Predictive Value of Combined Serum NOX4, Gal-13, and Cyclophilin A for Prognosis in Severe Pneumonia

Objective: To analyze the predictive value of the combined use of serum NADPH oxidase 4 (NOX4), galectin-13 (Gal-13), and cyclophilin A (CyPA) for poor prognosis in patients with severe pneumonia(SP). Methods: This study was a retrospective study.A total of 172 patients with SP admitted to our hospital from September 2023 to September 2025 were enrolled. They were assigned into the good prognosis group (n=98) and the poor prognosis group (n=74) according to the prognosis at 28 days. The levels of NOX4, Gal-13 and CyPA in the serum of patients were detected by ELISA. The point-biserial method was conducted to analyze correlations. Logistic method was conducted to discuss the influencing factors.Receiver operating characteristic (ROC) curve was used to discuss the predictive efficiency. In addition, decision curve analysis(DCA) was used to analyze their clinical application value. Results: The CPIS score and the levels of serum CRP, PCT, NOX4, Gal-13 and CyPA in the poor prognosis group were higher than those in the good prognosis group ( P < 0.05). The prognosis of SP patients 28 days after admission was positively correlated with the levels of serum NOX4 ( rpb =0.517, P < 0.001), Gal-13 ( rpb =0.539, P < 0.001), and CyPA ( rpb =0.485, P < 0.001) at admission. Higher CPIS score, CRP, PCT, NOX4, Gal-13 and CyPA levels were risk factors for poor prognosis ( P < 0.05). The area under the curve (AUC) of the joint prediction of serum NOX4, Gal-13 and CyPA levels for poor prognosis in SP patients was 0.939. Within the high-risk range of 0.07 to 0.94, the joint prediction of serum NOX4, Gal-13 and CyPA levels for the prognosis of SP patients had obvious positive clinical benefits. Conclusion: Detecting the levels of serum NOX4, Gal-13 and CyPA in patients at admission can assist clinicians in evaluating the prognosis of patients with SP.