Analysis on predictive efficacy of HNP-1,HNP-2 and human cathelicidin LL-37 levels in sputum for acute exacerbation of bronchiectasis

NI Weibo; GUO Lijuan; DENG Ye; BAO Jie; SHANG Huanxia

doi:10.3969/j.issn.1674-3806.2025.03.13

Abstract：Objective To analyze the predictive efficacy of human neutrophil peptide-1(HNP-1),human neutrophil peptide-2(HNP-2)and human cathelicidin LL-37 levels in sputum for acute exacerbation of bronchiectasis.Methods A total of 129 patients with stable bronchiectasis who were admitted to Hebei Chest Hospital from September 2021 to June 2023 were recruited.Before treatment,sputum samples of the patients were collected by natural cough method,and the levels of HNP-1,HNP-2 and human cathelicidin LL-37 were detected by using enzyme-linked immunosorbent assay(ELISA).According to the occurrence of acute exacerbation within 6 months of follow-up,the patients were divided into acute exacerbation group(48 cases)and non-exacerbation group(81 cases).The correlations of HNP-1,HNP-2 and human cathelicidin LL-37 levels with enhanced FACED(E-FACED)scores and lung function were analyzed by using Pearson correlation analysis.Multivariate logistic regression was used to analyze the influencing factors for acute exacerbation of bronchiectasis.The efficacy of HNP-1,HNP-2 and human cathelicidin LL-37 levels in predicting acute exacerbation of bronchiectasis was analyzed by using receiver operating characteristic(ROC)curve.Results The proportion of patients smoking,the proportion of patients with diabetes,the E-FACED scores,and the levels of HNP-1,HNP-2 and human cathelicidin LL-37 in the acute exacerbation group were higher than those in the non-exacerbation group,and the forced expiratory volume in 1 second(FEV1)as percentage of predicted value(FEV1％pred)in the acute exacerbation group were lower than those in the non-exacerbation group,with statistically significant differences between the two groups(P＜0.05).Levels of HNP-1,HNP-2 and human cathelicidin LL-37 were positively correlated with E-FACED scores(P＜0.05)and were negatively correlated with FEV1％pred(P＜0.05).The results of multivariate logistic regression analysis showed that smoking history,diabetes and higher HNP-1,HNP-2 and human cathelicidin LL-37 levels were independent risk factors for acute exacerbation of bronchiectasis(P＜0.05).The results of ROC curve analysis showed that HNP-1,HNP-2 and human cathelicidin LL-37 levels were helpful for predicting acute exacerbation of bronchiectasis(P＜0.05),and the predictive efficacy of the combination of the three indicators[AUC(95％ CI)=0.908(0.845-0.952)]was higher than that of the single indicator(P＜0.001),with a sensitivity of 75.00％and a specificity of 93.83％.Conclusion Levels of HNP-1,HNP-2 and human cathelicidin LL-37 in sputum are all associated with acute exacerbations of bronchiectasis,and the combination of the three indicators can improve the predictive efficacy for acute exacerbation of bronchiectasis.