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 intedeukin-1 β (IL-1 β) 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 transcdption-polymerase chain reaction (PCR) and/or realtime quantitative PCR.PYCARD and nuclear factor-κ B (p50) [NF-K B (p50)] protein was detected by Westem blot in PBMCs respectively.IL-1 β,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 gone and its transcript variant mRNA,the protein of PYCARD and NF-κ B (p50) and the plasma IL-1 β,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-1 β,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-1 β 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 inflammatory response of PG patients with different phases and CM syndromes.