Clinical significance of D-dimer levels in refractory Mycoplasma pneumoniae pneumonia

Huang, Xia; Li, Dan; Liu, Feng; Zhao, Deyu; Zhu, Yifan; Tang, Heng

doi:10.1186/s12879-020-05700-5

Cited by 45 publications

(42 citation statements)

References 24 publications

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“…All patients had positive MP PCR tests and serological detection. According to the peak value of D-dimer (Huang et al, 2021), they were divided into three groups, the normal group (D-dimer <0.55 mg/L, n=106), the mild-moderately elevated group (D-dimer 0.55-5.5 mg/L, n=204) and the severely elevated group (more than 10 times higher than the normal range, D-dimer >5.5 mg/L, n=46). As shown in Table 1, the median age in the normal group was 4.1 years (range, 2.1-6.1), younger than that in the mild-moderately elevated group 5.8 years (range, 4.3-7.0) and the severely elevated group 6.1 years (range, 4.6-8.0) (P<0.01), but no difference was found in gender distribution (P>0.05).…”

Section: General Information Of Patientsmentioning

confidence: 99%

The Level of D-Dimer Is Positively Correlated With the Severity of Mycoplasma pneumoniae Pneumonia in Children

Zheng

Hua

Zhao

et al. 2021

Front. Cell. Infect. Microbiol.

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ObjectiveMycoplasma pneumoniae pneumonia (MPP) is an important disease in children. Studies have demonstrated that the levels of D-dimer are elevated in some children with MPP, especially those with thrombotic complications. However, the potential association between MPP and D-dimer remains unclear. In our study, we sought to explore the relationship between the levels of plasma D-dimer and clinical characteristics of MPP patients.MethodsRetrospective analysis was conducted on 356 patients who were hospitalized in our hospital for MPP between January 1, 2017, and December 31, 2019. According to the peak value of D-dimer, patients were divided into three groups: the normal group (D-dimer<0.55 mg/L), the mild-moderately elevated group (D-dimer 0.55–5.5 mg/L) and the severely elevated group (D-dimer >5.5 mg/L). The demographic and clinical information, radiological findings, laboratory data, and treatments of patients were compared among different groups.Results106 patients were in the normal group, 204 patients were in the mild-moderately elevated group, and 46 patients were in the severely elevated group. More severe clinical and radiographic manifestations, longer length of fever, hospital stay and antibiotic therapy duration, higher incidences of extra-pulmonary complications, refractory MPP (RMPP), severe MPP (SMPP) were found in the elevated group, when compared with the normal group (P<0.01). Meanwhile, we found that the percentage of neutrophil (N%) and CD8+ lymphocyte (CD8+%), C-reactive protein (CRP), lactate dehydrogenase (LDH), interleukin (IL)-6, IL-10, and interferon-gamma (IFN-γ) trended higher with increasing D-dimer, whereas the percentage of lymphocyte (L%) and prealbumin (PAB) trended lower (P<0.01). In addition, the proportions of patients requiring oxygen therapy, glucocorticoid, bronchoscopy, immunoglobulin use, thoracentesis, or ICU admission were significantly higher in the severely elevated group than those in the other two groups (P<0.01). Correlation analysis showed that N%, L%, CRP, LDH, IL-10, length of fever, length of stay, and length of antibiotic therapy had strong correlations with the level of D-dimer.ConclusionsMPP patients with higher levels of D-dimer had more severe clinical manifestations and needed longer duration of treatment, which might be closely related to the severity of lung inflammation after MP infection.

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Section: General Information Of Patientsmentioning

confidence: 99%

The Level of D-Dimer Is Positively Correlated With the Severity of Mycoplasma pneumoniae Pneumonia in Children

Zheng

Hua

Zhao

et al. 2021

Front. Cell. Infect. Microbiol.

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“…When we analysed the correlation between the miR-10a-3p expression level and laboratory inflammatory indicators, we found a positive correlation between miR-10a-3p expression level and WBC, ESR, and CRP. Indicators such as WBC, ESR, and CRP play a role in the evaluation of pneumonia and the determination of treatment efficacy and are associated with progression of pneumonia in a certain sense (9,17). These results suggest that upregulation of miR-10a-3p expression in paediatric MPP might participate in disease development and progression.…”

Section: Changes In Expression Levels Of Nf-κb Signalling Pathwayrelated Proteins and Crp In Thp-1 Cells After Transfectionmentioning

confidence: 87%

The role of targeted regulation of COX11 by miR-10a-3p in the development and progression of paediatric mycoplasma pneumoniae pneumonia

Ding¹,

Zhao²,

Xiong³

et al. 2021

J Thorac Dis

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Background: MiR-10a-3p is associated with the pathogenesis of many immune inflammatory diseases including Mycoplasma pneumoniae pneumonia (MPP), and cytochrome coxidase assembly homologue 11 (COX11) is one of its direct target proteins. This study investigates the function and mechanism of miR-10a-3p targeting with COX11 in the development and progression of paediatric MPP. Methods: Ninty-seven paediatric MPP patients and 100 age-and sex-matched healthy children were enrolled. Clinical and laboratory indicators of paediatric MPP patients were collected. The mRNA levels of the COX11 gene and miR-10a-3p were detected by qRT-PCR. THP-1 mononuclear macrophages were stimulated using MPP lipid-associated membrane proteins (Mp-LAMPs). The relative expression level of miR-10a-3p was detected after 12, 24, and 48 h. THP-1 cells were transfected to overexpress or inhibit the expression of miR-10a-3p, miR-10a-3p, COX11 mRNA, NF-κB signalling pathway-related proteins, and C-reactive protein (CRP) were detected after 48 h by Western blot. Results:The relative expression level of miR-10a-3p in the MPP group was 2.38±0.52, compared with 1.76±0.38 in control group (t=4.584, P<0.001) whileCOX11 in MPP group was 3.70±1.12, compared to 5.78±1.84 in control group (t=4.876, P<0.001). Pearson correlation analysis showed that miR-10a-3p and COX11 in MPP group presented a negative correlation (r=-0.679, P<0.001). By searching in the prediction website of TargetScan database, it was found that miR-10a-3p and Cox11 genes had targeted regulatory binding sites, and the targeting relationship between miR-10a-3p and Cox11 genes was confirmed by dual luciferase reporting assay in 293T cells. Among paediatric MPP patients, miR-10a-3p expression had a positive correlation with the white blood cells count, erythrocyte sedimentation rate (ESR), and CRP expression, while COX11 mRNA expression had a positive correlation with ESR and CRP. After LAMP stimulation, the miR-10a-3p expression level in THP-1 cells significantly increased (P<0.05). After THP-1 cells were transfected with the miR-10a-3p mimic or inhibitor, the relative expression level of miR-10a-3p significantly increased or decreased, respectively. COX11 expression in the mimic group significantly decreased, whereas COX11 in the inhibitor group significantly increased (both P<0.05). In addition, after transfection, IκBα expression significantly decreased and that of p-IKKα/β, p-p65, and CRP significantly increased in the mimic group, and the opposite was true in the inhibitor group. Conclusions:In paediatric MPP, increased miR-10a-3p downregulated COX11, activating NF-κB signalling pathway to promote disease development and progression.Li et al. miR-10a-3p targets COX11 leading paediatric MPP progression

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“…The correlation of blood hypercoagulation with RMPP has been substantially demonstrated. It is attributed to the possible involvement of severe hypercoagulability and vascular endothelial cell injury, which results from an excessive inflammatory response, in lung injury ( Huang et al, 2021 ). Based on TCM theory, “promoting blood circulation” was an important method for treating RMPP, which seemed to be better at relieving lung rale in our meta-analyses.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of RMPP is multifactorial, including macrolide resistance ( Zhao et al, 2020 ), mixed infection ( Zhou et al, 2020 ), excessive inflammatory reaction ( Li et al, 2019a ), immunity dysfunction ( Yu et al, 2017 ), and blood hypercoagulability ( Huang et al, 2021 ). The first line antibiotics used for RMPP are macrolides.…”

Section: Introductionmentioning

confidence: 99%

Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis

et al. 2021

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Objectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to evaluate whether CHM combination therapy could bring benefits to children and adolescents with RMPP.Methods: Seven databases were used for data searching through November 11, 2020 following the PRISMA checklist generally. Review Manager 5.3, Trial sequential analysis 0.9.5.10 Beta software and Stata16.0 were applied to perform data analyses. Mean difference or risk ratio was adopted to express the results, where a 95% confidence interval (CI) was applied.Results: In general, this research enrolled 17 trials with 1,451 participants. The overall pooled results indicated that CHM was beneficial for children and adolescents with RMPP by improving the clinical efficacy rate [RR = 1.20, 95% CI (1.15, 1.25), p < 0.00001], shortening antipyretic time [MD = −2.60, 95% CI (−3.06, −2.13), p < 0.00001], cough disappearance time [MD = −2.77, 95% CI (−3.12, −2.42), p < 0.00001], lung rale disappearance time [MD = −2.65, 95% CI (−3.15, −2.15), p < 0.00001], lung X-ray infiltrates disappearance time [MD = −2.75, 95% CI (−3.33, −2.17), p < 0.00001], reducing TNF-α level [MD = −5.49, 95% CI (−7.21, −3.77), p < 0.00001]. Moreover, subgroup results suggested that removing heat-phlegm and toxicity therapy had more advantages in shortening antipyretic time, cough disappearance time, lung X-ray infiltrates disappearance time and reducing TNF-α level. Meanwhile promoting blood circulation therapy seemed to be better at relieving lung rale. However, regarding adverse events, the two groups displayed no statistical difference [RR = 0.97, 95% CI (0.60, 1.57), p = 0.91].Conclusion: Despite of the apparently positive results in relieving clinical symptoms, physical signs and reducing inflammation, it is premature to confirm the efficacy of CHM in treating RMPP because of the limitation of quality and the number of the included studies. More large-scale, double-blind, well-designed, randomized controlled trials are needed in future research.

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Clinical significance of D-dimer levels in refractory Mycoplasma pneumoniae pneumonia

Cited by 45 publications

References 24 publications

The Level of D-Dimer Is Positively Correlated With the Severity of Mycoplasma pneumoniae Pneumonia in Children

The Level of D-Dimer Is Positively Correlated With the Severity of Mycoplasma pneumoniae Pneumonia in Children

The role of targeted regulation of COX11 by miR-10a-3p in the development and progression of paediatric mycoplasma pneumoniae pneumonia

Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis

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