Abstract: Objective The aim of this study was to explore the predictive efficacy of peripheral blood mononuclear cells (PBMCs) nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and cysteine protease-1 (caspase-1) mRNA levels in patients with hepatitis B cirrhosis and complicated spontaneous bacterial peritonitis (SBP). Methods 65 patients with hepatitis B cirrhosis complicated by SBP were enrolled in our hospital between January 2018 and May 2020. The PBMC NLRP3 and caspase-1 mRNA levels were detected by real-time fluorescence quantitative PCR and serum interleukin-1β (IL-1β) and IL-18 levels were detected by ELISA. The predictive performance was evaluated by the area under receiver operating characteristic curve (AUC). Results The PBMCs NLRP3, caspase-1 mRNA and serum IL-1β and IL-18 levels in 21 patients with severe SBP were (1.5±0.3), (2.0±0.4), (11.7±2.1)pg/mL and (17.4±1.6)pg/mL, all significantly higher than [(1.1±0.2), (1.6±0.3), (8.6±1.3)pg/mL and (12.1±1.3)pg/mL, respectively, P<0.05] in 44 patients with mild SBP; the AUC was 0.899, with SE(95%CI) of 0.036(0.828-0.971), when predicting severe disease by the combination of PBMCs NLRP3 and caspase-1 levels; the PBMCs NLRP3, caspase-1 mRNA and serum IL-1β and IL-18 levels in 15 dead patients at presentation were (1.7±0.3), (2.3±0.5),(12.5±2.2)pg/mL and (18.2±3.1)pg/mL, all significantly higher than [(1.1±0.2), (1.6±0.3), (8.9±1.8) pg/mL and (12.7±2.5)pg/mL, respectively, P<0.05] in 50 survivals; the AUC was 0.916, with SE(95%CI) of 0.043(0.831-0.999), when predicting the prognosis of patients with SBP by the combination of PBMCs NLRP3 and caspase-1 mRNA levels. Conclusion The PBMCs NLRP3 and caspase-1 levels increase in patients with hepatitis B cirrhosis complicated by SBP, which might be related to the severity of the entity and needs further investigation.

Key words: Liver cirrhosis, Spontaneous bacterial peritonitis, Peripheral blood mononuclear cells, Nucleotide-binding oligomerization domain-like receptor protein 3, Cysteine protease-1, Prognosis