Serum CHI3L1，STAT3 and TSG-6 levels in monitoring the condition and wound healing degree of burn patients

doi:10.3969/j.issn.1673-8640.2026.08.006

Abstract

Abstract:

Objective To investigate the roles of serum chitinase 3-like protein 1（CHI3L1），signal transducer and activator of transcription 3（STAT3） and tumor necrosis factor-alpha-stimulated gene-6（TSG-6） levels in monitoring the condition and wound healing of burn patients. Methods A total of 85 burn patients（burn group） and 85 healthy subjects（healthy control group） from Linfen People's Hospital from January 2022 to December 2023 were enrolled. The burn patients were classified into superficial burn group（36 cases）and deep burn group（49 cases）. After 28 d of treatment，the patients were classified into good healing group（32 cases）and poor healing group（53 cases）. The clinical data and clinical laboratory determination results [tumor necrosis factor-alpha（TNF-α），interleukin-10（IL-10），C-reactive protein（CRP），platelet（PLT）count] were collected，and serum CHI3L1，STAT3 and TSG-6 were also determined. Spearman correlation analysis was used to evaluate the correlation between serum CHI3L1，STAT3 and TSG-6 and the degree of burn. Logistic regression analysis was used to evaluate the factors affecting the poor healing of burn patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum CHI3L1，STAT3 and TSG-6 in judging the poor healing of burn patients. Results The serum CHI3L1，STAT3 and TSG-6 levels in burn group were lower than those in healthy control group（P<0.05）. The serum CHI3L1，STAT3 and TSG-6 levels in deep burn group were lower than those in superficial burn group（P<0.05）. Serum CHI3L1，STAT3 and TSG-6 were negatively correlated with the degree of burn（r values were -0.412，-0.397 and -0.365，respectively，P<0.05）. The proportion of deep burn in poor healing group and the acute physiology and chronic health evaluation（APACHE） Ⅱ score were higher than those in good healing group（P<0.05），and the serum CHI3L1，STAT3 and TSG-6 levels were lower than those in good healing group（P<0.05）. There was no statistical significance in the other clinical data between the 2 groups（P>0.05）. The areas under curves（AUC） of single and combined determinations of serum CHI3L1，STAT3 and TSG-6 for judging the poor healing of burn patients were 0.886，0.895，0.894 and 0.979，respectively. Conclusions Serum CHI3L1，STAT3 and TSG-6 are related to the condition and healing of burn patients，and the combined determination has a high efficacy in evaluating the poor healing of burn patients.

Key words: Chitinase 3-like protein 1, Signal transducer and activator of transcription 3, Tumor necrosis factor-alpha-stimulated gene-6, Burn, Healing

CLC Number:

R446.11

FENG Shengjuan, ZHAO Qingyi, ZHOU Limin, CHAI Zhijie, SUN Sihang, SHANG Ayong, WEN Ronghua. Serum CHI3L1，STAT3 and TSG-6 levels in monitoring the condition and wound healing degree of burn patients[J]. Laboratory Medicine, 2026, 41(8): 757-762.

Figures/Tables 6

References 22

[1]	游艾佳, 李文婕, 周俊丽, 等. 异种脱细胞真皮基质敷料治疗烧伤患者创面效果的荟萃分析[J]. 中华烧伤与创面修复杂志, 2023, 39(2):175-183.
[2]	杨茹茜, 李小兵, 田新立, 等. 脉冲短波促进烧伤患儿创面愈合的效果观察[J]. 陆军军医大学学报, 2024, 46(13):1569-1576.
[3]	秦春堂. 几丁质酶样3蛋白1联合估算肾小球滤过率评价粥样硬化性肾动脉狭窄的介入治疗效果[J]. 检验医学, 2018, 33(11):991-996.
[4]	Huang J, Gu Z, Xu Y, et al. CHI3L1(Chitinase 3 Like 1)upregulation is associated with macrophage signatures in esophageal cancer[J]. Bioengineered, 2021, 12(1):7882-7892.
[5]	Xiao Y, Qian J, Deng X, et al. Macrophages regulate healing-associated fibroblasts in diabetic wound[J]. Mol Biol Rep, 2024, 51(1):203.
[6]	Jia Y, Wang Q, Liang M, et al. KPNA2 promotes angiogenesis by regulating STAT3 phosphorylation[J]. J Transl Med, 2022, 20(1):627.
[7]	Ma L, Hua L, Yu W, et al. TSG-6 inhibits hypertrophic scar fibroblast proliferation by regulating IRE1α/TRAF2/NF-κB signalling[J]. Int Wound J, 2023, 20(4):1008-1019.
[8]	孙林利, 陈丽娟, 程雨虹, 等. 2018年《ISBI烧伤处理实践指南(第2部分)》解读[J]. 护理研究, 2020, 34(8):1305-1310.
[9]	中华医学会烧伤外科学分会, 中国医师协会烧伤科医师分会. 烧伤康复治疗指南(2013版)[J]. 中华烧伤杂志, 2013, 29(6):497-504.
[10]	李茂清, 贾鸿飞, 高学坡. 烧伤患者血清ICAM-1、IL-10、TNF-α水平变化及与创面愈合程度的关系分析[J]. 中国美容整形外科杂志, 2024, 35(3):145-149.
[11]	Klifto K M, Hultman C S. Pain management in burn patients:pharmacologic management of acute and chronic pain[J]. Clin Plast Surg, 2024, 51(2):267-301.
[12]	Dobson G P, Morris J L, Letson H L. Pathophysiology of severe burn injuries:new therapeutic opportunities from a systems perspective[J]. J Burn Care Res, 2024, 45(4):1041-1050.
[13]	陈卓, 胡光俊, 褚志刚, 等. 丙泊酚通过减轻炎症反应和内质网应激缓解烧伤后急性肾损伤[J]. 华中科技大学学报(医学版), 2022, 51(6):786-790.
[14]	Qin Y, Zhao W. The modeling analysis and effect of chi3l1 and cd31-marked microvessel density in the occurrence and development of cervical squamous cell carcinoma[J]. Comput Math Methods Med, 2022, 2022:3516335.
[15]	Connolly K, Lehoux M, O'rourke R, et al. Potential role of chitinase-3-like protein 1(CHI3L1/YKL-40)in neurodegeneration and Alzheimer's disease[J]. Alzheimers Dement, 2023, 19(1):9-24.
[16]	Lananna B V, Mckee C A, King M W, et al. Chi3l1/YKL-40 is controlled by the astrocyte circadian clock and regulates neuroinflammation and Alzheimer's disease pathogenesis[J]. Sci Transl Med, 2020, 12(574):eaax3519.
[17]	Chen J, Kitagawa Y, Xie F, et al. Activated microglia mediate the motor neuron-,synaptic denervation- and muscle wasting-changes in burn injured mice[J]. J Cachexia Sarcopenia Muscle, 2025, 16(2):e13755.
[18]	张智慧, 马娟, 于扬, 等. 静态磁场通过激活FGFR1/JAK2/STAT3信号通路促进皮肤成纤维细胞的增殖活性和迁移表型[J]. 河北医学, 2024, 30(5):750-756.
[19]	Verma S, Moreno I Y, Prinholato Da Silva C, et al. Endogenous TSG-6 modulates corneal inflammation following chemical injury[J]. Ocul Surf, 2024, 32:26-38.
[20]	Eom Y W, Hong J E, Jung P Y, et al. TGF-β expressed by M2 macrophages promotes wound healing by inhibiting TSG-6 expression by mesenchymal stem cells[J]. PLoS One, 2025, 20(4):e0316692.
[21]	Greeny A, Shenoy R R. Advances in burn wound management:innovative strategies for healing and infection control[J]. Wounds, 2025, 37(5):198-209.
[22]	Yu J E, Jeon S H, Kim M J, et al. Anti-chitinase-3-like 1 antibody attenuated atopic dermatitis-like skin inflammation through inhibition of STAT3-dependent CXCL8 expression[J]. Br J Pharmacol, 2024, 181(17):3232-3245.

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
烧伤组	85	54.05±5.15	19.88±2.98	0.25±0.05
正常对照组	85	68.42±5.02	32.45±3.86	0.38±0.05
t值		17.064	23.765	16.950
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
烧伤组	85	54.05±5.15	19.88±2.98	0.25±0.05
正常对照组	85	68.42±5.02	32.45±3.86	0.38±0.05
t值		17.064	23.765	16.950
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
浅度烧伤组	36	57.34±5.81	21.63±2.67	0.28±0.04
深度烧伤组	49	51.63±4.12	18.59±2.35	0.23±0.03
t值		5.304	5.562	6.589
P值		<0.001	<0.001	<0.001

组别	例数	CHI3L1/（ng·mL^-1）	STAT3/（ng·L^-1）	TSG-6/（U·mL^-1）
浅度烧伤组	36	57.34±5.81	21.63±2.67	0.28±0.04
深度烧伤组	49	51.63±4.12	18.59±2.35	0.23±0.03
t值		5.304	5.562	6.589
P值		<0.001	<0.001	<0.001

组别	例数		年龄/岁	性别						烧伤总面积/%			烧伤原因
组别	例数		年龄/岁	男/[例（%）]			女/[例（%）]			烧伤总面积/%			火焰烧伤/[例（%）]			其他/[例（%）]
愈合不良组	53		41.25±8.26	33（62.26）			20（37.74）			8.97±2.36			36（67.92）			17（32.08）
愈合良好组	32		40.76±7.18	15（46.88）			17（53.13）			8.41±2.23			20（62.50）			12（37.50）
统计值			0.272	1.922						1.082			0.261
P值			0.786	0.166						0.282			0.609
组别		烧伤深度							ΙL-10/（mg·L^-1）		ΤΝF-α/（μg·L^-1）			CRP/（mg·L^-1）
组别		浅度烧伤/[例（%）]				深度烧伤/[例（%）]			ΙL-10/（mg·L^-1）		ΤΝF-α/（μg·L^-1）			CRP/（mg·L^-1）
愈合不良组		27（50.94）				26（49.06）			158.63±29.26		4.34±1.15			11.91±3.35
愈合良好组		23（71.88）				9（28.13）			147.62±17.90		3.88±0.89			13.32±3.26
统计值		4.255							1.920		1.938			1.899
P值		0.039							0.058		0.056			0.061
组别	PLT计数/（×10⁹L^-1）				APACHEⅡ评分/分			CHI3L1/（ng·mL^-1）				STAT3/（ng·L^-1）			TSG-6/（U·mL^-1）
愈合不良组	64.93±7.96				17.23±2.74			51.32±4.94				18.15±2.54			0.22±0.04
愈合良好组	68.32±7.22				15.33±2.47			58.56±4.56				22.74±3.12			0.30±0.05
统计值	1.969				3.212			6.735				7.399			8.121
P值	0.052				0.002			<0.001				<0.001			<0.001