Zhao Qianye, Zhang Teng, Zhu Beibei, Bi Ying, Jiang Shi-Wen, Zhu Yifan, Zhao Deyu, Liu Feng
Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Department of Pediatrics, Lianyungang Maternal and Child Health Care Hospital, Lianyungang, Jiangsu, People's Republic of China.
J Inflamm Res. 2021 Aug 14;14:3933-3943. doi: 10.2147/JIR.S321656. eCollection 2021.
It is well known that age is related to the incidence of pneumonia (MPP), and how age and other factors contribute to MPP remains unclear. In this study, we investigate how age affects the prognosis of MPP.
A total number of 1875 hospitalized children with pneumonia were enrolled in this study, including 52 children with refractory pneumonia (RMPP) and 298 children with non-RMPP. We used multiple logistic regression analysis to further identify the risk factors of RMPP, and found that age and polymorphonuclear neutrophils (PMNs) count were the key independent risk factors for the occurrence of RMPP. In order to improve specificity, 4.5 years old was taken as the cut-off value. Then, according to the cut-off value of age, 76 participants were recruited and divided into four groups: <4.5y MPP group, ≥4.5y MPP group, <4.5y health control (<4.5yHC) and ≥4.5y HC group. We explored the diverse functions of primary PMNs from children of different ages with MPP at cellular level. Besides, we studied the relationship between lung injury and PMNs in mice model with MPP of different ages.
We found that the age and PMNs count of RMPP group were significantly higher than those of the non-RMPP group. Importantly, there is a linear correlation between the age of patients with RMPP and the percentage of PMNs. Further analysis showed that elderly patients infected with had more active PMNs function. Meanwhile, proteomics showed that children with infection in different age groups have differences in PMNs apoptosis, nicotinamide adenine dinucleotide phosphate, mitochondrial function and oxidative stress. Finally, we found that age is also involved in the pathogenesis of mouse model with MPP.
We speculate that age may contribute to the development of RMPP.
众所周知，年龄与支原体肺炎（MPP）的发病率相关，但年龄及其他因素如何影响MPP尚不清楚。在本研究中，我们探讨年龄如何影响MPP的预后。
本研究共纳入1875例住院肺炎患儿，其中难治性肺炎（RMPP）52例，非RMPP 298例。我们采用多因素logistic回归分析进一步确定RMPP的危险因素，发现年龄和多形核中性粒细胞（PMN）计数是RMPP发生的关键独立危险因素。为提高特异性，以4.5岁作为截断值。然后，根据年龄截断值，招募76名参与者并分为四组：<4.5岁MPP组、≥4.5岁MPP组、<4.5岁健康对照组（<4.5yHC）和≥4.5岁HC组。我们在细胞水平上探讨了不同年龄MPP患儿原代PMN的多种功能。此外，我们研究了不同年龄MPP小鼠模型中肺损伤与PMN的关系。
我们发现RMPP组的年龄和PMN计数显著高于非RMPP组。重要的是，RMPP患者的年龄与PMN百分比之间存在线性相关性。进一步分析表明，老年感染患者的PMN功能更活跃。同时，蛋白质组学显示不同年龄组感染的儿童在PMN凋亡﹑烟酰胺腺嘌呤二核苷酸磷酸、线粒体功能和氧化应激方面存在差异。最后，我们发现年龄也参与了MPP小鼠模型的发病机制。
我们推测年龄可能促进RMPP的发生发展。
