Inflammatory Cell Counts in Gout Tissues Closely Linked to Hypertension Presence

A pair of researchers based in Texas has gained valuable insight into the correlation between individual cell type in the tissues of gout patients and comorbidity factors of the chronic inflammatory autoimmune disorder.

To define that association, Syeling Lai, MD, an assistant professor of pathology and immunology at Baylor College of Medicine, and Xiaodong Zhou, MD, an associate professor of internal medicine at the University of Texas Medical School, identified and counted T and B lymphocytes, neutrophils, mononucleated macrophages, multinucleated giant cells, plasma cells, and uric acid in surgically resected or biopsied tissue specimens from 48 male gout patients aged between 39 and 84 years old. (Figure 1)

In their initial comorbidity measurements, the researchers found that 87.5 percent of the patients had hypertension, 70.8 percent had hyperlipidemia, 37.5 percent had diabetes, 40.4 percent had a body mass index that suggested obesity, and 84.4 percent had hyperuricemia described as serum uric acid levels higher than 7 mg/dL, which is the level when plasma concentration exceeds uric acid solubility and facilitates the formation of monosodium urate crystals in the tissue.

Examining those comorbidities alongside immune cell measures, the authors determined that in the tissue sections of gout patients, increased T cells were linked to hyperlipidemia (p = 0.0363) and hypertension (p = 0.0138), increased B cells also correlated with hypertension (p = 0.0033), and enriched neutrophils were slightly associated with hypertension (p = 0.0535). According to the authors, the positive correlations between those cell types and hypertension “suggests that inflammatory cells may play important roles in hypertension-associated gout,” though they noted that “whether gout can impact hypertension through an inflammatory process in the body — and/or hypertension predisposes local burden attributed to inflammatory cell response in gout tissues — is still unclear.”

On the other hand, the researchers discovered smaller amounts of macrophages in the tissues of gout patients with diabetes (p = 0.0016), as well as decreased giant cells in those with hyperuricemia (p = 0.0535) — an observation they said “is interesting, but needs further confirmation.” (Figure 2)

“Characterization of comorbidities and immune response cells in gout is valuable for future studying pathogenesis of gout, as well as for better patient management, (though) our understanding of the mechanism of any association between them is far from complete,” the authors concluded.

Nevertheless, their present study showed that hyperlipidemia, diabetes, and especially hypertension significantly correlate with inflammatory cells situated in the tissues of gout patients.