Histological findings in severe Mycoplasma pneumoniae pneumonia

Miyashita, Naoyuki; Narita, Mitsuo; Tanaka, Takaaki; Akaike, Hiroto; Teranishi, Hideto; Oishi, Tomohiro; Nakano, Takashi; Ouchi, Kazunobu; Okimoto, Niro

doi:10.1099/jmm.0.000501

Cited by 8 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increasing numbers of refractory or severe, even fatal, cases of M. pneumoniae infections have been reported in recent years [ 10 , 16 ], although M. pneumoniae infection was traditionally considered to be self-limiting. In the present study, children with RMPP had longer durations of hospital stay and fever as well as high levels of LDH, a useful marker for initiation of steroid therapy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia

Ding

Chu

et al. 2018

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundIncreasing numbers of refractory or severe, even fatal, cases of Mycoplasma pneumoniae infections have been reported in recent years. Excessive inflammatory responses play a vital role in the pathogenesis of refractory M. pneumoniae pneumonia (RMPP). HMGB1 is an actively secreted cytokine produced by macrophages and other inflammatory cells that participates in various infectious diseases. The present study aimed to explore the role and clinical significance of HMGB1 in children with RMPP and the potential mechanism of HMGB1 expression.MethodsFour hundred and fifty-two children diagnosed with M. pneumoniae pneumonia, including 108 children with RMPP, were enrolled from January 2013 to December 2015 at the Children’s Hospital of Soochow University. HMGB1, TNF-α, and IL-6 in peripheral blood from RMPP and non-RMPP (NRMPP) cases were detected by real-time PCR and ELISA. Lipid-associated membrane proteins (LAMPs) were extracted from live M. pneumoniae and prepared at different concentrations for stimulation of THP-1 cells. After coculture with LAMPs, HMGB1, TNF-α, IL-6, RAGE, TLR2, and TLR4 in THP-1 cells were detected by real-time PCR.ResultsOccurrences of cough, fever, and abnormal lung signs were more frequent in RMPP cases compared with NRMPP cases (all p < 0.05). Children with RMPP had longer hospital stays than children with NRMPP (p < 0.05). Different distributions of lymphocytes were noted between RMPP and NRMPP cases. HMGB1, TNF-α, and IL-6 levels were significantly higher in RMPP cases compared with NRMPP cases (all p < 0.05). HMGB1 had good diagnostic ability to differentiate RMPP with AUC of 0.876, sensitivity of 0.833, and specificity of 0.824 compared with TNF-α and IL-6. HMGB1 expression in THP-1 cells was increased by stimulation with 10 μg/ml LAMPs. TLR2 expression was increased after stimulation with 6 μg/ml LAMPs. HMGB1 level was positively associated with TNF-α, IL-6, and TLR2 levels.ConclusionsHMGB1 is a good diagnostic biomarker for differentiating RMPP and NRMPP. LAMPs from M. pneumoniae may induce HMGB1 expression in immune cells through the TLR2 pathway. Further in vitro and in vivo studies are needed for the development of a new treatment strategy to inhibit the HMGB1 pathway, thereby preventing the inflammation in RMPP.

show abstract

Section: Discussionmentioning

confidence: 99%

High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia

Ding

Chu

et al. 2018

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…In particular, some authors showed that several lipoproteins of M. pneumoniae (MALP2, P48, M161Ag, N-ALP1/NALP2, and F0F1-ATPase) seem to stimulate the host immune system via Toll-like receptors (TLRs), mainly TLR1, TLR2, and TLR6 ( Andrews et al, 2013 ). This stimulation could promote the production of cytokines and chemokines and the development of the humoural and cellular immune response, leading to the histological findings seen in human M. pneumoniae CAP ( Miyashita et al, 2017 ). Similar pathogenetic mechanisms can be supposed for early-onset CNS M. pneumoniae diseases, as increased cytokine and chemokine concentrations have been found in patients with these diseases ( Narita et al, 2005 ).…”

Section: Hypothesized Pathogeneses and Clinical Manifestations Of mentioning

confidence: 99%

Pathogenesis and Treatment of Neurologic Diseases Associated With Mycoplasma pneumoniae Infection

et al. 2018

View full text Add to dashboard Cite

Mycoplasma pneumoniae is mainly recognized as a respiratory pathogen, although it is associated with the development of several extra-respiratory conditions in up to 25% of the cases. Diseases affecting the nervous system, both the peripheral (PNS) and the central nervous system (CNS), are the most severe. In some cases, particularly those that involve the CNS, M. pneumoniae-related neuropathies can lead to death or to persistent neurologic problems with a significant impact on health and a non-marginal reduction in the quality of life of the patients. However, the pathogenesis of most of the M. pneumoniae-related neuropathies remains undefined. The main aim of this paper is to discuss what is presently known regarding the pathogenesis and treatment of the most common neurologic disorders associated with M. pneumoniae infection. Unfortunately, the lack of knowledge of the true pathogenesis of most of the cases of M. pneumoniae-mediated neurological diseases explains why treatment is not precisely defined. However, antibiotic treatment with drugs that are active against M. pneumoniae and able to pass the blood-brain barrier is recommended, even though the best drug, dosage, and duration of therapy have not been established. Sporadic clinical reports seem to indicate that because immunity plays a relevant role in the severity of the condition and outcome, attempts to reduce the immune response can be useful. However, further studies are needed before the problem of the best therapy for M. pneumoniae-mediated neurological diseases can be efficiently solved.

show abstract

“…The treatment time of the study group was the same as that of the control group. Observation Indexes Criteria for curative effect: 10 After 10d of treatment, the therapeutic effect was evaluated, and the clinical efficacy was divided into four grades: cured, markedly effective, effective and ineffective. Cured: The children's body temperature returned to normal, lung rales and symptoms disappeared completely, and the lung lesions were 95% absorbed by X-ray examination.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

Effect of bronchofiberscopic lavage with budesonide suspension on refractory mycoplasma pneumoniae pneumonia

Yang²,

Wu³

et al. 2022

Pak J Med Sci

View full text Add to dashboard Cite

Objectives: To investigate the clinical efficacy of budesonide suspension through bronchofiberscopic lavage in the treatment of refractory mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 108 children with refractory mycoplasma pneumoniae pneumonia from June 2018 to October 2020 were randomly divided into two groups: the study group and the control group, with 54 cases in each group. Children in the control group were treated with anti-infective, antitussive, antipyretic routine symptomatic treatment and nebulization of budesonide suspension, while children in the study group were treated with bronchofiberscopic lavage with Budesonide suspension along with standard treatment as in control group. The clinical efficacy, changes in blood gas analysis indexes, levels of inflammatory mediators, time for improvement of clinical symptoms and the incidence of adverse reactions were compared between the two groups. Results: The efficacy of treatment in the study group was 85.19%, which was higher than 66.67% in the control group (P<0.05). The antipyretic time, antitussive time, lung rales disappearance time and length of hospital stay in the study group were shorter than those in the control group (P<0.05). Moreover, the levels of arterial oxygen partial pressure (PaO2) in the study group were higher than those in the control group, while the levels of partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (SaO2) in the study group were lower than those in the control group (P<0.05). The levels of inflammatory mediators interleukin-6 (IL-6), interleukin-4 (IL-4), and interferon-γ (IFN-γ) in the study group were lower than those in the control group (P<0.05), and no significant difference was found in the comparison of the incidence of adverse reactions between the two groups (P>0.05). Conclusions: Budesonide suspension combined with bronchofiberscopic lavage with Budesonide suspension is a safe treatment regimen that can significantly improve the clinical outcome in children with RMPP. With such a combined treatment regimen, the clinical symptoms of children can be ameliorated, the ventilation function can be enhanced, and the level of inflammatory mediators will be reduced. doi: https://doi.org/10.12669/pjms.38.4.4835 How to cite this:Li Y, Yang W, Wu X, Gou X. Effect of bronchofiberscopic lavage with budesonide suspension on refractory mycoplasma pneumoniae pneumonia. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4835 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

Histological findings in severe Mycoplasma pneumoniae pneumonia

Cited by 8 publications

References 19 publications

High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia

High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia

Pathogenesis and Treatment of Neurologic Diseases Associated With Mycoplasma pneumoniae Infection

Effect of bronchofiberscopic lavage with budesonide suspension on refractory mycoplasma pneumoniae pneumonia

Contact Info

Product

Resources

About