Analysis of the changes in serum NLRP3,FGF21,TGF-β1 levels and their correlation with gut microbiota in patients with severe pneumonia
ZHANG Hong
SUN Hui
TANG Jingyi
HUA Limei
HU Yang
Abstract：Objective To investigate the changes in the levels of serum NOD-like receptor pyrin domain-containing protein 3(NLRP3),fibroblast growth factor 21(FGF21),and transforming growth factor-β1(TGF-β1)in patients with severe pneumonia and their correlation with the gut microbiota.Methods A total of 133 patients with severe pneumonia(observation group),110 patients with common pneumonia(control group),and 100 healthy physical examinees(healthy group)between February 2023 and June 2024 were selected.According to the Acute Physiology and Chronic Health Evaluation Ⅱ score(APACHE Ⅱ),the patients with severe pneumonia were divided into low-risk subgroup(n=43),medium-risk subgroup(n=56),and high-risk subgroup(n=34).The observation group was further divided into the survival subgroup(n=76)and the death subgroup(n=57)based on the 28-day survival status after admission.The levels of serum NLRP3,FGF21,and TGF-β1 in each group were detected,and the number of gut microbiota in the observation group and the control group was compared.Pearson correlation analysis was used to analyze the correlation between the levels of serum NLRP3,FGF21,and TGF-β1 and the gut microbiota in patients with severe pneumonia.Multivariate logistic regression analysis was used to analyze the influencing factors of the prognosis of patients with severe pneumonia,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum NLRP3,FGF21,and TGF-β1 for the prognosis of patients with severe pneumonia.Results The levels of serum NLRP3,FGF21,and TGF-β1 in the observation group and the control group were higher than those in the healthy group.The levels of serum NLRP3,FGF21,TGF-β1 and the number of Escherichia coli and Enterococcus in the observation group were higher than those in the control group,while the number of Bacteroides,Bifidobacterium,and Lactobacillus was lower than that in the control group(P<0.05,P<0.01).The levels of serum NLRP3,FGF21,and TGF-β1 were higher in the medium-risk and high-risk subgroups than in the low-risk subgroup,and higher in the high-risk subgroup than in the medium-risk subgroup(P<0.05).The levels of serum NLRP3,FGF21,and TGF-β1 in the survival subgroup were lower than those in the death subgroup(P<0.01).The levels of serum NLRP3,FGF21,and TGF-β1 were positively correlated with Escherichia coli and Enterococcus,and negatively correlated with Bacteroides,Bifidobacterium,and Lactobacillus(P<0.01).Serum NLRP3,FGF21,and TGF-β1 were all risk factors for the prognosis of patients with severe pneumonia(P<0.05).The combined detection of serum NLRP3,FGF21,and TGF-β1 had a higher predictive value for the prognosis of patients with severe pneumonia than the prediction by each indicator alone(P<0.05).Conclusion The levels of serum NLRP3,FGF21,and TGF-β1 in patients with severe pneumonia are elevated,and the gut microbiota changes.The levels of serum NLRP3,FGF21,and TGF-β1 are related to the gut microbiota.In the meantime,the combined detection of serum NLRP3,FGF21,and TGF-β1 has certain predictive value for the prognosis of patients with severe pneumonia.
Keywords：pneumoniasevereNOD-like receptor heat shock protein domain-containing protein 3fibroblast growth factor 21transforming growth factor-β1gut microbiotacorrelationanalysis of influencing factors
Publication Date：2026-01-28
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：7( 46-52 )