{
  "abstract": "Severe Hymenoptera sting envenomation can cause systemic inflammation, shock, and multi-organ injury. Gasdermin D cleavage and RIPK3 phosphorylation are associated with inflammatory cell-death pathways, but circulating measurements cannot by themselves establish a specific cellular death mechanism. We therefore evaluated the clinical associations of serum GSDMD-p30, p-RIPK3, IL-1β, and IL-18 with illness severity in patients with Hymenoptera sting envenomation. We conducted a single-center retrospective study of 142 adults admitted between January 2023 and December 2025. Clinical severity was categorized at admission using a four-level institution-specific scheme: Grade I, local/minimal systemic manifestations without organ dysfunction; Grade II, systemic allergic manifestations without organ dysfunction; Grade III, single-organ failure; and Grade IV, multi-organ failure and/or anaphylactic shock. Archived serum was available for 98 patients (Grade I/II/III/IV: 30/33/22/13). Serum GSDMD-p30, p-RIPK3, IL-1β, and IL-18 were measured by ELISA-based assays. Associations with severity grade and SOFA score and exploratory same-cohort ROC performance for Grade III-IV disease were assessed. The cohort included 42 Grade I, 48 Grade II, 34 Grade III, and 18 Grade IV patients. Sting count, time to hospital presentation, inflammatory indices, organ-injury markers, SOFA score, ICU admission, and length of stay increased with clinical severity. In the serum subset, mean GSDMD-p30 increased from 0.82 ± 0.21 ng/mL in Grade I to 9.43 ± 2.18 ng/mL in Grade IV, and p-RIPK3 increased from 0.64 ± 0.18 to 7.84 ± 1.87 ng/mL (global p < 0.001 for both). IL-1β and IL-18 showed similar severity-associated increases. Correlations with SOFA score were ρ = 0.814 for GSDMD-p30, ρ = 0.783 for p-RIPK3, ρ = 0.791 for IL-18, and ρ = 0.762 for IL-1β (all p < 0.001). Apparent AUCs for Grade III-IV disease were 0.861, 0.843, 0.834, and 0.812, respectively. Circulating GSDMD-p30, p-RIPK3, IL-1β, and IL-18 were associated with clinical severity and organ-failure burden in this retrospective cohort. These findings support further evaluation of these proteins as candidate severity-associated biomarkers, but they do not demonstrate PANoptosis, establish cell-specific origin, or validate a clinical triage tool. Prospective multicenter studies with standardized assays and adjusted analyses are required.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency Medicine, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Pan Bian"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuhua Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Shaohui Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yang Gui"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhenya Shen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9h1ye2jtsjhj5.bib",
  "cited_by": 0,
  "doi": "10.3389/fcell.2026.1970146",
  "fulltext_url": "https://europepmc.org/articles/PMC13713688",
  "id": "9h1ye2jtsjhj5",
  "issns": [
    "2296-634X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42952992",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "1311|Venomous Animal Envenomation and Studies"
    ]
  ],
  "openalex": "W7221814065",
  "pdf_url": "https://europepmc.org/articles/PMC13713688?pdf=render",
  "pmcid": "PMC13713688",
  "pmid": "42952992",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9h1ye2jtsjhj5.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:41Z",
      "native_id": "MED:42952992",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42952992"
    },
    {
      "first_seen": "2026-10-31T12:24:11Z",
      "native_id": "PMC13713688",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fcell.2026.1970146"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|Venomous Animal Envenomation and Studies",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Circulating cell-death-associated biomarkers and inflammatory severity in Hymenoptera sting envenomation: a single-center retrospective study.",
  "title_text": "Circulating cell-death-associated biomarkers and inflammatory severity in Hymenoptera sting envenomation: a single-center retrospective study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:19Z",
  "url": "https://research.draconitic.com/paper/9h1ye2jtsjhj5",
  "venue": "Frontiers in cell and developmental biology",
  "versions": []
}