Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children

Lee, Yi‐Chen; Chang, Chih‐Hao; Lee, Wei Ju; Liu, Ta-Yu; Tsai, Chih-Min; Tsai, Tsung‐Lin; Tsai, Chih-Ming; Kuo, Kuang-Che; Chen, Chih‐Cheng; Niu, Chi‐Chien; Yu, Hong‐Ren

doi:10.1016/j.jmii.2020.03.030

Cited by 38 publications

(24 citation statements)

References 38 publications

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“…Simultaneously, following MP infection, the immune function of several links between innate and adaptive immunity was disordered, leading to excessive inflammation in the lungs and the whole body (23). Cytokines and chemokines released during these hyperinflammatory responses produce inflammatory cascade amplifications (24). Numerous studies have revealed an increase in Il-18, Il-6, TNF-α, and Il-10 levels in children with RMPP (12,25).…”

Section: Discussionmentioning

confidence: 99%

Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children

et al. 2022

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BackgroundIn children, refractory Mycoplasma pneumoniae pneumonia (RMPP) may result in severe complications and high medical costs. There is research on a simple and easy-to-use nomogram for early prediction and timely treatment of RMPP.MethodsFrom December 2018 to June 2021, we retrospectively reviewed medical records of 299 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in Tianjin Children's Hospital. According to their clinical manifestations, patients were divided into the RMPP group and the general Mycoplasma pneumoniae pneumonia (GMPP) group. The clinical manifestations, laboratory indicators, and radiological data of the two groups were obtained. Stepwise regression was employed for variable selection of RMPP. The predictive factors selected were used to construct a prediction model which presented with a nomogram. The performance of the prediction model was evaluated by C statistics, calibration curve, and receiver operating characteristic (ROC) curve.ResultsThe RMPP group significantly showed a higher proportion of females, longer fever duration, and longer hospital stay than the GMPP group (P < 0.05). Additionally, the RMPP group revealed severe clinical characteristics, including higher incidences of extrapulmonary complications, decreased breath sounds, unilateral pulmonary consolidation >2/3, and plastic bronchitis than the GMPP group (P < 0.05). The RMPP group had higher neutrophil ratio (N%), C-reactive protein (CRP), interleukin-6 (IL-6), lactic dehydrogenase (LDH), and D-dimer than the GMPP group (P < 0.05). Stepwise regression demonstrated that CRP [OR = 1.075 (95% CI: 1.020–1.133), P < 0.001], LDH [OR = 1.015 (95% CI: 1.010–1.020), P < 0.001], and D-dimer [OR = 70.94 (95% CI: 23.861–210.904), P < 0.001] were predictive factors for RMPP, and developed a prediction model of RMPP, which can be visualized and accurately quantified using a nomogram. The nomogram showed good discrimination and calibration. The area under the ROC curve of the nomogram was 0.881, 95% CI (0.843, 0.918) in training cohorts and 0.777, 95% CI (0.661, 0.893) in validation cohorts, respectively.ConclusionC-reactive protein, LDH, and D-dimer were predictive factors for RMPP. The simple and easy-to-use nomogram assisted us in quantifying the risk for predicting RMPP, and more accurately and conveniently guiding clinicians to recognize RMPP, and contribute to a rational therapeutic choice.

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Section: Discussionmentioning

confidence: 99%

Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children

et al. 2022

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“…Through database search, 3426 articles in total were retrieved. After the deletion of duplicate articles, 2639 articles were left, and 20 case-control studies were selected according to the inclusion and exclusion criteria [3,[10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Figure 1 shows the detailed retrieval process.…”

Section: Literature Search and Studymentioning

confidence: 99%

Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors

Huang

Zhao

et al. 2022

Journal of Immunology Research

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Background. Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia (CAP) in children. M. pneumoniae infection is usually regarded as a self-limiting disease, but in some special cases, it can also develop into refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to analyze the clinical characteristics of CRP (C-reactive protein), LDH (lactate dehydrogenase), ESR (erythrocyte sedimentation rate), D-dimer, neutrophils (%), lymphocytes (%), and lung consolidation in RMPP and explore their prediction results in the early stage of RMPP, which is important for early treatment. Methods. This systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, and Cqvip, and the date was set until February 23, 2021. For the continuous variables, mean difference (MD) with 95% CI was adopted to evaluate CRP, LDH, ESR, D-dimer, neutrophils (%), lymphocytes (%), and the correlation between lung consolidation and RMPP. Results. 20 studies including 5289 patients were included in the analysis, and the results showed that the CRP of the RMPP group (MD (95% CI): 22.29 (12.20, 32.38), P < 0.001 ), LDH (MD (95% CI): 145.13 (78.62, 211.64), P < 0.001 ), neutrophils (%) (MD (95% CI): 7.27 (0.31, 14.23), P = 0.04 ), and D-dimer (MD (95% CI): 1.79 (-1.17, 4.74), P = 0.24 ) was higher than that of the NRMPP group; the risk of lung consolidation in the RMPP group (OR (95% CI): 14.29 (4.52, 45.12), P < 0.001 ) was higher than that in the NRMPP group, and there was no difference in ESR (MD (95% CI): 8.11 (-1.34, 17.56), P = 0.09 ) and lymphocytes (%) (MD (95% CI): -6.27 (-12.81, 0.27), P = 0.06 ) between the two groups. Conclusion. So, the available evidence indicates that CRP, LDH, neutrophils (%), D-dimer, and lung consolidation are predictive factors for RMPP.

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“…It has been reported that the pathogenesis of severe Mycoplasma pneumoniae pneumonia is related to cell-mediated immunity, and corticosteroid therapy may be effective. Intravenous immunoglobulin (IVIG) has been used as a potent immunomodulator for Kawasaki disease and other immune-mediated diseases [ 4 ]. Intravenous immune globulin can also be used to treat refractory Mycoplasma pneumoniae pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Gamma Globulin Combined with Azithromycin Sequential Therapy in the Treatment of RMPP and Its Effect on Th1/Th2 Cytokine Levels

Jia

Tian

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To investigate the efficacy of gamma globulin combined with azithromycin sequential therapy in the treatment of children with refractory mycoplasma pneumonia and its effect on Th1/Th2 cytokine levels. Method. From January 2021 to January 2022, 100 children diagnosed with refractory mycoplasma pneumonia were randomly divided into 2 groups (50 cases in each one), the control group was treated with azithromycin plus comprehensive basic treatment, and the treatment group was treated with combined treatment on the basis of the control group, gamma globulin therapy; the treatment effect and cytokine levels of the two groups were compared. Results. Th1, Th2, and Th1/Th2 before treatment were not significantly different between the two groups. Th1, Th2, and Th1/Th2 in the treatment group were significantly downregulated compared with those in the control group after treatment. The levels of IgG, IgA, and IgM in the treatment group were not significantly different from those in the control group before treatment but were significantly upregulated after treatment. IL-10, IL-6, and IL-2 levels were also significantly increased in the treatment group. The disappearance time of clinical symptoms such as fever, cough, and pulmonary rales in the treatment group was significantly shorter than that in the control group, and the cure rate in the treatment group was significantly better than that in the control group. Conclusion. The clinical effect of gamma globulin combined with azithromycin sequential therapy in the treatment of children with refractory mycoplasma pneumonia is remarkable, which can reduce inflammatory factors, improve patients’ immunity, and promote disease recovery.

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Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children

Cited by 38 publications

References 38 publications

Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children

Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children

Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors

Efficacy of Gamma Globulin Combined with Azithromycin Sequential Therapy in the Treatment of RMPP and Its Effect on Th1/Th2 Cytokine Levels

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