阿奇霉素治疗后肺炎支原体肺炎患儿血清 microRNA-146a 及炎症因子的临床意义。

Clinical significance of serum microRNA-146a and inflammatory factors in children with Mycoplasma pneumoniae pneumonia after azithromycin treatment.

机构信息

Children's Hospital of Soochow University, Department of Infectious Disease, Suzhou, Jiangsu, China.

出版信息

J Pediatr (Rio J). 2024 Jan-Feb;100(1):108-115. doi: 10.1016/j.jped.2023.06.004. Epub 2023 Sep 28.

DOI:10.1016/j.jped.2023.06.004

PMID:37778397

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10751685/

Abstract

OBJECTIVE

This study aimed to investigate the clinical significance of serum microRNA-146a and pro-inflammatory factors in children with Mycoplasma pneumoniae pneumonia after azithromycin treatment. microRNA-146a is known to regulate inflammatory responses, and excessive inflammation is a primary characteristic of MPP.

METHODS

Children with MPP received conventional symptomatic therapy along with intravenous administration of azithromycin for one week. Serum levels of microRNA-146a and pro-inflammatory factors were measured using RT-qPCR and ELISA kits, respectively. The correlation between microRNA-146a and pro-inflammatory factors was analyzed by the Pearson method. Pulmonary function indexes were assessed using a pulmonary function analyzer, and their correlation with microRNA-146a and pro-inflammatory factors after treatment was evaluated. Children with MPP were divided into effective and ineffective treatment groups, and the clinical significance of microRNA-146a and pro-inflammatory factors was evaluated using receiver operating characteristic curves and logistic multivariate regression analysis.

RESULTS

Serum microRNA-146a was downregulated in children with MPP but upregulated after azithromycin treatment, contrasting with the trend observed for pro-inflammatory factors. MicroRNA-146a showed a negative correlation with pro-inflammatory cytokines. Pulmonary function parameters were initially reduced in children with MPP, but increased after treatment, showing positive/inverse associations with microRNA-146a and pro-inflammatory factors. Higher microRNA-146a and lower pro-inflammatory factors predicted better efficacy of azithromycin treatment. MicroRNA-146a, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) were identified as independent factors influencing treatment efficacy.

CONCLUSION

Azithromycin treatment in children with MPP upregulates microRNA-146a, downregulates pro-inflammatory factors, and effectively improves pulmonary function.

摘要

目的

本研究旨在探讨肺炎支原体肺炎（MPP）患儿阿奇霉素治疗后血清微小 RNA-146a 和促炎因子的临床意义。已知微小 RNA-146a 可调节炎症反应，而过度炎症是 MPP 的主要特征。

方法

MPP 患儿给予常规对症治疗，同时给予阿奇霉素静脉滴注 1 周。采用 RT-qPCR 和 ELISA 试剂盒分别检测血清微小 RNA-146a 和促炎因子水平。采用 Pearson 法分析微小 RNA-146a 与促炎因子的相关性。采用肺功能分析仪检测肺功能指标，并评估其与治疗后微小 RNA-146a 和促炎因子的相关性。将 MPP 患儿分为有效治疗组和无效治疗组，采用受试者工作特征曲线和 logistic 多因素回归分析评估微小 RNA-146a 和促炎因子的临床意义。

结果

MPP 患儿血清微小 RNA-146a 下调，阿奇霉素治疗后上调，与促炎因子的趋势相反。微小 RNA-146a 与促炎细胞因子呈负相关。MPP 患儿肺功能参数最初降低，但治疗后增加，与微小 RNA-146a 和促炎因子呈正/负相关。较高的微小 RNA-146a 和较低的促炎因子预示着阿奇霉素治疗的疗效更好。微小 RNA-146a、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和第 1 秒用力呼气量/用力肺活量（FEV1/FVC）被确定为影响治疗效果的独立因素。