Hao Yan-Ping
Department of Pediatrics, Maternal and Child Health Hospital, Shaoxing 312400, Zhejiang Province, China.
World J Clin Cases. 2024 Aug 16;12(23):5346-5353. doi: 10.12998/wjcc.v12.i23.5346.
(MP) frequently causes respiratory infections in children, whereas Epstein-Barr virus (EBV) typically presents subclinical manifestations in immunocompetent pediatric populations. The incidence of MP and EBV co-infections is often overlooked clinically, with the contributory role of EBV in pulmonary infections alongside MP remaining unclear.
To evaluate the serum concentrations of interleukin-2 (IL-2) and interleukin-12 (IL-12) in pediatric patients with MP pneumonia co-infected with EBV and assess their prognostic implications.
We retrospectively analyzed clinical data from patients diagnosed with MP and EBV co-infection, isolated MP infection, and a control group of healthy children, spanning from January 1, 2018 to December 31, 2021. Serum IL-2 and IL-12 levels were quantified using enzyme-linked immunosorbent assay. Logistic regression was employed to identify factors influencing poor prognosis, while receiver operating characteristic (ROC) curves evaluated the prognostic utility of serum IL-2 and IL-12 levels in co-infected patients.
The co-infection group exhibited elevated serum IL-2 and C-reactive protein (CRP) levels compared to both the MP-only and control groups, with a reverse trend observed for IL-12 ( < 0.05). In the poor prognosis cohort, elevated CRP and IL-2 levels, alongside prolonged fever duration, contrasted with reduced IL-12 levels ( < 0.05). Logistic regression identified elevated IL-2 as an independent risk factor and high IL-12 as a protective factor for adverse outcomes ( < 0.05). ROC analysis indicated that the area under the curves for IL-2, IL-12, and their combination in predicting poor prognosis were 0.815, 0.895, and 0.915, respectively.
Elevated serum IL-2 and diminished IL-12 levels in pediatric patients with MP and EBV co-infection correlate with poorer prognosis, with combined IL-2 and IL-12 levels offering enhanced predictive accuracy.
支原体肺炎(MP)常导致儿童呼吸道感染,而在免疫功能正常的儿童群体中,爱泼斯坦-巴尔病毒(EBV)通常表现为亚临床症状。临床上,MP与EBV合并感染的发生率常被忽视,EBV在MP伴发肺部感染中的作用仍不明确。
评估MP肺炎合并EBV感染的儿科患者血清白细胞介素-2(IL-2)和白细胞介素-12(IL-12)的浓度,并评估其对预后的影响。
我们回顾性分析了2018年1月1日至2021年12月31日期间诊断为MP与EBV合并感染、单纯MP感染的患者以及健康儿童对照组的临床资料。采用酶联免疫吸附测定法定量血清IL-2和IL-12水平。采用逻辑回归分析确定影响预后不良的因素,同时通过受试者工作特征(ROC)曲线评估血清IL-2和IL-12水平对合并感染患者预后的预测价值。
与单纯MP感染组和对照组相比,合并感染组血清IL-2和C反应蛋白(CRP)水平升高,而IL-12水平呈相反趋势(P<0.05)。在预后不良的队列中,CRP和IL-2水平升高,同时发热持续时间延长,而IL-12水平降低(P<0.05)。逻辑回归分析确定IL-2升高是不良结局的独立危险因素,而IL-12水平高是保护因素(P<0.05)。ROC分析表明,IL-2、IL-12及其联合检测预测预后不良的曲线下面积分别为0.815、0.895和0.915。
MP与EBV合并感染的儿科患者血清IL-2升高和IL-12水平降低与较差的预后相关,IL-2和IL-12联合检测可提高预测准确性。