Relationship Between Gout And Constitution Of Traditional Chinese Medicine.

Objective: The objective of this study was to explore common TCM constitutions among gout patients and investigate the potential relationship between traditional Chinese medicine's (TCM) constitution and clinical parameters. Methods: A total of 219 gout patients with 195 participants were included in this study. All participants completed a baseline questionnaire on demographic characteristics, including age, weight, and family history. The biased constitution of TCM was identified by questionnaires surveyed with a TCM constitution table. Results: Of 195 patients with gout, phlegm-damp accounted for the majority of TCM constitution classifications, followed by Qi-deficiency, damp-heat, and Yang-deficiency constitutions. Besides, patients with these four constitutions have a higher BMI, blood sugar, and homocysteine. Conclusion: The major types of constitution among these gout patients were phlegm-damp, Yang-deficiency, Qi-deficiency, and damp-heat. Gout symptoms with TCM constitutional theory may contribute to provide new insights into more rapid diagnosis and treatment for the effective prevention or therapy of gout. It is necessary to design more case-control studies and high-quality cohort in the future researches to provide a more helpful evidence-based basis for evaluating the relationship between TCM constitution and gout patients.

Expression of PYCARD gene transcript variant mRNA in peripheral blood mononuclear cells of primary gout patients with different Chinese medicine syndromes.

OBJECTIVE: 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. METHODS: The expressions of PYCARD gene transcript variant mRNA and interleukin-1ß (IL-1ß) 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-1ß, IL-4 and IL-10 protein levels in plasma of HCs and PG patients were measured by enzyme-linked immuno sorbent assay. RESULTS: 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-1ß, 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-1ß, 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-1ß in APPG patients (r=0.3088, P=0.0183). CONCLUSION: 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.

Expression of Caspase-1 Gene Transcript Variant mRNA in Peripheral Blood Mononuclear Cells of Patients with Primary Gout in Different TCM Syndromes.

A large number of studies have shown that cysteinyl aspartate specific protease-1 (CASP1) played an important role in the inflammatory response of primary gout, but the decreased expression of different CASP1 transcript variant could inhibit the activation of IL-1ß. Our study mainly analyzed the expression level and function of CASP1 gene transcript variant mRNA in peripheral blood mononuclear cells of patients with gout in different TCM syndromes. The expression of CASP1 gene transcript variant and IL-1ß mRNA in PBMCs were detected in patients with PG [acute phase (AP: 44 cases); nonacute phase (NAP: 52 cases)] and healthy controls (HC: 30 cases) by reverse transcription-polymerase chain reaction and/or real-time quantitative polymerase chain reaction. The expressions of plasma IL-1ß in patients with PG and HC were detected by enzyme-linked immunosorbent assay. Dysregulated expression of the CASP1 gene and its transcript variant, plasma proinflammatory cytokines in all patients with primary gout in different TCM syndromes, correlation analysis showed that there was negative correlation between the expression of CASP1-gamma gene transcript variant mRNA and IL-1ß protein in APPG group. The study suggested that CASP1 gene and its transcript variant may play a critical role in the inflammatory response of patients with PG in different phases and TCM syndromes.

[Comparative analysis of clinical indicators of gout patients of different syndrome types and its significance].

OBJECTIVE: To understand the difference in clinical indicators of gout patients of different Chinese medical syndromes and its clinical significance. METHODS: Form November 2011 to December 2012, syndrome typed were 257 male gout in-/outpatients from Affiliated Hospital of Chuanbei Medical College. Another 50 healthy male subjects were recruited as the control. Their clinical and laboratory data were collected. All were excluded from infections and other inflammatory diseases. RESULTS: Four syndrome types existed in gout patients, i.e., intermingled phlegm-stasis blood syndrome (IPSBS), obstruction of dampness and heat syndrome (ODHS), Pi-deficiency induced dampness syndrome (PDIDS), qi-blood deficiency syndrome (QBDS). Of them, 53 acute phase gout patients suffered from IPSBS, 41 from ODHS, 25 from QBDS, and 17 from PDIDS; 41 non-acute phase gout patients suffered from QBDS, 40 from PDIDS, 24 from ODHS, and 16 from IPSBS. Statistical analysis of clinical data showed that, when compared with the normal control group, there was statistical difference in blood routines (WBC, GR, LY, MO) and blood biochemical indices (UA, Ur, Cr, ALT, AST, ALB, GLOB, TG, HDL-C, VLDL-C, apoA, apoB100) of gout patients of different syndromes (P < 0.05, P < 0.01). There was also statistical difference or correlation among different syndromes (P < 0.05). CONCLUSIONS: In the acute phase gout patients, IPSBS and ODHS were dominated, while in the non-acute phase gout patients, QBDS and PDIDS were often seen. In patients of IPSBS and ODHS, inflammation and immune response were more obvious, indicating that better efficacy might be achieved by clearing heat and removing blood stasis associated anti-inflammatory and immune regulation therapies. In patients of QBDS and PDIDS, impaired renal functions were more significant, indicating that better efficacy might be achieved by invigorating Pi and tonifying Shen dominated treatment.

[Preliminary study on change of serum proteome in noxious heat blood stasis syndrome treated by radix Paeoniae rubra].

OBJECTIVE: To study the effect of red peony root (RPR) on serum proteome in rat suffering from noxious heat with blood stasis Syndrome (NH-BS). METHODS: The differences of serum proteome among rats in four groups, treated with lipopolysaccharide (LPS), RPR, LPS + RPR and saline respectively, were analyzed by bi-dimensional electrophoresis (2DE) assay. LPS was administered by intravenous injection and RPR by oral intake. RESULTS: (1) Serum of rats with LPS induced NH-BS showed significant changes in volume of serum protein (xPr) in 13 points on 2DE collagen, the volume of xPr 16 and 19 were significantly lower, volume of xPr 1, 2, 3, 4, 6, 7, 8, 9, 11, 12 and 23 were significantly higher respectively, as compared with those in the normal control group. (2) After being treated with RPR, the increased volume of xPr 1, 2, 3, 4 and 9 significantly decreased, and the decreased xPr 16 significantly increased, with xPr 2, 3 restored to normal level but the xPr16 still lower and xPr 1, 4, 9 higher than those in the normal group. RPR showed interaction with LPS on xPr 1, 3, 9, and 16. (3) For xPr 19, the interaction of RPR with LPS might be synergistic. (4) In the group treated with RPR, volumes of xPr 13 and 14 were significantly higher and those of 15, 17 were significantly lower than those in the normal group respectively, but the similar changes didn't found in the LPS group. CONCLUSION: The molecular basis of therapeutic effect of RPR on NH-BS might be through the regulation of xPr 1, 2, 3, 4, 9 and 16.

[Study on serum proteome of rat endotoxemia treated by figwort root].

OBJECTIVE: To study the serum proteome of rat endotoxemia treated by figwort root (FR). METHOD: The differences of serum proteome among rats treated with lipopolysaccharide (LPS), FR, LPS + FR and saline respectively were analyzed by two-dimensional electrophoresis (2DE) assay. RESULT: The volumes of sixteen serum proteins (xPr) in LPS induced-endotoxemia group were greatly changed compared with those of the control group. Among them, the volumes of xPr 16, 19 were significantly decreased, and the volumes of xPr 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly increased. When treated with FR, the volumes of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly decreased, and the volumes of xPr 8, 9, 11, 12, 23, 14 were back to normal level. Two factors statistic analysis showed that FR had interaction with LPS for xPr 1, 5, 8, 10, 11, 12, 18, 19, 20, 21, 22, and FR might be the functional antagonist of LPS. We also observed that the volumes of xPr 10, 13, 15, 20, 21, 22 were found to change significantly only in FR treated group but not in LPS treated group or control group. Interestingly, the volume of xPr 13, 20, 21, 22 were increased and the volume of xPr 10, 15 were decreased. CONCLUSION: The molecular basis of therapeutic effect of FR on endotoxemia might be through the regulation of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23. We can use proteomic techniques to study the molecular mechanisms of diseases treated by functional Chinese herbs and the combination of different herbs is necessary for the treatment of endotoxemia, as FR can not regulated all the changed proteins induced by LPS.