[Predictive value of TXNIP/NLRP3 signaling pathway expression in nasal polyps for postoperative recurrence of chronic...

Objective:To investigate the expression of thioredoxin interacting protein（TXNIP）/nod like receptor thermoprotein domain related protein 3（NLRP3） signaling pathway in nasal polyps of patients with chronic sinusitis with nasal polyps（CRSwNP）, and to analyze its predictive value for postoperative recurrence. Methods:A prospective study was conducted on 130 patients with CRSwNP who underwent endoscopic sinus surgery at Wenzhou People's Hospital from January 2019 to January 2024. These patients were divided into a recurrence group and a non-recurrence group based on the recurrence status within one year after surgery. The clinical data and the expression of TXNIP, NLRP3 mRNA, and protein in nasal polyp tissues were compared between the two groups. The impact of TXNIP and NLRP3 expression on postoperative recurrence was analyzed. The interaction between TXNIP and NLRP3 expression in postoperative recurrence was also analyzed. The predictive value of TXNIP and NLRP3 expression for postoperative recurrence was evaluated. Results:The recurrence group had a higher proportion of eosinophilic（EOS） nasal polyps, postoperative infection, allergic rhinitis, preoperative Lund-Mackay score, and sinus CT score, as well as higher levels of serum interleukin-5（IL-5） and interleukin-21（IL-21） than those in the non-recurrence group（P<0.05）. The expression levels of TXNIP and NLRP3 mRNA and protein in nasal polyps from the recurrence group were also higher than those from the non-recurrence group（P<0.05）. After adjusting for EOS nasal polyps, postoperative infection, preoperative Lund-Mackay score, and serum IL-5 and IL-21 levels, the expression of TXNIP and NLRP3 proteins in nasal polyps remained independent risk factors for postoperative recurrence（P<0.05）. High levels of TXNIP and High levels of NLRP3 showed a positive interaction in the risk of postoperative recurrence（P<0.05）. A conventional prediction model was constructed based on EOS nasal polyps, postoperative infection, preoperative Lund-Mackay score, and serum IL-5 and IL-21 levels. A novel prediction model was constructed based on these factors as well as the expression of TXNIP and NLRP3 proteins in nasal polyps. The AUC value of the novel prediction model for predicting postoperative recurrence was significantly higher than that of the conventional model（P<0.05）. Conclusion:The expression levels of TXNIP and NLRP3 in nasal polyps of patients with postoperative recurrence of CRSwNP are increased. High levels of TXNIP and high levels of NLRP3 have a positive interaction in the risk of postoperative recurrence. Detection of their levels has a certain predictive value for postoperative recurrence, and TXNIP and NLRP3 have a significant gain value in the construction of the prediction model of postoperative recurrence in patients with CRSwNP.