焦亡相关炎症因子与痛风性关节炎疾病活动度的相关性研究

The correlation between levels of serum pyroptosis-related inflammatory factors and pain in gouty arthritis patients

目的分析焦亡相关炎症因子在痛风性关节炎(gouty arthritis,GA)患者不同病程中的表达水平,探讨细胞焦亡是否参与GA的病理生理过程。方法收集2022年6月至2023年6月就诊于中日友好医院风湿免疫科50例急性痛风性关节炎(acute gouty arthritis,AGA)患者(AGA组)和50例健康体检者(健康对照组)的外周静脉血样本,分别检测两组患者血清生化指标、血常规指标及焦亡相关炎症因子如C反应蛋白(C-reactive protein,CRP)、白介素(interleukin,IL)-1β、IL-18的表达水平;蛋白免疫印迹法检测尿酸钠结晶刺激的THP-1细胞中焦亡相关蛋白水平变化。采用SPSS统计学软件对受试者的尿酸水平、疾病活动度等指标进行统计分析。结果与健康对照组相比,AGA组患者外周血血清尿酸(uric acid,UA)、白细胞、CRP、IL-1β、IL-18、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、Ca^(2+)水平显著升高,Mg^(2+)水平显著降低,差异具有统计学意义(P<0.05);AGA组急性发作期UA、白细胞、CRP、IL-1β、IL-18、IL-6、TNF-α、Ca^(2+)和数字分级评分法(numerical rating scale,NRS)评分显著高于缓解期,Mg^(2+)水平显著降低(P<0.05);NRS评分与血清IL-1β、IL-8、IL-18水平呈正相关(P<0.05)。尿酸钠结晶刺激的THP-1细胞中焦亡相关功能蛋白表达水平显著高于无特殊处理的THP-1细胞。结论GA患者焦亡相关炎症因子水平高于健康对照者,且GA急性期焦亡相关炎症因子水平高于GA缓解期,提示细胞焦亡可能参与了GA的免疫炎性反应。

Objective This study aimed to analyze the expression of inflammatory factors in patients with gouty arthritis(GA)in different clinical courses and discussed whether pyroptosis participated in the occurrence and development of GA.Methods Peripheral venous blood samples from 50 patients with acute gouty arthritis(AGA group)and 50 healthy subjects(healthy control group)who visited the Rheumatology and Immunology Department of China-Japan Friendship Hospital from June 2022 to June 2023 were collected respectively.The levels of biochemical parameters,blood routine indicators,and inflammatory factors such as,IL-1β,IL-8,and IL-18 in the serum of two groups were tested.And the expression of pyroptosis related proteins in THP-1 cells stimulated by MSU,were detected by Western blotting.SPSS 19.0 statistical software was used to compare the differences of inflammatory factors levels between the two groups and the correlations between serum inflammatory factors and disease activity.Results Compared with the healthy control group(HC group),the levels of peripheral blood uric acid(UA),WBC,CRP,IL-1β,IL-18,IL-6,TNF-αand Ca^(2+) in AGA group increased significantly,the Mg^(2+) levels significantly reduced,(P<0.05).The levels of UA,WBC,ESR,CRP,IL-1β,IL-18,IL-6,TNF-α、Ca^(2+) and NRS scores in the GA group in GA acute stage were significantly higher than those in the remission stage,and the level of Mg^(2+) significantly reduced(P<0.05).NRS scores were positively correlated with the level of serum CRP,IL-1β,and IL-18 levels(P<0.05).The expression level of functional protein related to pyroptosis in monosodium urate crystal group was significantly higher than that in the control group.Conclusions The levels of pyroptosis related factors in GA patients are higher than those in the healthy control group,and the levels in acute onset stage of GA is higher than that in the remission stage,indicating that cell pyroptosis may be involved in the immune inflammatory response of GA.