Zhao Qian-Ye, Shi Su-Jie, Sun Da-Quan, Zhang Shan-Shan, Zhou Xu-Hua
Department of Pediatrics, Lianyungang Maternal and Child Health Care Center Affiliated to Yangzhou University, Lianyungang, Jiangsu 222006, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Feb;21(2):150-154. doi: 10.7499/j.issn.1008-8830.2019.02.008.
To study the correlation of galectin-3 level in bronchoalveolar lavage fluid (BALF) with Mycoplasma pneumoniae (MP) load and cellular immunity of neutrophils and macrophages in the airway in children with refractory MP pneumonia (RMPP).
A total of 64 children with RMPP who were hospitalized from January 2013 to January 2017 were enrolled. In addition to the conservative medical treatment, all the 64 children with RMPP were given bronchoalveolar lavage in the acute stage (5-7 days after admission) and 48 out of the 64 children were given bronchoalveolar lavage in the recovery stage (10-14 days after admission). Four milliliters of BALF of the affected lung lobe or segment were collected. ELISA was used to measure the level of galectin-3 in BALF supernatant. RT-PCR was used to measure MP load. Hematoxylin and eosin staining was used to measure the percentage of neutrophils and macrophages. Six children with bronchial foreign bodies were enrolled as the control group.
The RMPP group had a significantly higher level of galectin-3 in BALF in both the acute and recovery stages than the control group (P<0.01), and the level of galectin-3 in the acute stage was significantly higher than in the recovery stage (P<0.01). The RMPP group had a significantly higher percentage of neutrophils in BALF in both the acute and recovery stages than the control group (P<0.01), and the percentage of neutrophils in the acute stage was significantly higher than in the recovery stage (P<0.01). The RMPP group had a significantly lower percentage of macrophages in BALF in both the acute and recovery stages than the control group (P<0.01), but there was no significant difference in the percentage of macrophages between the acute and recovery stages (P>0.05). The RMPP group had a significantly higher MP load in BALF in both the acute and recovery stages than the control group (P<0.01), and the MP load in the acute stage was significantly higher than in the recovery stage (P<0.01). In the children with RMPP, galectin-3 level in BALF in the acute stage was positively correlated with MP load and the percentage of neutrophils (r=0.789 and 0.726 respectively; P<0.01).
Galectin-3 is involved in the process of airway inflammation in children with RMPP, and the level of galectin-3 in BALF is positively correlated with MP load. RMPP is a cellular immune inflammatory lesion with the increase of neutrophils and the reduction in macrophages. Galectin-3 is closely associated with neutrophil chemotaxis and luminal infiltration in children with RMPP. MP load gradually decreases with the recovery from RMPP, but it is not completely eliminated by the immune system in the recovery stage. MP infection can increase the consumption of macrophages in children with RMPP.
研究难治性支原体肺炎（RMPP）患儿支气管肺泡灌洗液（BALF）中半乳糖凝集素-3水平与肺炎支原体（MP）载量及气道中中性粒细胞和巨噬细胞的细胞免疫的相关性。
选取2013年1月至2017年1月住院的64例RMPP患儿。除保守药物治疗外，所有64例RMPP患儿在急性期（入院后5 - 7天）均接受支气管肺泡灌洗，其中48例在恢复期（入院后10 - 14天）也接受了支气管肺泡灌洗。收集患侧肺叶或肺段的4毫升BALF。采用酶联免疫吸附测定（ELISA）法检测BALF上清液中半乳糖凝集素-3水平。采用逆转录聚合酶链反应（RT-PCR）法检测MP载量。采用苏木精-伊红染色法检测中性粒细胞和巨噬细胞的百分比。选取6例支气管异物患儿作为对照组。
RMPP组急性期和恢复期BALF中半乳糖凝集素-3水平均显著高于对照组（P<0.01），且急性期半乳糖凝集素-3水平显著高于恢复期（P<0.01）。RMPP组急性期和恢复期BALF中中性粒细胞百分比均显著高于对照组（P<0.01），且急性期中性粒细胞百分比显著高于恢复期（P<0.01）。RMPP组急性期和恢复期BALF中巨噬细胞百分比均显著低于对照组（P<0.01），但急性期和恢复期巨噬细胞百分比差异无统计学意义（P>0.05）。RMPP组急性期和恢复期BALF中MP载量均显著高于对照组（P<0.01），且急性期MP载量显著高于恢复期（P<0.01）。在RMPP患儿中，急性期BALF中半乳糖凝集素-3水平与MP载量及中性粒细胞百分比呈正相关（r分别为0.789和0.726；P<0.01）。
半乳糖凝集素-3参与RMPP患儿气道炎症过程，BALF中半乳糖凝集素-3水平与MP载量呈正相关。RMPP是一种细胞免疫性炎症病变，中性粒细胞增多而巨噬细胞减少。半乳糖凝集素-3与RMPP患儿中性粒细胞趋化和管腔浸润密切相关。随着RMPP的恢复，MP载量逐渐降低，但在恢复期免疫系统并未将其完全清除。MP感染可增加RMPP患儿巨噬细胞的消耗。
