Xu Xuefeng, Sheng Yuanjian, Yang Li, Zhou Haichun, Tang Lanfang, Du Lizhong
Department of Rheumatology Immunology & Allergy, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Pulmonary Medicine, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Pediatr. 2021 Apr 20;9:651487. doi: 10.3389/fped.2021.651487. eCollection 2021.
Inflammatory response, oxidative stress, and immunologic mechanism are involved in the pathogenesis of pneumonia (MPP). However, the role of immune system of pediatric interstitial pneumonia due to infections remains poorly understood. The aim of this study was to analyze the immunologic features of pediatric interstitial pneumonia due to . A retrospective study was conducted on a primary cohort of children with MPP. Propensity score analysis was performed to match interstitial pneumonia and pulmonary consolidation children. The clinical characteristics strongly associated with the development of interstitial pneumonia were boys, age >5 years, wheezing history, hydrothorax free, lymphocytes (>3.0 × 10/L), CD19 (>0.9 × 10/L), CD3 (>2.5 × 10/L), CD4 (>1.5 × 10/L), CD8 (>0.9 × 10/L), interleukin-6 (IL-6, <30 pg/ml), IL-10 (<6 pg/ml), and interferon-γ (IFN-γ, <15 pg/ml). After propensity score analysis, children with interstitial pneumonia showed significantly higher CD19, CD3, and CD4 T cell counts, and lower serum IL-6, IL-10, and IFN-γ levels. The final regression model showed that only CD4 T cells (>1.5 × 10/L, OR = 2.473), IFN-γ (<15 pg/ml, OR = 2.250), and hydrothorax free (OR = 14.454) were correlated with the development of interstitial pneumonia among children with MPP. The -induced interstitial pneumonia showed increased CD4 T cells and lower serum IFN-γ level. Specific immunologic profiles could be involved in the development of pediatric interstitial pneumonia due to infections.
炎症反应、氧化应激和免疫机制参与了肺炎（支原体肺炎，MPP）的发病机制。然而，感染所致小儿间质性肺炎的免疫系统作用仍知之甚少。本研究旨在分析感染所致小儿间质性肺炎的免疫特征。对一组原发性支原体肺炎患儿进行了回顾性研究。采用倾向评分分析对间质性肺炎患儿和肺实变患儿进行匹配。与间质性肺炎发生密切相关的临床特征为男性、年龄>5岁、有喘息史、无胸腔积液、淋巴细胞（>3.0×10⁹/L）、CD19（>0.9×10⁹/L）、CD3（>2.5×10⁹/L）、CD4（>1.5×10⁹/L）、CD8（>0.9×10⁹/L）、白细胞介素-6（IL-6，<30 pg/ml）、IL-10（<6 pg/ml）和干扰素-γ（IFN-γ，<15 pg/ml）。倾向评分分析后，间质性肺炎患儿的CD19、CD3和CD4 T细胞计数显著更高，血清IL-6、IL-10和IFN-γ水平更低。最终回归模型显示，在支原体肺炎患儿中，只有CD4 T细胞（>1.5×10⁹/L，OR = 2.473）、IFN-γ（<15 pg/ml，OR = 2.250）和无胸腔积液（OR = 14.454）与间质性肺炎的发生相关。感染所致间质性肺炎显示CD4 T细胞增加，血清IFN-γ水平降低。特定的免疫谱可能参与了感染所致小儿间质性肺炎的发生。
