Inflammatory Cells in Tissues of Gout Patients and Their Correlations with Comorbidities



Syeling Lai1, 2, Xiaodong Zhou*, 3
1 Department of Pathology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
2 Department of Pathology, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
3 Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA


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© Lai and Zhou; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA; Tel: 713-500-6900; Fax: 713-500-0580; E-mail: xiaodong.zhou@uth.tmc.edu


Abstract

Background:

The major pathological finding of gout is the deposition of monosodium urate monohydrate (MSU) crystals with inflammatory infiltrate in the tissue. There have been many reports of in vitro analysis of inflammatory mechanism and comorbidities in gout. However, the associations of immune response cells and comorbidities of gout have not been well documented. Our studies aimed to examine the immune cell types and quantity in gout tissues, and to define the association of individual cell type with comorbidities.

Methods:

Surgically resected or biopsied tissues from 48 patients diagnosed as gout were used for this study. Cell count was performed on Hemotoxylin and Eosin stained sections for macrophages, plasma cells, neutrophils and on immunostained slides for T and B lymphocytes.

Results:

Hyperlipidemia, hypertension and diabetes mellitus were seen in 70.8%, 87.5% and 37.5% of patients, respectively. There were 35.6% and 37.8% of patients who admitted history of smoking and alcohol intake, respectively. Mean serum uric acid level was 8.5 mg/dl. The average body mass index was 30.1 kg/m2. H&E stained tissue sections demonstrated the crystalline deposits rimmed by palisading multinucleated giant cells, macrophages, neutrophils, plasma cells, T and B cells. Significant correlations between the clinical features and tissue inflammatory cells were observed in hyperlipidemia with number of T cells (p = 0.0363), hypertension with number of T cells and B cells (p = 0.0138 and 0.0033, respectively), diabetes mellitus with macrophages (p = 0.0016), and uric acid level with giant cells (p = 0.0088).

Conclusion:

Comorbidity factors including hyperlipidemia, hypertension and diabetes are significantly associated with the inflammatory cells in the tissues.

Keywords: Gout, mononucleated macrophages, multinucleated giant cells, T-cells, B-cells, uric acid, comorbidities..