Changes of serum IL-17,TIM-4 and TLR7 levels in patients with severe pneumonia and their association with prognosis
LI Zhen
ZHANG Qiaomei
SHI Ruiping
ZHANG Yingjie
Abstract：Objective To investigate the changes of serum levels of interleukin-17(IL-17),T-cell immunoglobulin and mucin domain-containing protein 4(TIM-4)and Toll-like receptor 7(TLR7)in patients with severe pneumonia and the clinic value in predicting prognosis.Methods A retrospective study was conducted on 154 patients with severe pneumonia admitted to Zhengzhou Second People's Hospital between January 2021 and December 2024.According to the prognosis status after 28 days of treatment,they were divided into a good prognosis group(n=93;condition unchanged,stabilized or improved)and a poor prognosis group(n=61;condition deteriorated,with multiple organ failure or death).General clinical data and serum levels of IL-17,TIM-4 and TLR7 at admission,and on the 3rd and 7th day after admission were compared between the two groups.Multivariate logistic regression analysis was used to identify factors influencing poor prognosis in severe pneumonia patients.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of serum IL-17,TIM-4 and TLR7 at admission in predicting poor prognosis.Results The proportion of patients using mechanical ventilation was significantly higher in the poor prognosis group than in the good prognosis group[67.21%(41/61)vs.40.86%(38/93);χ2=10.240,P<0.05].At admission,serum levels of IL-17(79.65±14.21)pg/mL,TIM-4(105.35±25.16)pg/mL and TLR7(68.26±9.67)ng/mL in the poor prognosis group were significantly higher than in the good prognosis group[(72.83±12.14)pg/mL,(86.95±19.64)pg/mL and(62.35±8.86)ng/mL;t=3.185,5.080,3.904,respectively,P<0.01].Serum IL-17,TIM-4 and TLR7 levels in poor prognosis group on the 3rd day and 7th day after admission were significantly higher than those in good prognosis group(on the 3rd day:t=17.962,11.826,6.398,on the 7rd day:t=25.670,22.028,12.671,P<0.05).Multivariate logistic regression analysis identified mechanical ventilation(OR=1.689,95%CI:1.229-2.320,P=0.001),IL-17(OR=2.705,95%CI:1.456-5.025,P=0.002),TIM-4(OR=3.155,95%CI:1.564-6.364,P=0.001),and TLR7(OR=1.622,95%CI:1.622-5.165,P<0.001)as independent risk factors for a poor prognosis.ROC curve analysis reveled that the areas under the curve(AUC)for predicting poor prognosis using serum IL-17,TIM-4,TLR7,and their combination were 0.641,0.744,0.685,and 0.834,respectively.The corresponding sensitivities were 49.18%,50.82%,54.10%,and 81.97%,and the specificities were 78.49%,89.25%,79.57%,and 76.34%.Conclusions Serum levels of IL-17,TIM-4 and TLR7 are significantly elevated in patients with a poor prognosis and are closely associated with clinical outcomes in severe pneumonia.The combined detection of these biomarkers provides the highest predictive efficacy for patient prognosis.
Keywords：severe pneumoniainterleukin-17T-cell immunoglobulin and mucin domain-containing protein 4Toll-like receptor 7prognosis
Publication Date：2025-10-28
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：5( 334-338 )