Comprehensive mapping of immune perturbations associated with Acute Gouty Arthritis

Abstract Background Acute gout is a form of inflammatory arthritis characterized by a sudden, acute onset of pain, swelling, warmth, erythema, and decreased range of motion in the affected joint. Although numerous studies have focused on the phenotypes of immune cells, the complete immunophenotypic atlas of patients with acute gout remains unelucidated. Hence, we aimed to comprehensively examine the general immunologic condition of patients with acute gout and compare it with that of healthy donors (HD). Methods We collected peripheral blood mononuclear cells (PBMCs) from patients with acute gout (n = 31) and healthy donors (HDs) (n = 16) to investigate the immunophenotype of acute gout. Furthermore, the components and kinetics of the immune response were examined in these patients. Results By demonstrating the frequency and phenotype of immune cells, such as neutrophils, monocytes, and natural killer (NK) cells, we discovered that patients with acute gout had significantly higher neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-T-cell ratio (NTR) than that in HDs. We also observed a significant association between NTR and C-reactive protein (CRP) levels. Furthermore, NK cell cytotoxicity was reduced, and heterogeneous T cell activation and plasmablasts (PBs) frequencies were increased in patients with acute gout. Conclusion Our findings demonstrate substantial perturbations in leukocytes, including T cells, B cells, NK cells, and monocytes, in patients with acute gout. Thus, NTR may serve as a biomarker of acute gout. These findings may facilitate the easier implementation of novel preventive and therapeutic strategies against acute gouty arthritis.