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儿童血清白细胞介素-17水平与肺炎的关联:一项系统评价和荟萃分析。

Association of serum interleukin-17 level and pneumonia in children: a systematic review and meta-analysis.

作者信息

Leerach Nontaphat, Sitthisak Sutthirat, Kitti Thawatchai, Teerawattanapong Nattawat, Mahikul Wiriya, Lamlertthon Supaporn, Chaiyakunapruk Nathorn, Tasanapak Kannipa

机构信息

Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand.

Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand.

出版信息

Transl Pediatr. 2024 Sep 30;13(9):1588-1599. doi: 10.21037/tp-24-218. Epub 2024 Sep 26.

Abstract

BACKGROUND

(. ) is a common pathogen of community-acquired pneumonia. Interleukin-17 (IL-17) plays a role in host defense and contributes to disease severity in infection. This present study aims to investigate the association between pneumonia (MPP) and changes of IL-17 level in the serum of pediatric patients.

METHODS

The protocol has been registered in PROSPERO (CRD42023489451). A literature search was conducted in PubMed, EMBASE, Scopus, and Web of Science from inception to October 2023. A meta-analysis was performed to pool the mean difference (MD) with 95% confidence intervals (CIs) of IL-17 levels between patients and controls. Publication bias was assessed, and the risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS).

RESULTS

Out of 207 records, 10 studies were included in the review and 9 studies were included in the meta-analysis. Of these, 7 studies compared IL-17 in general MPP patients with controls, 6 studies compared severe MPP patients with mild MPP patients. Serum IL-17 levels were significantly elevated in general MPP patients compared with control (MD =33.94 pg/mL, 95% CI: 24.66, 43.22 pg/mL, P=0.01, I=99.07%; P=0.01). Subgroup analyses showed a difference in serum IL-17 levels treated by macrolide between patients and control (MD =83.96 pg/mL, 95% CI: 76.62, 91.29 pg/mL, P=0.01). In severe and mild MPP, the IL-17 levels were significantly increased (MD =19.08 pg/mL, 95% CI: 11.51, 26.65 pg/mL, P=0.01) and heterogeneity was appeared (I=99.39%; P=0.01). For the risks of bias, two studies had a "high risk" in comparability domain, and the 7 studies were classified as "low risk" and "unclear risk".

CONCLUSIONS

Our meta-analysis revealed that serum IL-17 levels are significantly elevated in pediatric with general and severe MPP. IL-17 might be a potential biomarker or therapeutic target for pneumonia caused by . .

摘要

背景

(. )是社区获得性肺炎的常见病原体。白细胞介素-17(IL-17)在宿主防御中发挥作用,并在感染中导致疾病严重程度增加。本研究旨在探讨小儿肺炎支原体肺炎(MPP)与患儿血清IL-17水平变化之间的关联。

方法

该方案已在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42023489451)登记。从建库至2023年10月,在PubMed、EMBASE、Scopus和Web of Science数据库进行文献检索。进行荟萃分析以汇总患者与对照组之间IL-17水平的平均差值(MD)及其95%置信区间(CI)。评估发表偏倚,并使用纽卡斯尔-渥太华量表(NOS)评估偏倚风险。

结果

在207条记录中,10项研究纳入综述,9项研究纳入荟萃分析。其中,7项研究比较了一般MPP患者与对照组的IL-17水平,6项研究比较了重症MPP患者与轻症MPP患者的IL-17水平。与对照组相比,一般MPP患者血清IL-17水平显著升高(MD =33.94 pg/mL,95%CI:24.66,43.22 pg/mL,P=0.01,I²=99.07%;P=0.01)。亚组分析显示,使用大环内酯类药物治疗的患者与对照组血清IL-17水平存在差异(MD =83.96 pg/mL,95%CI:76.62,91.29 pg/mL,P=0.01)。在重症和轻症MPP中,IL-17水平均显著升高(MD =19.08 pg/mL,95%CI:11.51,26.65 pg/mL,P=0.01),且存在异质性(I²=99.39%;P=0.01)。在偏倚风险方面,2项研究在可比性领域存在“高风险”,7项研究被归类为“低风险”和‘’不清楚风险‘’。

结论

我们的荟萃分析显示,一般和重症MPP患儿血清IL-17水平显著升高。IL-17可能是由(. )引起的肺炎的潜在生物标志物或治疗靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffaf/11467231/d595907c62e8/tp-13-09-1588-f1.jpg

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