The relationship between serum HSP47,NLRC4,RvD1 levels with the condition and prognosis of patients with trau-matic brain injury

Yi Xin; Cai Yafeng; Peng Shangguan; Huo Xiaocheng

doi:10.3969/j.issn.1671-6450.2026.02.007

Abstract：Objective To investigate the correlation between serum levels of heat shock protein 47(HSP47),NLR family CARD domain-containing protein 4(NLRC4),and resolvin D1(RvD1)and the condition and prognosis of patients with traumatic brain injury(TBI).Methods A total of 124 TBI patients admitted to the Department of Emergency Medicine of our hospital from September 2022 to September 2024 were selected as the observation group.Another 105 age-matched healthy volunteers undergoing physical examinations during the same period were selected as the healthy control group.Serum levels of HSP47,NLRC4,and RvD1 were measured by ELISA.According to the Glasgow Coma Scale(GCS)scores,patients were divided into mild(n=55),moderate(n=25),and severe(n=44)TBI groups.Based on the Glasgow Outcome Scale(GOS)scores,patients were categorized into a good prognosis subgroup(n=70)and a poor prognosis subgroup(n=54).ROC curve analysis was used to evaluate the predictive value of serum HSP47,NLRC4,and RvD1 for the prognosis of TBI pa-tients.Additionally,relative risk analysis was performed to explore the relative risk of different serum levels of HSP47,NLRC4,and RvD1 on the prognosis of TBI patients.Results Compared with the control group,the observation group had significantly higher serum HSP47 and NLRC4 levels and a lower serum RvD1 level(t/P=9.531/＜0.001,10.188/＜0.001,10.561/＜0.001).As the severity of TBI increased(mild → moderate → severe),serum HSP47 and NLRC4 levels significantly increased,while the serum RvD1 level decreased(F/P=53.882/＜0.001,71.180/＜0.001,46.400/＜0.001).The poor prognosis subgroup had higher serum HSP47 and NLRC4 levels and lower serum RvD1 levels than the good prognosis subgroup(t/P=7.545/＜0.001,7.273/＜0.001,6.780/＜0.001).Patients with high serum levels of HSP47 and NLRC4 had significantly lower GCS scores than those with low levels,and patients with low serum RvD1 levels had significantly lower GCS scores than those with high levels(t/P=25.739/＜0.001,24.993/＜0.001,25.188/＜0.001).The areas under the ROC curve(AUC)of serum HSP47,NLRC4,RvD1,and their combination for predicting poor prognosis were 0.828,0.821,0.806,and 0.941,respectively.The predictive efficacy of the combination was superior to that of each indicator alone(Z=3.555/＜0.001,3.770/＜0.001,3.794/＜0.001).The incidence of poor prognosis in patients with high serum levels of HSP47 and NLRC4 was 4.333 and 3.388 times that of patients with low levels,respectively,and the incidence in patients with low serum RvD1 levels was 3.722 times that of patients with high levels(x2=50.468,35.826,38.194;all P＜O.001).Conclusion Serum HSP47 and NLRC4 levels are elevated,while serum RvD1 levels are decreased in TBI patients,and these factors may be involved in the development of TBI and affect its prognosis.The combined prediction using the three biomarkers has high value in predicting the prognosis of TBI patients.