Relationship between serum nucleotide-binding oligomerization domain-like receptor protein 3 and interleukin-1β levels and disease severity and prognosis of patients with acute respiratory distress syndrome

CHEN Yazheng; CHEN Weiwen; ZENG Haiwen; WEI Sican; LI Rongfu; SU Zhiwei

doi:10.3969/j.issn.1672-8521.2025.06.002

Abstract：Objective To explore the relationship between serum levels of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3)and interleukin-1β(IL-1β)and disease severity and prognosis in patients with acute respiratory distress syndrome(ARDS).Methods A total of 102 cases diagnosed with ARDS from January 2024 to February 2025 were prospectively selected(study group)and divided into mild group(n=43),moderate group(n=31),and severe group(n=28).Based on prognosis,they were further divided into a survival group(n=80)and a non-survival group(n=22).Additionally.112 age-matched healthy individuals during the same period were selected as the control group.Serum levels of NLRP3 and IL-1β were compared between the study group and the control group,among ARDS patients with different severity levels,and between the survival and non-survival groups.Spearman correlation analysis was used to assess the relationship between serum NLRP3/IL-1β levels and disease severity in ARDS patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of serum NLRP3 and IL-1β for poor prognosis in ARDS patients.Univariate analysis and multivariate stepwise logistic regression analysis were employed to identify factors influencing poor prognosis in ARDS patients.Results Serum levels of NLRP3 and IL-1β were significantly higher in the study group than in the control group(t=30.938,54.966,respectively,P<0.001).Both serum NLRP3 and IL-1β levels exhibited a stepwise increase with worsening ARDS severity(F=54.940 and 189.672,respectively,P<0.001).Spearman correlation analysis showed that the levels of serum NLRP3 and IL-1β in patients with ARDS were positively correlated with the disease severity(r=0.423,0.536,P<0.001).Serum levels of NLRP3 and IL-1β were significantly lower in the survival group than in the non-survival group(t=20.733 and 29.276,respectively,P<0.001).The areas under the curve(AUC)for predicting poor prognosis in ARDS patients were 0.863(95%CI:0.816-0.916)for serum NLRP3,0.736(95%CI:0.676-0.798)for IL-1β,and 0.913(95%CI:0.863-0.963)for their combination.Multivariate logistic regression analysis identified NLRP3≥8.71 pg/mL(OR=3.766,95%CI:2.381-5.957),IL-1β≥32.78 pg/mL(OR=3.340,95%CI:2.460-4.535),and APACHE Ⅱ score≥20(OR=2.620,95%CI:1.760-3.900)as risk factors for poor prognosis in ARDS patients(P<0.001).Conclusions Serum levels of NLRP3 and IL-1β are significantly elevated in ARDS patients,correlate positively with disease severity,and the combined detection demonstrates high predictive value for prognosis.