Relationship Between Peripheral Blood TLR4 and IL-17 Expression and Liver Injury in Sepsis Patients

DONG Yuqian; PAN Yajing; CHEN Sujie; ZHANG Jianxin

doi:10.3969/j.issn.1004-437X.2025.16.019

Abstract：Objective To investigate the relationship between the expression of Toll-like receptor 4(TLR4)and interleukin-17(IL-17)in peripheral blood and liver injury in sepsis patients.Methods Sepsis patients admitted to the First Affiliated Hospital of Xinxiang Medical University from June 2022 to June 2024 were selected as the research subjects,and their peripheral blood TLR4 and IL-17 levels were measured at admission.The incidence of sepsis related liver injury during hospitalization was analyzed,and the patients were divided into liver injury group and no liver injury group.Logistic regression analysis,receiver operating characteristic(ROC)curve and decision curve were used to investigate the relationship between TLR4 and IL-17 expression in peripheral blood and liver injury in sepsis patients.Results Among 124 sepsis patients,25(20.16％)had concurrent liver injury during hospitalization.The age of the liver injury group,the sequential organ failure assessment(SOFA)score at the time of enrollment,and the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score at the time of enrollment were all higher than those in the non liver injury group.The proportion of septic shock was higher in the non liver injury group(P＜0.05).The peripheral blood TLR4 and IL-17 levels in the liver injury group were higher than those in the non liver injury group(P＜0.05).According to logistic regression analysis,after adjusting for confounding factors,the expression of TLR4 and IL-17 in peripheral blood remained as influencing factors for sepsis patients with concurrent liver injury(P＜0.05).ROC curves were drawn,and the results showed that the area under the curve(AUC)values of TLR4 and IL-17 in peripheral blood alone and in combination for predicting liver injury in sepsis patients were 0.782,0.786,and 0.876,respectively,with the highest joint predictive value.The decision curve results showed that compared to predicting TLR4 and IL-17 separately in peripheral blood,the combination of TLR4 and IL-17 in peripheral blood had a higher benefit rate in predicting liver injury in sepsis patients.When the threshold was between 0-0.86,the net return rate was greater than 0,and the maximum net return rate was 0.202.Conclusion The concurrent liver injury in sepsis patients is related to the high expression of TLR4 and IL-17 in peripheral blood.