Department of Translational Medicine, the First Hospital of Jilin University, Changchun, 130021, China.
Department of Pediatrics, the First Hospital of Jilin University, Changchun, 130021, China.
Sci Rep. 2017 Oct 11;7(1):12934. doi: 10.1038/s41598-017-13292-5.
Early distinction between severe Mycoplasma pneumoniae pneumonia (MPP) and mild MPP is still difficult. The aim of this study was to analyze cytokines in bronchoalveolar lavage fluid (BALF) and explore predicting factors of severe MPP in children. Retrospective analysis was performed on 150 children with MPP or bronchial foreign body (FB) admitted in our hospital. The mRNA levels of IL17A were found significantly lower in severe MPP group comparing with mild MPP group or FB group. However, no significant difference was found in the levels of IL4, IL10 or interferon beta1 (IFNβ1) between the two groups. Receiver operator characteristic (ROC) curve analysis showed that IL17A can be used to distinguish severe MPP from mild MPP. These results were confirmed in a validation cohort including 40 MPP children from another hospital. IL17A levels were correlated with some clinical characters, such as refractoriness and pleural effusion. Lower IL17A levels were more likely to be found in refractory MPP children or in MPP children with pleural effusion. Moreover, the protein levels of IL17A in BALF were also found greatly decreased in children with severe MPP. Thus, decreased IL17A levels in BALF may be a valuable biomarker to identify severe MPP in children.
早期区分严重肺炎支原体肺炎（MPP）和轻度 MPP 仍然很困难。本研究旨在分析支气管肺泡灌洗液（BALF）中的细胞因子，并探讨儿童重症 MPP 的预测因素。对我院收治的 150 例 MPP 或支气管异物（FB）患儿进行回顾性分析。与轻度 MPP 组或 FB 组相比，重症 MPP 组 IL17A 的 mRNA 水平明显降低。然而，两组间 IL4、IL10 或干扰素β1（IFNβ1）水平无明显差异。受试者工作特征（ROC）曲线分析表明，IL17A 可用于区分重症 MPP 和轻症 MPP。在另一所医院的 40 名 MPP 患儿验证队列中得到了验证。IL17A 水平与一些临床特征相关，如难治性和胸腔积液。难治性 MPP 患儿或合并胸腔积液的 MPP 患儿更可能出现较低的 IL17A 水平。此外，重症 MPP 患儿 BALF 中的 IL17A 蛋白水平也明显降低。因此，BALF 中 IL17A 水平降低可能是识别儿童重症 MPP 的有价值的生物标志物。
