Cytokine signatures associate with disease severity in children with Mycoplasma pneumoniae pneumonia

Abstract

Host immune response may be involved in the pathogenesis of children Mycoplasma pneumoniae pneumonia (MPP). In the current study, we investigated the alterations of cytokines levels among control, mild MPP and severe MPP children to determine whether cytokine signatures associate with MPP and correlate with disease severity. We measured 13 cytokines in bronchoalveolar lavage fluid (BALF) of 88 children with MPP and 26 children with foreign body aspiration (FB) using a Luminex system. Linear discriminant analyses were performed to develop predictive models of mild MPP and severe MPP on these children. We observed nearly complete separations of severe MPP group, mild MPP group and control group in linear discriminant analyses. Eleven cytokines significantly increased in children with MPP, and seven cytokines had statistically significant upward linear trends correlated with MPP severity. In addition, compared to control group, both IFNγ/IL4 ratio and IFNγ/IL13 ratio increased in mild MPP and severe MPP groups. Our results suggest that children MPP can alter BALF cytokines signatures which associate with disease severity and can be characterized by a distinct airway molecular phenotype that has elevated Th1/Th2 ratios.

Mycoplasma pneumoniae–Specific IFN-γ–Producing CD4+ Effector-Memory T Cells Correlate with Pulmonary Disease

“…Our findings on the Mp -specific Th1 cell response are corroborated by previous observations in animal models suggesting that Th1 cells contribute to inflammatory lesions in mycoplasma pneumonia ( 1 , 2 , 15 ), and clinical studies in children and adults where the IFN-γ response correlated with the disease severity and/or radiological changes in CAP associated with Mp ( 16 – 18 ). Furthermore, we expand these observations by revealing Mp -specific T EM cells as the major Th1 cell compartment associated with more severe disease.…”

Characteristics of Inflammatory Storm in BALF of Severe Pneumonia in Children: A Case Control Study

“…In our study, the levels of IL-6, IL-10, IL-17A, TNF-α and the number of in ammatory cells (including neutrophils, macrophages and lymphocytes) in BALF of children with severe pneumonia were signi cantly higher than those of children with mild pneumonia. These results were similar to previous study 8,26 . Interestingly, compared with children with mild pneumonia, the percentage of macrophages in BALF of children with severe pneumonia was decreased relatively, while the percentage of neutrophils increased signi cantly.…”

“…C-reactive protein (CRP) and procalcitonin (PCT) are often used to re ect the severity of pneumonia, but their application in clinical practice is limited due to their poor speci city and delayed response to in ammation. Studies have shown that the cytokine signals in patients with severe and mild pneumonia are different 8,9 . Studies have also pointed out that in children and adults with pneumonia, serum cytokine signals (mainly IL-6 and IL-10) help to identify the pathogen 10,11 , evaluate the severity and prognosis of pneumonia [12][13][14] .…”

Susceptibility Analysis in Several Mouse Strains Reveals Robust T-Cell Responses After Mycoplasma pneumoniae Infection in DBA/2 Mice

“…Indeed, Mp-specific CD4 + T cell responses are important for exacerbated inflammation (Dobbs et al, 2009). For example, Yang et al have shown that an elevated Th1/Th2 ratio is associated with disease severity in mycoplasma pneumonia in humans (Yang et al, 2019). Other reports have shown increased levels of IFN-g in the serum of children with mycoplasma pneumonia (Fan et al, 2015) or refractory mycoplasma pneumonia (Wang et al, 2014;Zhang et al, 2016b).…”