The expression of serum Trx1 and PDCD4 in sepsis patients and their relationship with 28-day survival

Chu Wenmei; Wang Wenqing; Chen Liyun; Li Shufang; Yuan Zhongzhao

doi:10.3969/j.issn.1671-6450.2026.03.005

Abstract：Objective To analyze the expression of serum thioredoxin-1(Trx1)and programmed cell death factor 4(PDCD4)in sepsis patients and their relationship with 28-day survival.Methods The clinical data of 146 patients with sepsis admitted to the Department of Intensive Care Medicine of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to December 2021(study group)and 146 volunteers who underwent physical examina-tions in the hospital at a 1∶1 ratio during the same period(healthy control group)were retrospectively collected.Patients in the study group were divided into the simple sepsis subgroup(112 cases)and the septic shock subgroup(34 cases)according to disease severity,and into the survival subgroup(106 cases)and the death subgroup(40 cases)according to 28-day survival status.Enzyme-linked immunosorbent assay was used to detect serum levels of Trxl and PDCD4 in all subjects.Point-biserial correlation analysis was used to investigate the correlation between serum Trx1,PDCD4 levels and the severity of sepsis.Cox regression analysis and receiver operating characteristic(ROC)curve analysis were used to evaluate the relationship and pre-dictive value between serum Trx1 and PDCD4 levels and 28-day survival in sepsis patients.Results Compared with the healthy control group,serum PDCD4 levels were significantly increased and serum Trx1 levels were significantly decreased in the study group(t/P=43.407/＜0.001,8.867/＜0.001).Compared with the simple sepsis subgroup,the septic shock subgroup showed significantly increased serum PDCD4 levels and decreased serum Trx1 levels(t/P=3.320/＜0.001,5.106/＜0.001).Point-biserial correlation analysis showed that serum Trx1 levels were negatively correlated with disease severity,while serum PDCD4 levels were positively correlated with disease severity(r/P=-0.441/＜0.001,0.303/＜0.001).High APACHE Ⅱ score,high CRP level,and high serum PDCD4 level at admission were independent risk factors for 28-day survival in sepsis patients,while high serum Trx1 level was an independent protective factor[HR(95％CI)=1.106(1.033-1.184),1.014(1.004-1.023),1.078(1.029-1.128),0.770(0.653-0.907)].The AUCs for serum Trx1,PDCD4,and their combination in predicting 28-day survival in sepsis patients were 0.814,0.807,and 0.886,respectively.The combined predictive value was significantly better than that of either marker alone(Z/P=1.670/0.047,1.787/0.035).Conclusion Serum Trxl levels are decreased and PDCD4 levels are increased in sepsis patients.The expression levels of both markers are correlated with disease severity and 28-day survival.Combined detection of Trx1 and PDCD4 provides improved predictive value for 28-day survival in sepsis patients.