Relationship between peripheral blood PI3K/Akt/mTOR signaling pathway and pulmonary function and prognosis in patients with idiopathic pulmonary fibrosis

doi:10.3877/cma.j.issn.1674-6880.2026.02.003

Abstract

Abstract:

Objective

To explore the relationship between the peripheral blood phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway and the pulmonary function and prognosis in patients with idiopathic pulmonary fibrosis (IPF).

Methods

A total of 180 patients with IPF were selected as the study group, and another 100 healthy volunteers who underwent physical examinations were taken as the control group. The expression levels of peripheral blood PI3K, Akt and mTOR messenger RNA (mRNA) and the pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and FEV₁/FVC] of the two groups were detected and compared. Correlation between the PI3K/Akt/mTOR signaling pathway in peripheral blood and the lung function parameters of IPF patients was analyzed by Pearson correlation analysis. After one-year follow-up, the patients with IPF were divided into a good prognosis group (n = 94) and a poor prognosis group (n = 86) based on their prognosis. Multivariate logistic regression was used to analyze the influencing factors for their prognosis.

Results

The expression levels of PI3K, Akt and mTOR mRNA in peripheral blood of the study group were higher than those of the control group, while the FVC, FEV₁ and FEV₁/FVC in the study group were lower than those in the control group (t = 15.263, 48.390, 45.704, 25.249, 37.731, 43.181; all P < 0.001). The expression of PI3K, Akt and mTOR mRNA in peripheral blood was negatively correlated with FVC, FEV₁ and FEV₁/FVC (all P < 0.05). Compared with the good prognosis group, patients in the poor prognosis group had higher PI3K, Akt and mTOR mRNA expression in peripheral blood and lower FVC, FEV₁ and FEV₁/FVC ratios, with older age (all P < 0.001). Advanced age, elevated PI3K, Akt and mTOR mRNA expression in peripheral blood, and decreased FVC, FEV₁ and FEV₁/FVC were risk factors for poor prognosis in IPF patients (all P < 0.05).

Conclusion

The upregulation of PI3K, Akt and mTOR mRNA expression in peripheral blood of IPF patients is closely associated with impaired lung function and poor prognosis.

Key words: Phosphatidylinositol 3-kinase, Protein kinase B, Mammalian target of rapamycin, Idiopathic pulmonary fibrosis, Pulmonary Function, Prognosis

Xinhua Zheng, Cuiying Zhang, Guangyi Liu. Relationship between peripheral blood PI3K/Akt/mTOR signaling pathway and pulmonary function and prognosis in patients with idiopathic pulmonary fibrosis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2026, 19(02): 109-114.

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Figures/Tables 5

References 24

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组别	例数	PI3K mRNA	Akt mRNA	mTOR mRNA
对照组	100	0.17 ± 0.03	0.103 ± 0.021	0.14 ± 0.04
研究组	180	0.66 ± 0.32	0.834 ± 0.152	0.75 ± 0.13
t值		15.263	48.390	45.704
P值		< 0.001	< 0.001	< 0.001

组别	例数	PI3K mRNA	Akt mRNA	mTOR mRNA
对照组	100	0.17 ± 0.03	0.103 ± 0.021	0.14 ± 0.04
研究组	180	0.66 ± 0.32	0.834 ± 0.152	0.75 ± 0.13
t值		15.263	48.390	45.704
P值		< 0.001	< 0.001	< 0.001

组别	例数	FVC（L）	FEV₁（L）	FEV₁/FVC（%）
对照组	100	2.9 ± 0.5	2.78 ± 0.64	80 ± 6
研究组	180	1.4 ± 0.4	0.80 ± 0.22	52 ± 5
t值		25.249	37.731	43.181
P值		< 0.001	< 0.001	< 0.001

组别	例数	FVC（L）	FEV₁（L）	FEV₁/FVC（%）
对照组	100	2.9 ± 0.5	2.78 ± 0.64	80 ± 6
研究组	180	1.4 ± 0.4	0.80 ± 0.22	52 ± 5
t值		25.249	37.731	43.181
P值		< 0.001	< 0.001	< 0.001

指标	PI3K mRNA		Akt mRNA		mTOR mRNA
指标	r值	P值	r值	P值	r值	P值
FVC	-0.498	< 0.001	-0.445	0.012	-0.492	< 0.001
FEV₁	-0.517	< 0.001	-0.477	< 0.001	-0.481	< 0.001
FEV₁/FVC	-0.486	< 0.001	-0.469	0.006	-0.471	< 0.001

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