Correlation of programmed cell death receptor 1/programmed cell death ligand 1 signaling pathway related proteins with clinical short-term prognosis in patients with Pseudomonas aeruginosa sepsis

Objective To investigate the effect of programmed cell death receptor 1/programmed cell death ligand 1 (PD-1/PD-L1) signal pathway associated protein on the short-term clinical prognosis in patients with Pseudomonas aeruginosa (PA) sepsis.

Methods A total of 122 patients with PA sepsis in the General Hospital of Ningxia Medical University from January 2021 to June 2023 were selected as the research objects, and all the patients were treated according to the therapeutic guideline of sepsis and the actual condition of disease. Clinical data and the score of the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) were collected; the levels of T lymphocytes (CD3⁺, CD4⁺ and CD8⁺) and the levels of serum PD-1 and PD-L1 in peripheral venous blood were determined before treatment.

Results Of the 122 PA sepsis patients, 101 cases (82.79%, survival group) survived for 28 days after being admitted to the Emergency Intensive Care Unit or other departments, while 21 cases (17.21%, death group) died. There were significant differences in the ratios of hypertension, chronic obstructive pulmonary disease and chronic liver disease, the APACHE Ⅱ scores, and levels of CD4⁺, CD4⁺/CD8⁺, PD-1 and PDL-1 between the survival group and the death group (P < 0.05). Univariate Logistic regression analysis showed that basic diseases (hypertension, chronic obstructive pulmonary disease, chronic liver disease), the APACHE Ⅱ score, CD4⁺/CD8⁺, PD-1 and PD-L1 were all factors influencing the short-term survival of PA sepsis patients (P < 0.01). Multivariate Logistic regression analysis indicated that basic diseases (hypertension, chronic obstructive pulmonary disease, chronic liver disease), the APACHE Ⅱ score, PD-1 and PD-L1 were all significant factors affecting the short-term survival of PA sepsis patients (P < 0.01).

Conclusion The PD-1/PD-L1 signaling pathway has an impact on the clinical prognosis of PA sepsis patients, and up-regulation of this pathway expression can increase the risk of adverse short-term clinical prognosis in PA sepsis patients.