Liu Yang, Zhang Xinxing, Wang Yuqing, Zhu Canhong, Fan Mingyue, Dou Xunwu, Hao Chuangli, Yan Yongdong, Ji Wei, Gu Guixiong, Lou Jiangyan, Chen Zhengrong
Department of Child Care, Children's Hospital of Soochow University, Soochow University, Suzhou, China; Department of Pediatrics, The Second Affiliated Hospital to Nanchang University, Nanchang, 330006, China.
Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China.
J Infect Chemother. 2018 Oct;24(10):789-794. doi: 10.1016/j.jiac.2018.06.003. Epub 2018 Jul 11.
Inappropriate inflammatory response in children with M. pneumoniae infection might be associated with disease severity. The role of Granulocyte macrophage colony stimulating factor (GM-CSF) in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP) has not been fully discussed.
Clinical and laboratory data of a total 40 children with MPP were collected. GM-CSF and myeloperoxidase (MPO) were detected by ELISAs. Meanwhile, normal human bronchial epithelium was infected by M. pneumoniae and neutrophils were stimulated by GM-CSF to explore GM-CSF and MPO release in supernatant, respectively.
Compared to control group, a significant increased percentage of neutrophils and decreased percentage of macrophages in bronchoalveolar lavage fluid of children with MPP was observed (P < 0.05). Children with MPP had significantly higher levels of GM-CSF (P = 0.0047) and MPO (P = 0.0002) in BALF compared to the controls. Level of GM-CSF in BALF was associated with duration of fever (r = 0.42, P = 0.007) and strongly correlated with level of MPO (r = 0.075, P = 0.0005). Levels of GM-CSF and MPO significantly decreased (both P < 0.05) after treatment. In vitro, M. pneumoniae induced GM-CSF expression in a time-dependent manner during a 72-h period (P < 0.05) and MPO secretion significantly increased by recombinant human GM-CSF stimulation at 24h (P < 0.05).
GM-CSF could be induced by M. pneumoniae infection in vivo and vitro. Childen with high level GM-CSF had longer duration of fever. GM-CSF probably plays a vital role in neutrophil inflammation in M. pneumoniae infection.
肺炎支原体感染儿童中不适当的炎症反应可能与疾病严重程度相关。粒细胞巨噬细胞集落刺激因子（GM-CSF）在住院的肺炎支原体肺炎（MPP）儿童中的作用尚未得到充分讨论。
收集了总共40例MPP儿童的临床和实验室数据。采用酶联免疫吸附测定法检测GM-CSF和髓过氧化物酶（MPO）。同时，用肺炎支原体感染正常人支气管上皮，并分别用GM-CSF刺激中性粒细胞，以探索上清液中GM-CSF和MPO的释放情况。
与对照组相比，MPP儿童支气管肺泡灌洗液中中性粒细胞百分比显著增加，巨噬细胞百分比显著降低（P<0.05）。与对照组相比，MPP儿童BALF中GM-CSF（P = 0.0047）和MPO（P = 0.0002）水平显著更高。BALF中GM-CSF水平与发热持续时间相关（r = 0.42，P = 0.007），并与MPO水平密切相关（r = 0.075，P = 0.0005）。治疗后GM-CSF和MPO水平显著降低（均P<0.05）。在体外，肺炎支原体在72小时内以时间依赖性方式诱导GM-CSF表达（P<0.05），并且在24小时时重组人GM-CSF刺激显著增加MPO分泌（P<0.05）。
GM-CSF可在体内和体外被肺炎支原体感染诱导。GM-CSF水平高的儿童发热持续时间更长。GM-CSF可能在肺炎支原体感染的中性粒细胞炎症中起重要作用。
