Levels of TLR4, MIF, IL-1β in umbilical cord blood of children with neonatal respiratory distress syndrome and their relationship with prognosis

doi:10.16352/j.issn.1001-6325.2026.01.0109

Abstract

Abstract: Objective To detect the expression level of Toll-like receptor 4 (TLR4), macrophage migration inhibitory factor (MIF) and interleukin-1β (IL-1β) in umbilical cord blood, and to analyze their relationship with the prognosis of neonatal respiratory distress syndrome (NRDS). Methods From January 2023 to June 2024, 206 premature infants in our hospital were reviewed. Complying with the NRDS diagnostic criteria, they were assigned into NRDS group (n=120) and non-NRDS group (n=86). Complying with the prognosis of NRDS patients, they were assigned into a good prognosis group (n=90) and a poor prognosis group (n=30). ELISA method was applied to detect the expression levels of TLR4, IL-1β, and MIF in umbilical cord blood. Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of NRDS. Receiver operating characteristic (ROC) curve was applied to analyze the efficacy of cord blood TLR4, MIF, and IL-1β in predicting poor prognosis in children with NRDS. Results Compared with the non-NRDS group, the level of TLR4, MIF and IL-1β in umbilical cord blood were significantly higher in the NRDS group (P＜0.05). Compared with the good prognosis group, the levels of TLR4, MIF and IL-1β in umbilical cord blood were greatly higher in the poor prognosis group (P＜0.05). Elevated levels of TLR4, MIF, and IL-1β in umbilical cord blood was a group of risk factors affecting for poor prognosis in children with NRDS (P＜0.05). The AUC of TLR4, MIF, IL-1β, and their combination in predicting the prognosis of NRDS children in umbilical cord blood was 0.843, 0.845, 0.850, and 0.976, respectively. The effectiveness of the combined prediction of the three indicators was greatly better than that of a single indicator (Z_{combination-TLR4}=3.841,Z_{combination-MIF}=3.615, Z_{combination-IL-1β}=2.452, P＜0.001, 0.001, 0.05). Conclusions The level of TLR4, MIF, and IL-1β in umbilical cord blood of children with NRDS is greatly elevated. The changes in their level of these factors are closely related to the prognosis of NRDS children. The combination of the three shows higher efficacy in predicting poor prognosis in NRDS children.

Key words: Toll-like receptor 4, macrophage migration inhibitory factor, interleukin-1β, neonatal respiratory distress syndrome, prognosis

CLC Number:

R722.1

QU Haixin, LIANG Junxia, YUAN Erwei, GAO Hongbo, KUI Xiaohua, GUO Weiping. Levels of TLR4, MIF, IL-1β in umbilical cord blood of children with neonatal respiratory distress syndrome and their relationship with prognosis[J]. Basic & Clinical Medicine, 2026, 46(1): 109-113.

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