Abstract

Background: This study aimed to investigate the role of the thioredoxin-interacting protein (TXNIP) and the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway in the inflammatory response of elderly patients with severe pneumonia and sepsis.

Methods: We conducted a retrospective analysis on the clinical data of 119 patients with severe pneumonia and sepsis treated at our hospital. Patients were categorized into two groups based on 28-day survival rate: the survival group (n = 89) and the death group (n = 30). Additionally, data from39 healthy individuals who underwent medical checkups during the same period were collected to serve as controls.

Results: The levels of serum C-reactive protein, tumor necrosis factor-alpha, and procalcitonin at 24 h post-admission were significantly higher in the death group compared to both the survival and control groups, with higher levels also observed in the survival group relative to controls (p < 0.05). TXNIP and NLRP3 mRNA expression levels were significantly increased in the death group than in the survival and control groups, andwere also higher in the survival group compared to the control group (p < 0.05). The death group exhibited higher respiratory rates and mean arterial pressures compared to those of the survival group (p < 0.05). Additionally, the Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, and Charlson  Comorbidity Index scoreswere significantly higher in the death group than in the survival group (p < 0.05).

Conclusion: The TXNIP/NLRP3 inflammasome pathway was implicated in the inflammatory response in elderly patients with severe pneumonia and sepsis,  and was closely associated with patient prognosis.