Analysis of the Correlation Between Serum 14-3-3β Protein and CD5L Levels with the Risk of Poor Prognosis in Adult Patients with Bronchial Asthma Complicated by Pulmonary Infection
ZHENG Xiangzhen, CHEN Wendeng, YU Le, et al
No.909 Hospital of PLA / Dongnan Hospital Affiliated to Xiamen University, Fujian Zhangzhou 363000, China
Abstract:Objective: To investigate the correlation between serum 14-3-3β protein, CD5 antigen-like protein (CD5L), and the risk of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection. Methods: A total of 155 adult patients with bronchial asthma complicated by pulmonary infection in 909th Hospital from January 2022 to January 2024 were selected. All patients received standardized treatment for bronchial asthma and individualized anti-infective therapy. They were followed up for one year and categorized into a good prognosis group and a poor prognosis group based on their prognosis. The clinical data, serum 14-3-3β protein, and CD5L levels were compared between the two groups. Logistic regression analysis was used to identify the influencing factors of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection. Smooth curve fitting analysis was employed to explore the relationship between serum 14-3-3β protein, CD5L, and the risk of poor prognosis. Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) were used to assess the predictive value of serum 14-3-3β protein and CD5L for poor prognosis risk. The interaction index (γ) was used to analyze the interactive effect of serum 14-3-3β protein and CD5L on poor prognosis risk. Results: At a 1-year follow-up, 4 cases were lost to follow-up, 104 cases had a good prognosis, and 47 cases had a poor prognosis. The serum level of 14-3-3β protein was higher in the poor prognosis group than in the good prognosis group, while the level of CD5L was lower (P<0.05). Logistic regression analysis indicated that serum 14-3-3β protein and CD5L levels were risk factors for poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection (P<0.05). Smooth curve fitting analysis showed that after adjusting for other factors, serum 14-3-3β protein level exhibited a monotonically positive correlation with the risk of poor prognosis in adult patients with bronchial asthma complicated with pulmonary infection (P<0.05), and serum CD5 L level showed a monotonically negative correlation with the risk of poor prognosis in adult patients with bronchial asthma complicated with pulmonary infection (P<0.05). The AUC values for predicting poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection using serum 14-3-3β protein and CD5L levels were 0.755 and 0.779, respectively. The optimal cutoff values were 57.84 ng/mL and 177.73 pg/mL, with sensitivities of 82.98% and 68.09%, and specificities of 63.46% and 80.77%, respectively. The combined prediction of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection had an AUC of 0.884, a sensitivity of 76.60%, and a specificity of 87.50%, showing significantly higher predictive value than either individual predictor alone (Z=2.542, 2.129, P=0.011, 0.033). High expression of serum 14-3-3β protein and low expression of CD5L showed a positive interaction in predicting poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection (γ=2.344, P<0.001). Conclusion: Serum 14-3-3β protein and CD5L are independent factors influencing the poor prognosis risk in adult patients with bronchial asthma complicated by pulmonary infection. Furthermore, high expression of serum 14-3-3β protein and low expression of CD5L exhibit a positive interaction, indicating a high combined predictive value.
郑向真, 陈文灯, 禹乐, 陈刘通. 血清14-3-3β蛋白CD5L与支气管哮喘合并肺部感染成人患者预后不良风险的相关性分析[J]. 河北医学, 2026, 32(1): 55-62.
ZHENG Xiangzhen, CHEN Wendeng, YU Le, et al. Analysis of the Correlation Between Serum 14-3-3β Protein and CD5L Levels with the Risk of Poor Prognosis in Adult Patients with Bronchial Asthma Complicated by Pulmonary Infection. HeBei Med, 2026, 32(1): 55-62.
[1] 王博,高麦仓,梁嘉斌.支气管哮喘急性发作患者治疗前后血清TXB2、CCR7水平变化及与肺功能的关系[J].临床误诊误治,2023,36(9):53-57. [2] Rosas-Salazar C,Chirkova T,Gebretsadik T,et al.Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE):a population-based, prospective birth cohort study[J].Lancet,2023,401(10389):1669-1680. [3] Wang DC,Rao LZ,Cui YL,et al.Serum 14-3-3β protein:a new biomarker in asthmatic patients with acute exacerbation in an observational study[J].Allergy Asthma Clin Immunol,2021,17(1):104. [4] Weng DL,Gao S,Shen HL,et al.CD5L attenuates allergic airway inflammation by expanding CD11chigh alveolar macrophages and inhibiting NLRP3 inflammasome activation via HDAC2[J].Immunology,2022,167(3):384-397. [5] 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2020年版)[J].中华结核和呼吸杂志,2020,43(12):1023-1048. [6] 中华医学会,中华医学会临床药学分会,中华医学会杂志社,等.支气管哮喘基层合理用药指南[J].中华全科医师杂志,2020,19(7):572-581. [7] Reddel HK,Bacharier LB,Bateman ED,et al.Global Initiative for asthma strategy 2021:executive summary and rationale for key changes[J].Respirology,2022,27(1):14-35. [8] 李舒芳,郭广恩,杨月琴,等.血清14-3-3β蛋白联合呼出气一氧化氮及常规通气肺功能参数对儿童支气管哮喘的诊断效能[J].中国当代儿科杂志,2024,26(7):723-729. [9] Segal D,Maier S,Mastromarco GJ,et al.A central chaperone-like role for 14-3-3 proteins in human cells[J].Mol Cell,2023,83(6):974-993. [10] Yasuda H,Fukusumi Y,Zhang Y,et al.14-3-3 Proteins stabilize actin and vimentin filaments to maintain processes in renal glomerular podocyte[J].FASEB J,2023,37(10):e23168. [11] 战海涛,刘丰遂,范志强,等.CD5L及PaCO2检测在重症哮喘机械通气患者预后判断中的应用研究[J].国际检验医学杂志,2017,38(11):1505-1506,1509. [12] Oliveira L,Silva MC,Gomes AP,et al.CD5L as a promising biological therapeutic for treating sepsis[J].Nat Commun,2024,15(1):4119.