| Objective: Using micro RNA gene chip technology tested the expression profiling of mi RNAs in the plasma of acute gouty arthritis, the different mi RNAs expression from acute gouty arthritis, asymptomatic hyperuricemia(HUA) and normal plasma were screened, and validated partial differential mi RNAs with quantitative real-time PCR(RT-q PCR). Meanwhile, observed Chuanhu anti-gout mixture clinical efficacy of the treatment of acute gouty arthritis, and studied Chuanhu anti-gout mixture interventions of differences mi RNAs expression. And to investigate the mechanism action of mi RNAs in acute gouty arthritis, explore the new targets of Chuanhu anti-gout mixture treatment of acute gouty arthritis, and provid new theoretical and experimental basis for the Chinese medicine preventing and treating acute gouty arthritis.Methods: 1. Collected 4 patients with acute gouty arthritis, 4 patients with asymptomatic HUA, and 4 healthy volunteers plasma, RNA was extracted using Trizol method, then used mi RNAs microarray LNATM exqion to detect plasma mi RNAs expression pedigree. Used clustering analysis software to analyze the differential expression of mi RNAs. 2. Collected 60 patients with acute gouty arthritis and 30 patients with asymptomatic HUA plasma and used RT-q PCR method to verify the partial differential mi RNAs. 3. Application of randomized, double-blind, double-dummy and parallel-controlled methods, a total of 189 patients with acute gouty arthritis were randomly allocated to Chuanhu anti-gout mixture treatment group, colchicine treatment group, or control treatment group on the basis of a computer-generated random number table. Collected plasma before and after treatment, used RT-q PCR method to test some differential mi RNAs, determined Chemokine ligand 2(CCL2) and CXCL8 levels by enzyme-linked immunosorbent assay(ELLASA), and analyzed the intervention effects of Chuanhu anti-gout mixture with differences mi RNAs and Chemokine ligand.Results: 1. There were 20 mi RNAs differentially expressed obviously in acute gouty arthritis patients plasma, which 6 mi RNA were obviously up-regulated including mi R-3146, mi R-4449, mi R-4531, mi R-3611, mi R-652-5p and mi R-4654, and 14 mi RNAs were dramatically down-regulated including mi R-451 a, mi R-223-3p, mi R-4763-5p, mi R-374b-5p, mi R-106b-5p, mi R-589-5p, mi R-3907, mi R-885-5p, mi R-361-5p, mi R-30c-5p, mi R-151a-3p, mi R-874-5p, mi R-299-5p and mi R-22-3p. 2. Further RT-q PCR verification showed that the expression levels of mi R-223-3p, mi R-885-5p and mi R-374b-5p in plasma of patients with acute gouty arthritis were significantly lower than those of asymptomatic HUA(p<0.05), which were consistent with the results of mi RNAs gene chip. 3. Clinical trial results showed that there were no statistically significant differences in the baseline characteristics of study participants between the three groups(p>0.05). Comparison of differences between pre- and five days post-treatment confirmed that the Chuanhu anti-gout mixture and colchicine treatment were more effective in up-regulating the expression levels of mi R-223-3p and mi R-374b-5p, and reducing knee pain score, swelling score, and plasma CCL2 level than those of the control therapy(p<0.05). Meanwhile, the Chuanhu anti-gout mixture therapy group was more effective in up-regulating mi R-885-5p and reducing the level of plasma CXCL8 than the colchicine and control treatment group(p<0.05). Further comparison of differences in the indicators between pre- and 8 weeks post-treatment levels confirmed that the Chuanhu anti-gout mixtureand and colchicine therapy were more effective in up-regulating mi R-223-3p and mi R-374b-5p levels(p<0.05), and the Chuanhu anti-gout mixture treatment was more effective in up-regulating mi R-885-5p and reducing serum uric acid than the colchicine and control treatment(p<0.05).Meanwhile, the Chuanhu anti-gout mixture treatment was more effective in decreasing alanine aninotransferase and serum creatinine than the colchicine therapy. The intention-to-treat(ITT) analysis indicated that Chuanhu anti-gout mixture and colchicine treatment could significantly reduce the recurrence rate of acute gouty arthritis compared with control therapy(p<0.05). 4. The expression levels of mi R-223-3p and mi R-885-5p in the plasma of patients with acute gouty arthritis were significantly negatively correlated with the score of pain and C reactive protein(CRP), and mi R-374b-5p were dramatically negatively correlated with the score of pain and CCL2(p<0.05).Conclusion: 1. 6 mi RNAs in acute gouty arthritis patients plasma were obviously up-rengulated and 14 mi RNAs were significantly down-regulated. The 20 mi RNAs differences mi RNAs may play an important role in the pathogenesis of acute gouty arthritis. 2. Plasma mi R-223-3p and mi R-885-5p levels were correlated with the severity of inflammation in patients with acute gouty arthritis, and plasma mi R-374b-5p was closely related to CCL2, which may be used as biological indicators to judge the patients condition and clinical efficacy. 3. The Chuanhu anti-gout mixture was non-inferior to colchicine for the treatment of acute gouty arthritis. It may be play a role mechanism through bidirectional regulation of the expression levels of mi R-223-3p, mi R-885-5p, mi R-374b-5p, CCL2, CXCL8. At the same time, the long-term application of Chuanhu anti-gout mixture can effectively prevent and control the repeated acute attacks of gout. The side effects of Chuanhu anti-gout mixture were significantly lower than those of colchicine, which is worthy of clinical promotion.
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