RESUMO
Previous studies have indicated that exosome-mediated intercellular microRNAs (miRNA) can influence fulminant myocarditis (FM) pathogenesis between immune and cardiac cells. This study explored plasma exosome miRNA profile in pediatric FM using a small RNA microarray. As per our analysis, we observed the differential expression of 266 miRNAs, including 197 upregulated and 69 downregulated candidate genes. Differentially expressed mRNAs in pediatric FM patients' peripheral blood mononuclear cells (PBMCs) were intersected with miRNA target genes predicting tools to screen for FM-specific target genes. The hub genes and their biological and mechanistic pathways related to inflammation and/or the immune system were identified. CeRNA networks of lncRNAs, circRNAs, miRNAs, and mRNAs between cardiomyocytes and PBMCs were finally established. Furthermore, we verified that hsa-miR-146a-5p, hsa-miR-23a-3p, and hsa-miR-27a-3p had higher expression levels in exosomes of pediatric FM patients by qRT-PCR, and hsa-miR-146a-5p shown high sensitivities and specificities for FM diagnosis. Overall, the results demonstrate that the exosome miRNAs play a regulatory role between immune and cardiac cells and provide research targets.
Assuntos
Exossomos , MicroRNAs , Miocardite , Humanos , Criança , MicroRNAs/metabolismo , Exossomos/metabolismo , Leucócitos Mononucleares/metabolismo , Biomarcadores , Redes Reguladoras de GenesRESUMO
OBJECTIVE: This study aimed to investigate the pathogen epidemiology of community-acquired pneumonia (CAP) among children in Southwest China before, during and after the COVID-19 non-pharmaceutical interventions (NPIs). METHODS: Pathogen data of hospitalised children with CAP, including multiple direct immunofluorescence test for seven viruses, bacterial culture and polymerase chain reaction (PCR) for Mycoplasma pneumoniae, were analysed across three phases: Phase I (pre-NPIs: 1 January 2019 to 31 December 2019), Phase II (NPI period: 1 January 2020 to 31 December 2020) and Phase III (post-NPIs: 1 January 2023 to 31 December 2023). RESULTS: A total of 7533 cases were enrolled, including 2444, 1642 and 3447 individuals in Phases I, II and III, respectively. M. pneumoniae predominated in Phases I and III (23.4% and 35.5%, respectively). In Phase II, respiratory syncytial virus (RSV) emerged as the primary pathogen (20.3%), whereas detection rates of influenza A virus (Flu A) and M. pneumoniae were at a low level (1.8% and 9.6%, respectively). In Phase III, both Flu A (15.8%) and M. pneumoniae epidemic rebounded, whereas RSV detection rate returned to Phase I level, and detection rates of Streptococcus pneumoniae and Haemophilus influenzae decreased significantly compared to those in Phase I. Detection rates of adenovirus and parainfluenza virus type 3 decreased phase by phase. Age-stratified analysis and monthly variations supported the above findings. Seasonal patterns of multiple pathogens were disrupted during Phases II and III. CONCLUSIONS: COVID-19 NPIs exhibited a distinct impact on CAP pathogen epidemic among children, with post-NPIs increases observed in M. pneumoniae and Flu A prevalence. Continuous pathogen monitoring is crucial for effective prevention and control of paediatric CAP.
Assuntos
COVID-19 , Infecções Comunitárias Adquiridas , Humanos , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , China/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Pré-Escolar , Feminino , Masculino , Criança , Lactente , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/genética , Mycoplasma pneumoniae/isolamento & purificação , Mycoplasma pneumoniae/genética , Adolescente , Pneumonia/epidemiologia , Pneumonia/microbiologia , Pneumonia/virologiaRESUMO
OBJECTIVE: To describe the incidence and epidemiological characteristics of child pulmonary tuberculosis (PTB) notified to the Chinese Center for Disease Control and Prevention (CDC) Tuberculosis Information Management System (TBIMS) from 2009 to 2015. STUDY DESIGN: A database of child PTB for 31 provinces in mainland China over 7 years was retrospectively analysed. The spatiotemporal distribution of child PTB was described. RESULTS: In total, 35,710 child PTB cases were notified to the TBIMS, representing only 0.60% of all 5,991,593 PTB case notifications. The average annual notified incidence of child PTB was 2.44/ per 100,000 children (95% CI: 1.77-3.10) and decreased by 52.53% in all age groups during the study period. Tibet had the highest incidence (15.95/ per 100,000 children), followed by Guizhou and Xinjiang. However, the case numbers were the most in Guizhou. The 0-1 year and 12-14 years of age groups exhibited the most cases. The positive rates of sputum smears, bacteriology and chest X-rays abnormality were 21.5%, 21.7% and 98.1%, respectively, which were lower than those 15 years of age and older (all p-values<0.0001). CONCLUSION: The notified incidence of child PTB in mainland China decreased substantially over 7 years. Future prevention and control of PTB in children should focus on the 0-1 and 12-14 years of age groups, and Tibet and Guizhou provinces. However, the notified incidence is still low, relative to adults, suggesting substantial under-reporting. Thus, more effective care seeking, identification and registration of children with TB are crucial.