The correlation between vitamin a status and refractory Mycoplasma Pneumoniae pneumonia (RMPP) incidence in children

Li, Yuanyuan; Guo, Ziyao; Zhang, Guangli; Tian, Xiaoyin; Li, Qinyuan; Chen, Dapeng; Luo, Zhengxiu

doi:10.1186/s12887-020-02254-y

Cited by 14 publications

(14 citation statements)

References 41 publications

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“…In a cross-sectional study performed by Abd El-Shaheed et al (2018) reported that there was a positive association between vitamin A and both CD4 and Tβ4, thus, vitamin A deficiency reduced the efficacy of the immunity system against infectious diseases. In another clinical trial, it was reported that vitamin A intervention caused a decrease in the duration of fever and hospital stay ( Li et al, 2020a ). In terms of hospital stay, we found that the interventions with zinc or vitamin A reduced days of hospitalization by an average of 3.21 days (95% CI: 5.01–−1.41, p < 0.01) and 2.43 days (95% CI: 4.29–−0.57, p = 0.01), respectively.…”

Section: Discussionmentioning

confidence: 99%

Effect of zinc versus vitamin A supplementation on pediatric patients with community-acquired pneumonia

Saied¹,

Borolossy

Ramzy

et al. 2022

Front. Pharmacol.

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Background: Community-acquired pneumonia (CAP) is one of the most common infectious diseases affecting the respiratory tract and is responsible for a high mortality rate in children less than 5 years of age. The mortality rate due to CAP is much higher in low/middle-income countries than in high-income countries due to malnutrition and different micronutrient deficiencies that weaken the immune system.Aim: The aim of this study was to compare the effects of zinc and vitamin A, as two elements of micronutrient agents, on the recovery rate of children suffering from CAP aged from 6 months to 5 years. The length of hospital stays was also investigated.Method: A comparative, randomized, open-label, controlled, interventional study was carried out among children less than 5 years of age in the pediatric intensive care unit (PICU) diagnosed with CAP who were randomly divided into three groups. In addition to the standard therapy, group 1 was given zinc, group 2 was given vitamin A, and group 3 was the control group, given the standard therapy only. We compared the three groups in terms of recovery rate and hospital stay.Result: The duration of hospitalization following zinc and vitamin A supplementation was reduced by an average of 3.21 days (95% CI: 5.01–1.41, p = 0.01) and 2.43 days (95% CI: 4.29–0.57, p = 0.01), respectively, compared to the control group. In addition, the two groups of vitamin A and zinc supplementation were associated with a shorter duration of pneumonic effusion (p < 0.001) in comparison to the control group. Additionally, there was no significant difference between the effects of zinc and vitamin A when compared to each other in terms of duration of hospital stay and pneumatic effusion.Conclusion: The administration of zinc or vitamin A supplementation proved to be useful as an add-on therapy in community-acquired pneumonia, where it reduced the length of hospital stay and the duration of pneumonic effusion in pneumonic children less than 5 years of age.

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Section: Discussionmentioning

confidence: 99%

Effect of zinc versus vitamin A supplementation on pediatric patients with community-acquired pneumonia

Saied¹,

Borolossy

Ramzy

et al. 2022

Front. Pharmacol.

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“…Therefore, early identification and diagnosis of RMPP is a major problem that clinicians need to solve urgently. Some studies have shown that CRP, LDH, ESR, neutrophils (%), and lymphocytes (%) are predictive factors for RMPP [ 5 – 7 ], but it is contradictory that some studies have found no difference for these factors in RMPP and NRMPP [ 8 , 9 ]. In addition, we have also found that a large-scale dense consolidation shadow of the lungs occurs in the RMPP population, which may also be one of the predictive factors for RMPP [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors

Huang

Zhao

et al. 2022

Journal of Immunology Research

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Background. Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia (CAP) in children. M. pneumoniae infection is usually regarded as a self-limiting disease, but in some special cases, it can also develop into refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to analyze the clinical characteristics of CRP (C-reactive protein), LDH (lactate dehydrogenase), ESR (erythrocyte sedimentation rate), D-dimer, neutrophils (%), lymphocytes (%), and lung consolidation in RMPP and explore their prediction results in the early stage of RMPP, which is important for early treatment. Methods. This systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, and Cqvip, and the date was set until February 23, 2021. For the continuous variables, mean difference (MD) with 95% CI was adopted to evaluate CRP, LDH, ESR, D-dimer, neutrophils (%), lymphocytes (%), and the correlation between lung consolidation and RMPP. Results. 20 studies including 5289 patients were included in the analysis, and the results showed that the CRP of the RMPP group (MD (95% CI): 22.29 (12.20, 32.38), P < 0.001 ), LDH (MD (95% CI): 145.13 (78.62, 211.64), P < 0.001 ), neutrophils (%) (MD (95% CI): 7.27 (0.31, 14.23), P = 0.04 ), and D-dimer (MD (95% CI): 1.79 (-1.17, 4.74), P = 0.24 ) was higher than that of the NRMPP group; the risk of lung consolidation in the RMPP group (OR (95% CI): 14.29 (4.52, 45.12), P < 0.001 ) was higher than that in the NRMPP group, and there was no difference in ESR (MD (95% CI): 8.11 (-1.34, 17.56), P = 0.09 ) and lymphocytes (%) (MD (95% CI): -6.27 (-12.81, 0.27), P = 0.06 ) between the two groups. Conclusion. So, the available evidence indicates that CRP, LDH, neutrophils (%), D-dimer, and lung consolidation are predictive factors for RMPP.

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“…Severe MPP can cause multisystem damage. In severe cases, respiratory and heart failure, and possibly death, may occur 4 , 5 . The pathogenesis of wheezing triggered by MP is complex, including autoimmune diseases, genetics, and environmental factors.…”

Section: Introductionmentioning

confidence: 99%

Intestinal bacteria flora changes in patients with Mycoplasma pneumoniae pneumonia with or without wheezing

Jiang

Bao

Zhao

et al. 2022

Sci Rep

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Mycoplasma pneumoniae (MP) infection is a common cause of community-acquired pneumonia in children. Furthermore, many children with Mycoplasma pneumoniae pneumonia (MPP) have recurrent wheezing and reduced small airway function after their clinical symptoms have resolved, eventually leading to asthma. MPP can trigger immune disorders and systemic inflammatory responses. Hence, the intestine is the largest immune organ of the body. Therefore, we sought to investigate whether the alteration of intestinal flora is correlated with the development of wheezing in children with MPP. We collected 30 healthy children as group A, 50 children with nonwheezing MPP as group B, and 50 children with wheezing MPP as group C. We found that the percentage of eosinophil cells (EC) was significantly higher in group C than that in group B for routine blood tests and serum inflammatory factors. The serum cytokines, including IL-4, IL-17, TNF-α, and TGF-β, were significantly higher in group C than in group B. In addition, the level of IL-10 was significantly lower in group C than in group B. The distribution characteristics of intestinal flora strains in children with MPP were detected by sequencing of 16S rRNA gene amplicon sequencing. There were differences in the abundance of intestinal flora between children with MPP and healthy children, with lower abundance of Ruminococcus flavefaciens, Clostridium butyricum, Lactobacillus, and Bifidobacterium in the intestine of children with MPP compared to healthy children. The abundance of Ruminococcus flavefaciens and Clostridium butyricum was significantly lower in the intestine of children with wheezing MPP compared to children without wheezing MPP. In the correlation analysis between children with MPP and inflammatory factors, Ruminococcus flavefaciens was found to be negatively correlated with IL-17. Clostridium butyricum was negatively correlated with L-4, IL-17, TNF-α, and TGF-β; however, it positively correlated with IL-10. Thus, it was concluded that alterations in intestinal flora play a crucial role in the immune response to MPP, where a significant decline in intestinal Ruminococcus flavefaciens and Clostridium butyricum leads to an exacerbation of the inflammatory responses, which may promote the development of children with wheezing MPP.

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The correlation between vitamin a status and refractory Mycoplasma Pneumoniae pneumonia (RMPP) incidence in children

Cited by 14 publications

References 41 publications

Effect of zinc versus vitamin A supplementation on pediatric patients with community-acquired pneumonia

Effect of zinc versus vitamin A supplementation on pediatric patients with community-acquired pneumonia

Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors

Intestinal bacteria flora changes in patients with Mycoplasma pneumoniae pneumonia with or without wheezing

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