Objective To study the expression level of NLRP3 (NLR family, pyrin domain containing 3)inflammasome (NL-RP3, ASC, caspase-1) mRNA in peripheral blood monocytes (PBMCs) and serum level of interleukin-6 (IL-6)of patients with acute gouty arthritis (AGA) in the course of it, and the roles of them in pathogenesis in AGA. Methods According to the standards of American College of Rheumatology (ACR) in 1997, 100 outpatients who had acute gouty arthritis (AGA) were selected as test group (T). All patients came from Department of Endocrinology of Qingdao Eighth People’s Hospital from August 2014 to February 2016. At the same time, 100 healthy subjects were selected as control group (C) who were lo-cal residents of Qingdao came from Health Examination Center of our hospital.NLRP3 inflammasome mRNA was measured using reverse transcription-polymerase chain reaction (RT-PCR) in PBMCs. The expression of NLRP3 inflammasome mR-NA in PBMCs was compared between T and C. T consisted of four stages of disease process : pretherapy (D0), 3rd day after medications (D3), 7th day after medications (D7) and 14th day after medications (D14). IL-6was measured accordingly using Enzyme-linked immunosorbent assay (ELISA) in the two groups. Results The expression of NLRP3 mRNA in D0 (0.077±0.039), D3 (0.086±0.046) and D7 (0.103±0.054) reduced significantly when compared to C (0.130±0.070)(P﹤0.01). The expression of ASC mRNA in AGA increased significantly when compared to healthy controls. D0 (0.028 ±0.016), D3 (0.030±0.020) and D7(0.017±0.012) vs C(0.011±0.006)(P﹤0.01), D14(0.013±0.007) vs C(P﹤0.05).The expression of cas-pase-1 mRNA in D0(0.047±0.030) and D3(0.052±0.030) reduced significantly when compared to C(0.119±0.061)(P﹤0.01). Serum level of IL-6(pg/ml) in D0(48.87±19.25), D3(49.84±21.14) and D7(43.81±18.30) increased significantly when com-pared to C(10.21±3.62) (P﹤0.01), and there was a significant increase in D14(11.40±4.55)vs C (P﹤0.05). Conclusion Dys-regulated expression of the NLRP3 inflammasome and IL-6 level are involved in the inflammatory response and play key roles in the pathogenesis of the process of AGA.%目的：检测急性痛风性关节炎(acute gouty arthritis, AGA)患者治疗前后外周血单核细胞(peripheral blood mono-cytes, PBMCs)中NLRP3炎性体[NLRP3、凋亡相关斑点样蛋白(ASC)、半胱天冬酶-1(caspase-1)]mRNA表达水平及血清白介素(IL)-6水平的变化,探讨该炎性体及IL-6在AGA发病中可能的作用机制。方法根据美国风湿病协会(ACR)1997年制定的诊断标准,随机选取来自该院2014年8月—2016年2月的门诊AGA患者100例(观察组,T),同时随机选取相同时间段青岛本地居民健康查体者100名(对照组,C)。用RT-PCR法检测对照组和观察组治疗前(D0)及应用药物治疗后第3天(D3)、第7天(D7)、第14(D14)天NLRP3炎性体mRNA表达水平,同时用ELISA法测定相应IL-6水平。结果与对照组(0.130±0.070)相比,NLRP3 mRNA表达水平在D0(0.077±0.039)、D3(0.086±0.046)及D7(0.103±0.054)均显著降低,差异有统计学意义(P﹤0.01)；与对照组(0.011±0.006)相比,观察组各阶段ASC mRNA表达水平均显著升高,差异有统计学意义,其中D0(0.028±0.016)、D3(0.030±0.020)及D7(0.017±0.012) vs C(P﹤0.01)、D14(0.013±0.007) vs C(P﹤0.05)；与对照组(0.119±0.061)相比,caspase-1 mRNA表达水平在D0(0.047±0.030)及D3(0.052±0.030)显著降低,差异有统计学意义(P﹤0.01)。观察组血清IL-6水平(pg/ml)与对照组(10.21±3.62)相比在各阶段均显著升高,差异有统计学意义,其中D0(48.87±19.25)、D3(49.84±21.14)、D7(43.81±18.30) vs C(P﹤0.01),D14(11.40±4.55) vs C(P﹤0.05)。结论 NLRP3炎性体及IL-6在AGA患者治疗过程中水平异常,提示它们在AGA发病中参与了炎症反应过程,在炎症机制中可能发挥了重要作用。
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