ABSTRACT
<p><b>OBJECTIVE</b>To study the expression level and role of apoptosis-associated speck-like protein containing a caspase recruitment domain (PYCARD) gene transcript variant mRNA in peripheral blood mononuclear cells (PBMCs) of primary gout (PG) patients with different Chinese medicine (CM) syndromes.</p><p><b>METHODS</b>The expressions of PYCARD gene transcript variant mRNA and interleukin-1β (IL-1β) mRNA in PBMCs were investigated in 96 PG patients with acute phase (APPG, 44 cases) and non-acute phase (NAPPG, 52 cases) and 30 healthy controls (HCs) by reverse transcription-polymerase chain reaction (PCR) and/or realtime quantitative PCR. PYCARD and nuclear factor-κB (p50) [NF-κB (p50)] protein was detected by Western blot in PBMCs respectively. IL-1β, IL-4 and IL-10 protein levels in plasma of HCs and PG patients were measured by enzyme-linked immuno sorbent assay.</p><p><b>RESULTS</b>The main CM syndromes in APPG patients were obstruction of dampness and heat syndrome (ODHS, 36.36%) and intermingled phlegm-blood stasis syndrome (IPBSS, 27.27%), while in NAPPG patients were Pi (Spleen)-deficiency induced dampness syndrome (PDIDS, 40.38%) and qi-blood deficiency syndrome (QBDS, 26.92%). It showed statistical significances of the expressions of PYCARD gene and its transcript variant mRNA, the protein of PYCARD and NF-κB (p50) and the plasma IL-1β, IL-4 and IL-10 in APPG, NAPPG, ODHS, IPBSS, PDIDS and QBDS groups, compared with the HC group respectively (P<0.05 or P<0.01). There were also significant differences of mRNA expressions of PYCARD-1 and PYCARD-2 as well as protein expressions of IL-1β, IL-4 and IL-10 among the 4 CM syndromes groups (P<0.05 or P<0.01). Correlation analysis showed positive correlation between the mRNA expressions of PYCARD-1 gene transcript variant and IL-1β in APPG patients (r=0.3088, P=0.0183).</p><p><b>CONCLUSION</b>PYCARD gene and its transcript variant may play a critical and regulative role in the inflflammatory response of PG patients with different phases and CM syndromes.</p>
ABSTRACT
Objective:To explore the curative effect and safety of febuxosta for the patients with primary gout complicated with mild to moderate renal insufficiency.Methods:60 male patients with primary gout complicated with mild to moderate renal insufficiency were enrolled in the affiliated Hospital of integrated traditional Chinese and Westem Medicine,Nanjing University of Chinese Medicine from January 2015 to August 2016 and randomly divided into two groups,the control group (n=30) was treated by allopurinol,and the study group (n=30) was treated by febuxosta treatment.The blood uric acid (BUA) and hepatorenal function were compared in the treatment period,and the incidence of adverse reactions and the recurrence of gout in post-treatment were compared.Results:At 1,2 and 3 month after treatment,the serum level of BUN in the study group was significantly lower than that of the control group (P＜0.05).The renal function of all patients were significantly improved compared with pre-treatment (P＜0.05),but the no significant difference was found between two groups at the same time(P＞0.05).The control group showed the adverse reactions with limb discomfort,drowsiness,nausea,abdominal distension,diarrhea and itch of skin,and the study group showed limb discomfort,drowsiness and abdominal distension,and one patients presenting allergic skin rash and discontinuation of allopurinol.The total incidence of adverse reactions in the study group was significantly lower than that of the control group (P＜0.05).Conclusions:Febuxosta could effectively and safely decrease the blood uric acid levels and improve the renal function of patients with primary gout complicated with mild to moderate renal insufficiency.