表达水平在治疗后显著降低(t=9.827,t=5.788;P均<0.001);AGA组患者的IL-6、TNF-α表达水平高于NAGA组(t=8.403、5.329,P<0.001);GA组患者的NLRP3 mRNA与IL-6、TNF-α呈负相关关系(r=-0.345、r=-0.524,P<0.001);PYCARD、CASP1 mRNA与GA患者的IL-6、TNF-α呈正相关关系(r=0.645,r=0.682,r=0.634,r=0.713,P<0.001)。结论:GA患者NLRP3、PYCARD、CASP1 mRNA表达水平变化与患者病情及炎症反应程度有关。

Objective:To investigate the changes of nucleotide binding oligomeric domain-like receptor 3(NLRP3),caspase-1(CASP1)and apoptosis-related spot-like protein(PYCARD)in peripheral blood mononuclear cells(PBMC)in patients with gouty arthritis(GA).Methods:90 patients with GA diagnosed in our hospital from February 2016 to April 2017(GA group)and 90 healthy volunteers(control group)were selected.RT-PCR was used to detect the expression levels of NLRP3,PYCARD and CASP1 mRNA in the two groups,and stratified analysis was performed according to the patient′s condition and before and after treatment to analyze the relationship between NLRP3,PYCARD,CASP1 mRNA and serum inflammatory factors in GA patients.Results:The expression level of NLRP3 mRNA in the GA group was lower than that in the control group(t=-9.263,P<0.001).The expression levels of PYCARD and CASP1 mRNA in the GA group were higher than those in the control group(t=13.975,t=10.064,P<0.001).The expression of NLRP3 mRNA and CASP1 mRNA in the AGA group was higher than that in the NAGA group(t=8.872,t=12.062,P<0.001).There was no significant difference in PYCARD mRNA between AGA group and NAGA group(t=0.823,P>0.05).The NLRP3 mRNA level was significantly increased after treatment in the GA group(t=-6.542,P<0.001);the expression levels of CASP1 mRNA and PYCARD mRNA were significantly decreased after treatment(t=9.827,t=5.788,P<0.001);IL-6 and TNF-αexpression levels were lower in the AGA group than in the NAGA group(t=8.403,t=5.329,P<0.001).There was a negative correlation between NLRP3 mRNA and IL-6 and TNF-αin the GA group(r=-0.345,r=-0.524,P<0.001).PYCARD and CASP1 mRNA were positively correlated with IL-6 and TNF-αin patients with GA(r=0.645,r=0.682,r=0.634,r=0.713,P<0.001).Conclusion:The changes of NLRP3,PYCARD and CASP1 mRNA expression levels in patients with GA are related to the changes of patients′condition and the degree of inflammatory reaction.