Relationship between peripheral blood NLRP3, IL-18, IL-1 β and the prognosis of acute exacerbation of chronic obstructive pulmonary disease

doi:10.16352/j.issn.1001-6325.2026.02.0273

Abstract

Abstract: Objective To investigate the expression of NLRP3 mRNA in peripheral blood mononuclear cells (PBMCs) and the serum levels of interleukin-18 (IL-18) and interleukin-1β (IL-1β), as well as their clinical significance, in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 220 patients with COPD were enrolled and divided into stable group (n=122) and AECOPD group (n=98) according to the severity of the disease. AECOPD patients were divided into poor prognosis group (n=31) and good prognosis group (n=67) according to prognosis. Fifty healthy subjects were selected as control group. Baseline data were collected, RT-qPCR was used to detect NLRP3 mRNA expression, and enzyme-linked immunosorbent assay was used to determine IL-1β and IL-18 levels. Multivariate Logistic stepwise regression model was used to analyze the prognostic factors of AECOPD. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of NLRP3 mRNA, IL-18 and IL-1β in predicting the poor prognosis of AECOPD. Results Compared with the control group, the levels of NLRP3 mRNA, IL-18 and IL-1β in stable group and AECOPD group were increased (P＜0.05), and those indices of AECOPD group were higher than those in stable group (P＜0.05). The disease duration, NLRP3 mRNA, IL-18 and IL-1β of poor prognosis group were higher than those of good prognosis group (P＜0.05), and the FEV₁% and FEV₁/FVC of poor prognosis group were lower than good prognosis group(P＜0.05). The disease course, NLRP3 mRNA, IL-18 and IL-1β were risk factors affecting prognosis of AECOPD. ROC results showed that NLRP3 mRNA, IL-18 and IL-1β combined predicted the poor prognosis of AECOPD with an AUC of 0.985, a sensitivity of 0.940 and a specificity of 0.968. Conclusions The expression of NLRP3 mRNA in PBMCs and the serum levels of IL-18 and IL-1β are elevated in AECOPD patients. The combined detection of these three indicators shows good predictive value for poor prognosis in AECOPD.

Key words: cell pyroptosis, acute exacerabation of chronic obstructive pulmonary disease(AECOPD), IL-18, NLRP3, IL-1β

CLC Number:

R563

GAO Shenghu, WU Zhifei, YANG Yongbao, LI Shu. Relationship between peripheral blood NLRP3, IL-18, IL-1 β and the prognosis of acute exacerbation of chronic obstructive pulmonary disease[J]. Basic & Clinical Medicine, 2026, 46(2): 273-277.

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