Ma Lingyan, Ge Shenghua, Song Dongqing
Department of Pediatrics, Shijiazhuang People's Hospital, Shijiazhuang, China.
Transl Pediatr. 2025 Aug 31;14(8):1806-1815. doi: 10.21037/tp-2025-296. Epub 2025 Aug 27.
pneumonia (MPP), a prevalent form of community-acquired pneumonia (CAP) in schoolchildren, frequently results in persistent fever or complications in 15-25% of cases despite azithromycin treatment. This highlights the urgent need for novel biomarkers to identify high-risk cases. This study aims to investigate the predictive value of serum C-C motif chemokine ligand 26 (CCL26) and C-C chemokine receptor 3 (CCR3) levels for treatment prognosis in children with MPP receiving azithromycin therapy.
Clinical data of 205 pediatric MPP patients treated in our hospital from February 2023 to February 2025 were collected. Serum levels of CCL26, CCR3, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and D-dimer (DD) were measured by enzyme-linked immunosorbent assay (ELISA), while (MP) antibody titers were determined using passive agglutination. Pearson correlation analysis evaluated relationships between CCL26 and CCR3 and inflammatory cytokines (IL-6, TNF-α). Logistic regression identified risk factors for poor prognosis, with receiver operating characteristic (ROC) curve analysis assessing the predictive value of CCL26 and CCR3.
Compared with healthy controls, MPP patients showed elevated serum CCL26, CCR3 and inflammatory cytokines (TNF-α, IL-6) both pre- and post-treatment (all P<0.05). These markers significantly decreased after therapy (all P<0.05). Pretreatment CCL26 and CCR3 levels positively correlated with inflammatory cytokines (P<0.05). Poor prognosis cases exhibited higher levels of CCL26, CCR3, TNF-α, IL-6, C-reactive protein (CRP), DD, MP antibody titers (≥1:160), fever duration (≥5 d), and peak temperature (≥38.5 °C) (P<0.05). Multivariate analysis identified MP antibody titer ≥1:160, elevated CCL26, CCR3, TNF-α, and IL-6 levels, fever ≥5 days, and temperature ≥38.5 °C as independent risk factors. The area under the curve (AUC) for CCL26 and CCR3 in predicting poor prognosis was 0.709 and 0.751, respectively, increasing to 0.798 when combined.
Serum CCL26 and CCR3 levels decrease following azithromycin treatment and demonstrate significant associations with inflammatory markers and clinical outcomes, serving as reliable predictors for poor prognosis in MPP patients.
肺炎支原体肺炎（MPP）是学龄儿童社区获得性肺炎（CAP）的常见形式，尽管使用阿奇霉素治疗，但15%-25%的病例仍常出现持续发热或并发症。这凸显了对新型生物标志物以识别高危病例的迫切需求。本研究旨在探讨血清C-C基序趋化因子配体26（CCL26）和C-C趋化因子受体3（CCR3）水平对接受阿奇霉素治疗的MPP患儿治疗预后的预测价值。
收集2023年2月至2025年2月在我院治疗的205例小儿MPP患者的临床资料。采用酶联免疫吸附测定（ELISA）法检测血清CCL26、CCR3、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和D-二聚体（DD）水平，同时采用被动凝集法测定肺炎支原体（MP）抗体滴度。Pearson相关性分析评估CCL26和CCR3与炎症细胞因子（IL-6、TNF-α）之间的关系。Logistic回归确定预后不良的危险因素，采用受试者工作特征（ROC）曲线分析评估CCL26和CCR3的预测价值。
与健康对照组相比，MPP患者治疗前后血清CCL26、CCR3和炎症细胞因子（TNF-α、IL-6）均升高（均P<0.05）。治疗后这些标志物显著降低（均P<0.05）。治疗前CCL26和CCR3水平与炎症细胞因子呈正相关（P<;0.05）。预后不良的病例表现出较高水平的CCL26、CCR3、TNF-α、IL-6、C反应蛋白（CRP）、DD、MP抗体滴度（≥1:160）、发热持续时间（≥5天）和体温峰值（≥38.5℃）（P<0.05）。多因素分析确定MP抗体滴度≥1:160、CCL26、CCR3、TNF-α和IL-6水平升高、发热≥5天和体温≥38.5℃为独立危险因素。CCL26和CCR3预测预后不良的曲线下面积（AUC）分别为0.709和0.751，联合时增至0.798。
阿奇霉素治疗后血清CCL26和CCR3水平降低，并与炎症标志物和临床结局显著相关，可作为MPP患者预后不良的可靠预测指标。
