Correlation of expression of programmed necrosis related proteins RIPK1 and RIPK3 in peripheral blood with chronicity and severity of HBV infection in elderly patients
OBJECTIVE To explore the relationship between the expression levels of programmed necrosis receptor-interacting protein kinase 1(RIPK1)and RIPK3 in peripheral blood and the chronicity and severity of hepatitis B virus(HBV)infection.METHODS A total of 103 patients with HBV infection treated in the gastroenterology de-partment of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between Mar 2021 and Mar 2023 were selected as the study group.They were divided into the chronic hepatitis B(CHB)group(n=56)and severe hepatitis B(CHB-S)group(n=47)according to the severity of the disease.Meanwhile,43 healthy volunteers under physical examination in the hospital during the same period were included in the control group.The levels of programmed necrosis-related factors of RIPK1,RIPK3 and HBV-DNA in peripheral blood were measured and compared between the two groups.Clinical significance of peripheral blood RIPK1 and RIPK3 levels was analyzed.RESULTS The expression levels of RIPK1,RIPK3 and MLKL in the study group were higher than those in the control group(P＜0.05).Peripheral blood RIPK1,RIPK3 and MLKL were positively correlated with the degree of liver fibrosis(r=0.613,0.654,0.766,P＜0.001)and the grade of inflammatory activity(r=0.429,0.572,0.491,P＜0.001).The levels of peripheral blood RIPK1,R1PK3,MLKL and HBV-DNA in the CHB-S group were higher than those in the CHB group(P＜0.05).Peripheral blood expression of RIPK1,RIPK3 and MLKL were positively correlated with HBV-DNA level(r=0.455,0.396,0.627,P＜0.001).Re-ceiver operating characteristics(ROC)curve analysis showed that the AUC values of peripheral blood RIPK1,RIPK3 and MLKL in the differentiation of chronic and severe HBV infection were 0.760,0.688 and 0.877,re-spectively.The AUC value of the combined detection of the three indicators was 0.929.CONCLUSION The ex-pression of programmed necrosis RIPK1 and RIPK3 in peripheral blood is closely related to chronicity and severity of HBV infection.The mechanism of action may be related to liver fibrosis,inflammation and HBV replication.
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