ABSTRACT
Kawasaki disease (KD) is a systemic vasculitis with an unknown cause that primarily affects children. The objective of this study was to explore the function and underlying mechanism of mitophagy in Mycoplasma pneumoniae (MP)-induced KD. To create MP-induced KD models, Human coronary endothelial cells (HCAECs) and DBA/2 mice were employed and treated with Mp-Lipid-associated membrane proteins ï¼LAMPsï¼. Lactate dehydrogenase (LDH) levels were tested to determine cellular damage or death. The inflammatory cytokines tumor necrosis factor (TNF)--α and interleukin (IL)-6 were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RT-qPCR and Western blotting were used to determine the expression of Intercellular Adhesion Molecule(ICAM)-1, vascular cell adhesion molecule (VCAM)-1, inducible nitric oxide synthase(iNOS), LC3, p62, PINK1(a mitochondrial serine/threonine-protein kinase), and PARKIN(a cytosolic E3-ubiquitin ligase). The adenosine triphosphate ï¼ATPï¼, reactive oxygen species ï¼ROSï¼, and mitochondrial membrane potentialï¼MMPï¼ levels were measured to determine mitochondrial function. Mitophagy was investigated using immunofluorescence and a mitophagy detection test. Autophagosome and mitochondrial morphology were examined using transmission electron microscopy. To identify inflammatory cell infiltration, hematoxylin and eosin staining was utilized. Mp-LAMPs increased the levels of TNF-α, IL-6, ICAM-1, VCAM-1, and iNOS in an HCAEC cell model, along with LDH release. After Mp-LAMPs exposure, there was a rise in LC3 and a reduction in p62. Meanwhile, the expression of PINK1 and Parkin was increased. Cyclosporin A dramatically increased ATP synthesis and MMP in HCAEC cells treated with Mp-LAMPs, while suppressing ROS generation, demonstrating excessive mitophagy-related mitochondrial dysfunction. Additionally, neither body weight nor artery tissue were affected due to PINK1 and Parkin suppression Cyclosporin A in Mp-LAMPs-treated mice. These findings indicated that PINK1/Parkin-mediated mitophagy inhibition may be a therapeutic target for MP-induced KD.
Subject(s)
Mitophagy , Mucocutaneous Lymph Node Syndrome , Mycoplasma pneumoniae , Protein Kinases , Ubiquitin-Protein Ligases , Animals , Mucocutaneous Lymph Node Syndrome/metabolism , Mucocutaneous Lymph Node Syndrome/pathology , Protein Kinases/metabolism , Humans , Mice , Ubiquitin-Protein Ligases/metabolism , Ubiquitin-Protein Ligases/genetics , Mycoplasma pneumoniae/pathogenicity , Mice, Inbred DBA , Endothelial Cells/metabolism , Endothelial Cells/pathology , Pneumonia, Mycoplasma/metabolism , Pneumonia, Mycoplasma/pathology , Pneumonia, Mycoplasma/microbiology , Mitochondria/metabolism , Mitochondria/pathology , Reactive Oxygen Species/metabolism , Membrane Potential, MitochondrialABSTRACT
Mycoplasma pneumonia may lead to hospitalizations and pose life-threatening risks in children. The automated identification of mycoplasma pneumonia from electronic medical records holds significant potential for improving the efficiency of hospital resource allocation. In this study, we proposed a novel method for identifying mycoplasma pneumonia by integrating multi-modal features derived from both free-text descriptions and structured test data in electronic medical records. Our approach begins with the extraction of free-text and structured data from clinical records through a systematic preprocessing pipeline. Subsequently, we employ a pre-trained transformer language model to extract features from the free-text, while multiple additive regression trees are used to transform features from the structured data. An attention-based fusion mechanism is then applied to integrate these multi-modal features for effective classification. We validated our method using clinic records of 7157 patients, retrospectively collected for training and testing purposes. The experimental results demonstrate that our proposed multi-modal fusion approach achieves significant improvements over other methods across four key performance metrics.
Subject(s)
Electronic Health Records , Pneumonia, Mycoplasma , Humans , Pneumonia, Mycoplasma/diagnosis , Electronic Health Records/statistics & numerical data , Child , Retrospective Studies , Mycoplasma pneumoniae/pathogenicity , Female , Male , Child, PreschoolABSTRACT
Airway epithelial cells function as both a physical barrier against harmful substances and pathogenic microorganisms and as an important participant in the innate immune system. Matrix metalloproteinase-9 (MMP-9) plays a crucial role in modulating inflammatory responses during respiratory infections. However, the signalling cascade that induces MMP-9 secretion from epithelial cells infected with Mycoplasma pneumoniae remains poorly understood. In this study, we investigated the mechanism of MMP-9 secretion in airway epithelial cells infected with M. pneumoniae. Our data clearly showed that M. pneumoniae induced the secretion of MMP-9 from bronchial epithelial cells and upregulated its enzymatic activity in a time- and dose-dependent manner. Using specific inhibitors and chromatin co-precipitation experiments, we confirmed that the expression of MMP-9 is reliant on the activation of the Toll-like receptor 2 (TLR2) and TLR6-dependent mitogen-activated protein kinase/nuclear factor- κB/activator protein-1 (MAPK/NF-κB/AP-1) pathways. Additionally, epigenetic modifications such as histone acetylation and the nuclear transcription factor Sp1 also regulate MMP-9 expression. M. pneumoniae infection also decreased the expression of the tumour suppressor reversion-inducing cysteine-rich protein with Kazal motifs (RECK) by inducing Sp1 phosphorylation. Overexpression of RECK significantly impaired the M. pneumoniae-triggered increase in MMP-9 enzymatic activity, although the level of MMP-9 protein remained constant. The study demonstrated that M. pneumoniae-triggered MMP-9 expression is modulated by TLR2 and 6, the MAPK/NF-κB/AP-1 signalling cascade, and histone acetylation, and M. pneumoniae downregulated the expression of RECK, thereby increasing MMP-9 activity to modulate the inflammatory response, which could play a role in airway remodelling.
Subject(s)
GPI-Linked Proteins , Matrix Metalloproteinase 9 , Mycoplasma pneumoniae , Epithelial Cells/metabolism , GPI-Linked Proteins/genetics , GPI-Linked Proteins/metabolism , Histones , Humans , Matrix Metalloproteinase 9/genetics , Mycoplasma pneumoniae/pathogenicity , NF-kappa B/metabolism , Toll-Like Receptor 2/genetics , Toll-Like Receptor 2/metabolism , Transcription Factor AP-1/metabolismABSTRACT
Mycoplasma genitalium and M. pneumoniae are two significant mycoplasmas that infect the urogenital and respiratory tracts of humans. Despite distinct tissue tropisms, they both have similar pathogenic mechanisms and infect/invade epithelial cells in the respective regions and persist within these cells. However, the pathogenic mechanisms of these species in terms of bacterium-host interactions are poorly understood. To gain insights on this, we infected HeLa cells independently with M. genitalium and M. pneumoniae and assessed gene expression by whole transcriptome sequencing (RNA-seq) approach. The results revealed that HeLa cells respond to M. genitalium and M. pneumoniae differently by regulating various protein-coding genes. Though there is a significant overlap between the genes regulated by these species, many of the differentially expressed genes were specific to each species. KEGG pathway and signaling network analyses revealed that the genes specific to M. genitalium are more related to cellular processes. In contrast, the genes specific to M. pneumoniae infection are correlated with immune response and inflammation, possibly suggesting that M. pneumoniae has some inherent ability to modulate host immune pathways.
Subject(s)
Epithelial Cells/microbiology , Mycoplasma genitalium/pathogenicity , Mycoplasma pneumoniae/pathogenicity , Transcriptome , Epithelial Cells/immunology , Epithelial Cells/metabolism , Gene Expression Profiling , Gene Regulatory Networks , HeLa Cells , Host-Pathogen Interactions , Humans , Mycoplasma genitalium/immunology , Mycoplasma pneumoniae/immunology , Protein Interaction Maps , RNA-Seq , Signal Transduction , Exome SequencingABSTRACT
Pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae) is a major cause of communityacquired pneumonia in children. In some cases, M. pneumoniae pneumonia (MPP) can develop into refractory MPP (RMPP), which shows no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. However, the pathogenesis of RMPP remains poorly understood. The present study aimed to identify target genes that could be used as biomarkers for the clinical diagnosis of earlystage RMPP through highthroughput sequencing technology. The differences in long noncoding (lnc)RNAs, mRNAs and circular (circ)RNAs were examined between wholeblood samples from two patients with nonrefractory MPP (NRMPP), two patients with RMPP and three healthy children using ribosomal (r)RNAdepleted RNAsequencing techniques and an integrated mRNA/circRNA analysis. A total of 17 lncRNAs (four upregulated and 13 downregulated), 18 mRNAs (six upregulated and 12 downregulated) and 24 circRNAs (12 upregulated and 12 downregulated) were the most significantly differentially expressed (P<0.05) between the NRMPP and RMPP groups. Upon functional analysis, the significantly differentially expressed genes encoded by the targeting mRNAs (prostaglandinendoperoxide synthase 2, IL8 and foslike antigen 1) were screened and identified to be enriched in the 'IL17 signaling pathway'. Furthermore, the key circRNAs in the NRMPP and RMPP comparative groups were primarily enriched in 'herpes simplex virus 1 infection', 'viral carcinogenesis' and 'RNA transport'. In the present study, a comprehensive analysis of the differences between the NRMPP and RMPP cases was performed based on rRNAdepleted RNAsequencing techniques, and the selected genes and circRNAs may be closely associated with the complex pathogenesis of RMPP.
Subject(s)
Anti-Bacterial Agents/pharmacology , Community-Acquired Infections/drug therapy , Drug Resistance, Bacterial/genetics , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/drug therapy , Anti-Bacterial Agents/therapeutic use , Biomarkers/analysis , Child , Child, Preschool , Community-Acquired Infections/genetics , Community-Acquired Infections/immunology , Community-Acquired Infections/microbiology , Female , Host-Pathogen Interactions/genetics , Host-Pathogen Interactions/immunology , Humans , Infant , Macrolides/pharmacology , Macrolides/therapeutic use , Male , Pneumonia, Mycoplasma/genetics , Pneumonia, Mycoplasma/immunology , Pneumonia, Mycoplasma/microbiology , RNA, Circular/analysis , RNA, Long Noncoding/analysis , RNA, Messenger/analysis , RNA, Ribosomal , Sequence Analysis, RNA/methodsABSTRACT
Mycoplasma pneumoniae-induced pneumonia (MPP) is a common cause of community-acquired respiratory tract infections, increasing risk of morbidity and mortality, in children. However, diagnosing early-stage MPP is difficult owing to the lack of good diagnostic methods. Here, we examined the protein profile of bronchoalveolar lavage fluid (BALF) and found that S100A8/A9 was highly expressed. Enzyme-linked immunosorbent assays used to assess protein levels in serum samples indicated that S100A8/A9 concentrations were also increased in serum obtained from children with MPP, with no change in S100A8/A9 levels in children with viral or bacterial pneumonia. In vitro, S100A8/A9 treatment significantly increased apoptosis in a human alveolar basal epithelial cell line (A549 cells). Bioinformatics analyses indicated that up-regulated S100A8/A9 proteins participated in the interleukin (IL)-17 signaling pathway. The origin of the increased S100A8/A9 was investigated in A549 cells and in neutrophils obtained from children with MPP. Treatment of neutrophils, but not of A549 cells, with IL-17A released S100A8/A9 into the culture medium. In summary, we demonstrated that S100A8/A9, possibly released from neutrophils, is a new potential biomarker for the clinical diagnosis of children MPP and involved in the development of this disease through enhancing apoptosis of alveolar basal epithelial cells.
Subject(s)
Alveolar Epithelial Cells/metabolism , Apoptosis , Calgranulin A/metabolism , Calgranulin B/metabolism , Interleukin-17/pharmacology , Mycoplasma pneumoniae/pathogenicity , Neutrophils/drug effects , Paracrine Communication , Pneumonia, Mycoplasma/metabolism , A549 Cells , Alveolar Epithelial Cells/immunology , Alveolar Epithelial Cells/microbiology , Alveolar Epithelial Cells/pathology , Biomarkers/metabolism , Case-Control Studies , Child , Child, Preschool , Female , Host-Pathogen Interactions , Humans , Infant , Male , Mycoplasma pneumoniae/immunology , Neutrophils/immunology , Neutrophils/metabolism , Neutrophils/microbiology , Pneumonia, Mycoplasma/immunology , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/pathology , Signal TransductionABSTRACT
BACKGROUND: Mycoplasma pneumoniae is one of the main causes of community-acquired pneumonia. Due to the imperfect immune system of children, this also causes Mycoplasma pneumoniae pneumonia (MPP) to be more common in children. Globally, the incidence of MPP in children is gradually increasing. This study was the first to systematically review the clinical efficacy and safety of Shuanghuanglian (SHL) oral preparations combined with azithromycin in the treatment of MPP in children. METHODS: This study fully retrieved 3 Chinese databases and 5 English databases to search the randomized controlled trials (RCTs) of SHL oral preparations combined with azithromycin in the treatment of children with MPP. The search time is from the inception to September 2020. Data extraction and risk bias evaluation were performed independently by two researchers. We conducted a Meta-analysis of all the outcome indicators. Besides, Meta-regression, subgroup analysis, and heterogeneity analysis were used for the primary outcomes to find the possible potential confounding factors. RESULTS: Finally, we included 27 RCTs involving 2884 patients. SHL oral preparations combined with azithromycin were better than azithromycin alone in response rate (RR = 1.14, 95% CI[1.11, 1.18]; low certainty evidence), disappearance time of fever(MD = -1.72, 95% CI[-2.47, -0.97]; low certainty evidence), disappearance time of cough (MD = -2.95, 95% CI[-3.55, -2.34]; low certainty evidence), and disappearance time of pulmonary rales (MD = -2.13, 95% CI[-2.88, -1.38]; low certainty evidence). The Meta-regression results showed that the course of disease, age, and method of administration may be the source of heterogeneity. Subgroup analysis and sensitivity analysis have found that the results were stable. For other related clinical symptoms, T lymphocytes, and Serum inflammatory factors, SHL oral preparations combined with azithromycin was better than azithromycin alone, and the difference was statistically significant. For adverse events with low certainty evidence, safety needs further verification. CONCLUSION: Based on the results of meta-analysis with low certainty evidence, we believed that SHL oral preparations combined with azithromycin likely be effectively improved clinical symptoms compared with azithromycin alone. Low certainty evidence showed that SHL may safety with no serious adverse events. Due to these limitations, the safety needs further verification. More high-quality, multicenter, and large-sample RCTs should be tested and verified in the future.
Subject(s)
Mycoplasma pneumoniae/pathogenicity , Adolescent , Asia , Azithromycin/therapeutic use , Child , Child, Preschool , Female , Humans , Male , Mycoplasma pneumoniae/drug effects , Randomized Controlled Trials as TopicABSTRACT
We compared pathogen detection between saliva, nasopharyngeal and oropharyngeal swabs in children with respiratory symptoms. The sensitivity in nasopharyngeal swabs was 93% (95% confidence interval [CI]: 78%-98%), in oropharyngeal swabs 79% (95% CI: 60%-90%), in saliva overall 76% (95% CI: 58%-88%) and in 18 saliva samples collected with drooling or sponges, 94% (95% CI: 74%-99%). Saliva could be a relevant specimen alternative.
Subject(s)
Clinical Laboratory Techniques/standards , Respiratory Tract Infections/diagnosis , Saliva/microbiology , Saliva/virology , Viruses/genetics , Adolescent , Bordetella pertussis/genetics , Bordetella pertussis/pathogenicity , Child , Child, Preschool , Clinical Laboratory Techniques/methods , Female , Humans , Infant , Male , Multiplex Polymerase Chain Reaction , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/pathogenicity , Nasopharynx/microbiology , Nasopharynx/virology , Oropharynx/microbiology , Oropharynx/virology , Prospective Studies , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Sensitivity and Specificity , Specimen Handling , Viruses/classification , Viruses/pathogenicityABSTRACT
Community-acquired pneumonia (CAP) is a common illness that can lead to mortality. ß-lactams are ineffective against atypical pathogen including Mycoplasma pneumoniae. We used molecular examinations to develop a decision tree to predict atypical pathogens with CAP and to examine the prevalence of macrolide resistance in Mycoplasma pneumoniae. We conducted a prospective observational study of patients aged ≥ 18 years who had fever and respiratory symptoms and were diagnosed with CAP in one of two community hospitals between December 2016 and October 2018. We assessed combinations of clinical variables that best predicted atypical pathogens with CAP by classification and regression tree (CART) analysis. Pneumonia was defined as respiratory symptoms and new infiltration recognized on chest X-ray or chest computed tomography. We analyzed 47 patients (21 females, 44.7%, mean age: 47.6 years). Atypical pathogens were detected in 15 patients (31.9%; 12 Mycoplasma pneumoniae, 3 Chlamydophila pneumoniae). Ten patients carried macrolide resistant Mycoplasma pneumoniae (macrolide resistant rate 83.3%). CART analysis suggested that factors associated with presence of atypical pathogens were absence of crackles, age < 45 years, and LD ≥ 183 U/L (sensitivity 86.7% [59.5, 98.3], specificity 96.9% [83.8, 99.9]). ur simple clinical decision rules can be used to identify primary care patients with CAP that are at risk for atypical pathogens. Further research is needed to validate its usefulness in various populations.Trial registration Clinical Trial (UMIN trial ID: UMIN000035346).
Subject(s)
Pneumonia/etiology , Respiratory Tract Infections/complications , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Area Under Curve , Chlamydophila pneumoniae/drug effects , Chlamydophila pneumoniae/pathogenicity , Community-Acquired Infections/complications , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Epidemiologic Studies , Female , Humans , Japan/epidemiology , Male , Middle Aged , Mycoplasma pneumoniae/drug effects , Mycoplasma pneumoniae/pathogenicity , Pneumonia/epidemiology , Pneumonia/microbiology , Polymerase Chain Reaction/methods , Prevalence , Prospective Studies , ROC Curve , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiologyABSTRACT
Now there is no clinical scale for early prediction of refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to identify indicators and develop an early predictive scale for RMPP in hospitalized children. First we conducted a retrospective cohort study of children with M. pneumoniae pneumonia admitted to Children's Hospital of Nanjing Medical University, China in 2016. Children were divided into two groups, according to whether their pneumonia were refractory and the results were used to develop an early predictive scale. Second we conducted a prospective study to validate the predictive scale for RMPP in children in 2018. 618 children were included in the retrospective study, of which 73 with RMPP. Six prognostic indicators were identified and included in the prognostic assessment scale. The sensitivity of the prognostic assessment scale was 74.0% (54/73), and the specificity was 88.3% (481/545) in the retrospective study. 944 children were included in the prospective cohort, including 92 with RMPP, the sensitivity of the prognostic assessment scale was 78.3% (72/92) and the specificity was 86.2% (734/852). The prognostic assessment scale for RMPP has high diagnostic accuracy and is suitable for use in standard clinical practice.
Subject(s)
Pneumonia, Mycoplasma/epidemiology , Child , Child, Hospitalized/statistics & numerical data , Child, Preschool , Female , Humans , Infant , Male , Models, Statistical , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/microbiologyABSTRACT
Mycoplasma pneumoniae pneumonia (MPP) is a type of pneumonia induced by M. pneumoniae (MP) infection. The present study investigated the effect of long noncoding RNA growth arrestspecific 5 (GAS5) in MPP and the underlying molecular mechanism of this. The expression of GAS5, microRNA2223p, (miR2223p) and tissue inhibitor of metalloproteinases3 (TIMP3) in MPP was investigated using reverse transcriptionquantitative PCR. Lipidassociated membrane protein (LAMP)induced THP1 cells were used to model MPP. The viability of LAMPinduced THP1 cells was analyzed using an MTT assay. Expression levels of interleukin (IL)1ß, IL6 and tumor necrosis factorα (TNFα) proinflammatory cytokines, and the antiinflammatory cytokine heme oxygenase1 (HO1) in LAMPinduced THP1 cells were measured by ELISA. A dualluciferase reporter assay assessed the associations among GAS5, miR2223p and TIMP3. The expression of GAS5 and TIMP3 was downregulated in MPP. Expression of miR2223p was upregulated. GAS5overexpression increased the viability of LAMPinduced THP1 cells. GAS5 upregulation decreased the levels of IL1ß, IL6, TNFα and HO1 levels in LAMPinduced THP1 cells. GAS5 directly interacted with miR2223p. TIMP3 was a target of miR2223p. miR2223p upregulation or TIMP3knockdown reversed the promotion effect on cell viability as well as the inhibitory effect on inflammation caused by GAS5overexpression in LAMPinduced THP1 cells. GAS5overexpression increased the viability and decreased the inflammation of LAMPinduced THP1 cells by regulating the miR2223p/TIMP3 axis. These results demonstrated a potential therapeutic target for MPP treatment.
Subject(s)
Inflammation/genetics , MicroRNAs/genetics , Pneumonia, Mycoplasma/genetics , RNA, Long Noncoding/genetics , Tissue Inhibitor of Metalloproteinase-3/genetics , Apoptosis/genetics , Cytokines/genetics , Gene Expression Regulation/genetics , Humans , Inflammation/microbiology , Inflammation/pathology , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/pathologyABSTRACT
OBJECTIVE: Thise study is aimed to identify the biomarkers for predicting refractory Mycoplasma pneumoniae pneumonia in Chinese children at the time of the hospital admission. METHODS: The case control study retrospectively analyzed the clinical characteristics and laboratory results of Chinese pediatric patients presenting with common and refractory Mycoplasma pneumoniae pneumonia (CMPP and RMPP). Overall, there were 216 cases in the CMPP group and 88 cases in the RMPP group. Venous blood was collected, and serum ferritin (SF), lactate dehydrogenase (LDH), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), neutrophil count/lymphocyte count (NLR), and other indexes were measured. A single factor analysis, an ROC curve analysis, and a logistic regression analysis were used to determine the independent risk factors of RMPP and find combination of initial markers for RMPP. RESULTS: There were significant differences between the RMPP group and the CMPP group in mean SF (529.82 [357.86] vs. 147.22 [122.68] ng/mL), LDH (522.08 [389.08] vs. 286.85 [101.02] U/L), D-dimer (6.65 [5.66] vs. 1.46 [2.45] µg/mL), CRP (62.80 [52.15] vs. 19.03 [24.50] mg/L), PCT (0.80 [2.61] vs. 0.16 [0.44]) ng/mL, and NLR (4.14 [2.52] vs. 2.62 [1.55]), with P < 0.05 for each comparison. ROC cut-off values of the above indexes were 329.01 ng/mL, 375.50 U/L, 2.10 µg/mL, 43.08 mg/L, 0.08 ng/mL, and 2.96, respectively. The logistic regression analysis showed that SF, D-dimer, and CRP are independent risk factors to predict RMPP. CONCLUSION: SF, D-dimer, and CRP are statistically significant biomarkers to predict RMPP in Chinese children patients in the settings of pediatric emergency department.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Resistance, Bacterial , Ferritins/blood , Fibrin Fibrinogen Degradation Products/analysis , Mycoplasma pneumoniae/drug effects , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Age Factors , Biomarkers/blood , Child , Child, Preschool , China , Female , Humans , Male , Mycoplasma pneumoniae/pathogenicity , Patient Admission , Pneumonia, Mycoplasma/blood , Pneumonia, Mycoplasma/microbiology , Predictive Value of Tests , Receptors, Immunologic/analysis , Retrospective Studies , Risk Assessment , Risk Factors , Treatment OutcomeABSTRACT
BACKGROUND: The research into the recurrence of cough variant asthma (CVA) in congenital heart disease (CHD) are few in number. The purpose of this study is to investigate the effect of CHD on the risk of the recurrence of CVA. METHODS: This study was a retrospective cohort study of 489 children with CVA aged between one and 14 years, of whom 67 had CHD complicated with CVA and 134 had CVA without CHD at a ratio of 1:2 according to age, sex and index year. The adjusted hazard ratio (aHR) of CVA recurrence in both the CHD cohort and the non-CHD cohort was determined by multivariate analysis using the Cox proportional hazard regression model. RESULTS: Adjusting for CHD classification, Mycoplasma pneumonia (MP) infection and immunoglobulin E (IgE) sensitization, the recurrence hazard of CVA in the complex congenital heart disease (CCHD) group (aHR = 3.281; 95% CI 1.648-6.530; P < 0.01) was significantly higher than that in the simple congenital heart disease group (aHR = 2.555; 95% CI 1.739-3.752; P < 0.01). Further, children with IgE sensitization (aHR = 2.172; 95% CI 1.482-3.184; P < 0.01) had a higher recurrence hazard of CVA than those without IgE sensitization, and children with MP infection (aHR = 1.777; 95% CI 1.188-2.657; P < 0.01) had a higher recurrence hazard of CVA than those without the MP infection. CONCLUSION: The hazard of recurrent CVA is higher in children with CHD, especially in the CCHD children. In addition, those children with IgE sensitization or a MP infection had an increased hazard of recurrent CVA.
Subject(s)
Asthma/etiology , Cough/etiology , Heart Defects, Congenital/complications , Adolescent , Age Factors , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Asthma/immunology , Asthma/microbiology , Child , Child, Preschool , Cough/drug therapy , Cough/immunology , Cough/microbiology , Female , Humans , Immunoglobulin E/blood , Infant , Male , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/microbiology , Recurrence , Retrospective Studies , Risk Assessment , Risk FactorsABSTRACT
ABSTRACT: Mycoplasma pneumoniae infection may induce a systemic hypercoagulable abnormality, like organ embolism and infarction. Indexes of blood coagulation and C-reactive protein (CRP) have been reported different between healthy people and mycoplasma pneumoniae pneumonia (MPP) patients, but this difference in MPP patients with different chest imaging findings has rarely been reported.We performed a retrospective study of 101 children with MPP and 119 controls, combined with radiological examination and blood tests, to compare the blood coagulation and CRP level among MPP children with different chest imaging findings.For the MPP children with different chest imaging findings, there were significant differences in CRP, fibrinogen (FIB) and D-dimer (D-D) levels among subgroups (Pâ=â.004, Pâ=â.008 and Pâ<â.001 respectively). The CRP level in group of interstitial pneumonia was significantly higher than that in groups of bronchopneumonia and hilar shadow thickening (Pâ=â.003 and Pâ=â.001 respectively). And the FIB and D-D values in group of lung consolidation were significantly higher than that in the other 3 groups (all Pâ<â.05). When compared with controls, the white blood cell, CRP, FIB, and D-D levels in MPP children were significantly higher, and the activated partial thromboplastin time and thrombin time levels were significantly lower (all Pâ<â.05).Our results showed that CRP level changed most significantly in group of interstitial pneumonia, whereas FIB, D-D levels changed most significantly in the lung consolidation group.
Subject(s)
Blood Coagulation Factors/analysis , C-Reactive Protein/analysis , Pneumonia, Mycoplasma/diagnostic imaging , Thorax/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Fibrin Fibrinogen Degradation Products/analysis , Fibrinogen/analysis , Humans , Infant , Male , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/bloodABSTRACT
Mycoplasma genitalium (Mge) and Mycoplasma pneumoniae (Mpn) are two human pathogens associated with urogenital and respiratory tract infections, respectively. The recent elucidation of the tridimensional structure of their major cytoadhesins by X-ray crystallography and cryo-electron microscopy/tomography, has provided important insights regarding the mechanics of infection and evasion of immune surveillance.
Subject(s)
Adhesins, Bacterial/chemistry , Adhesins, Bacterial/metabolism , Glycoproteins/metabolism , Mycoplasma genitalium/chemistry , Mycoplasma pneumoniae/chemistry , Cryoelectron Microscopy , Crystallography, X-Ray , Humans , Immune Evasion , Mycoplasma genitalium/metabolism , Mycoplasma genitalium/pathogenicity , Mycoplasma pneumoniae/metabolism , Mycoplasma pneumoniae/pathogenicity , N-Acetylneuraminic Acid/chemistry , N-Acetylneuraminic Acid/metabolismABSTRACT
BACKGROUND Bronchiolitis is common in infants under 2 years of age. Most infections are caused by respiratory syncytial virus (RSV), but the importance of Mycoplasma pneumoniae (MP) in the etiology of bronchiolitis is unclear. MATERIAL AND METHODS We investigated the clinical characteristics of bronchiolitis caused by MP in 79 infants admitted to Shunde Women's and Children's Hospital of Guangdong Medical University and Sanshui Women's and Children's Healthcare Hospital from January 2016 to December 2018. Infection with MP was confirmed by the presence of serum immunoglobulin M. RESULTS The peak detection rates of MP in the years 2016, 2017, and 2018 were 19.2%, 21.3%, and 24.0%, respectively. In each year, the peak of MP infections occurred during June and July. MP-associated bronchiolitis was mainly seen in infants from 6 to 12 months of age. Compared with RSV-associated bronchiolitis, the age of patients with bronchiolitis associated with MP was significantly older and they had a shorter hospital stay (all P<0.01 or P<0.05). CONCLUSIONS Our study indicated that MP is an important cause of bronchiolitis, with peaks of occurrence during June and July every year. Pulmonary interstitial infiltration was a characteristic of this infection. Azithromycin treatment can shorten the course of MP-associated bronchiolitis. Investigation of the epidemiological characteristics of pediatric MP-associated bronchiolitis can help diagnose and treat the disease correctly.
Subject(s)
Bronchiolitis/epidemiology , Pneumonia, Mycoplasma/epidemiology , Bronchiolitis/diagnosis , China/epidemiology , Epidemiologic Studies , Female , Hospitalization , Humans , Infant , Infant, Newborn , Length of Stay , Male , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/complications , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Viruses/pathogenicityABSTRACT
ABSTRACT: Mycoplasma pneumoniae (MP) is an atypical bacterial pathogen that typically causes mild respiratory symptoms. Rarely, MP is associated with acute respiratory distress syndrome, a condition marked by widespread inflammation in the lungs that often requires invasive support. We report a case of severe acute respiratory distress syndrome requiring veno-venous extracorporeal membrane oxygenation in an otherwise healthy adolescent because of MP.
Subject(s)
Extracorporeal Membrane Oxygenation/methods , Mycoplasma pneumoniae/drug effects , Pneumonia, Mycoplasma/therapy , Respiratory Distress Syndrome/microbiology , Respiratory Distress Syndrome/therapy , Anti-Bacterial Agents/therapeutic use , Child , Healthy Volunteers , Humans , Male , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/diagnostic imaging , Pneumonia, Mycoplasma/drug therapy , Respiratory Distress Syndrome/diagnostic imaging , Respiratory Distress Syndrome/drug therapy , Treatment OutcomeABSTRACT
To investigate the relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia (RMPP) in children. Serum levels of LncRNA NNT-AS1 of RMPP and non-RMPP (NRMPP) patients were detected by real-time PCR, and were analyzed together with serum c-reactive protein (CRP) and procalcitonin (PCT). Correlations between LncRNA NNT-AS1 and CRP and PCT were analyzed by Pearson correlation test. The ROC curve was used to analyze the potential of LncRNA NNT-AS1, CRP and PCT as biomarkers for predicting RMPP. Logistic regression crossover model and the Excel compiled by Andersson et al. were used to analyze the interactions among the biomarkers. We found that LncRNA NNT-AS1, CRP and PCT were all highly expressed in patients with RMPP. LncRNA NNT-AS1 could positively correlate with the expressions of CRP and PCT, and jointly promote the occurrence of RMPP. The combined diagnosis of LncRNA NNT-AS1, CRP and PCT could predict the occurrence of RMPP.
Subject(s)
C-Reactive Protein/metabolism , Pneumonia, Mycoplasma/blood , Procalcitonin/blood , RNA, Long Noncoding/blood , Biomarkers/blood , Child , Child, Preschool , Female , Humans , Logistic Models , Male , Mycoplasma pneumoniae/isolation & purification , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/microbiologyABSTRACT
To investigate the effect of Qingfei Huatan Huoxue Decoction combined with azithromycin on pulmonary function and inflammatory factors in children with Mycoplasma pneumonia. A total of 155 children with Mycoplasma pneumonia of toxic heat blocking lung syndrome were randomly divided into the control group (n=77) and the observation group (n=78) from March 2020 to March 2021. Both groups of children were given conventional treatment and azithromycin intravenous drip and the observation group was additionally given oral administration of Qingfei Huatan Huoxue Decoction, with 7 days as a course of treatment totaling 2 courses. The lung function, inflammatory factor level, immune function and coagulation function were compared between the two groups before and after treatment. After treatment, the symptom integral of fever, cough and pulmonary wet rales in the two groups were reduced, while FEV1, PEF and FEV1/ FVC were significantly increased, serum TNF-α, IFN- γ and IL-6 were significantly reduced, the levels of Immunoglobulin M (IgM), IgG and IgA were significantly reduced and plasma PT and APTT were significantly reduced, with more significant changes observed in the observation group (all P<0.05). The disappearance time of fever, cough and pulmonary moist rales in the observation group was significantly shorter than that in the control group (P<0.05). The recovery rate of the observation group was significantly higher than that of the control group (P<0.05). Qingfei Huatan Huoxue Decoction combined.
Subject(s)
Anti-Bacterial Agents , Azithromycin , Drugs, Chinese Herbal , Lung , Mycoplasma pneumoniae , Pneumonia, Mycoplasma , Adolescent , Child , Child, Preschool , Female , Humans , Male , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Azithromycin/adverse effects , Azithromycin/therapeutic use , Case-Control Studies , China , Drug Therapy, Combination , Drugs, Chinese Herbal/adverse effects , Drugs, Chinese Herbal/therapeutic use , Lung/drug effects , Lung/microbiology , Lung/physiopathology , Mycoplasma pneumoniae/drug effects , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/physiopathology , Random Allocation , Recovery of Function , Time Factors , Treatment OutcomeABSTRACT
This study aimed to investigate the effect of erythromycin sequential therapy plus azithromycin on lung function and inflammatory factors in children with severe mycoplasma pneumonia (MP). Ninety-three severe MP children were selected and randomized into azithromycin group, erythromycin group, and combination group, 31 cases in each. The disappearance time of cough, fever, lung rale and X-ray shadow in the combination group were shorter than those in the azithromycin group and erythromycin group. The clinical treatment efficiency of the combination group was higher than that of the azithromycin group. After treatment, FVC, FEV1/FVC and PEF in combination group were higher than before treatment; IL-8, IL-6, CRP in combination group were lower than erythromycin group and azithromycin group. IL-8, IL-6, CRP are negatively correlated with disappearance time of cough, fever, pulmonary rale, X-ray shadow and clinical treatment efficiency; FEV1/FVC is positively correlated with disappearance time of cough and fever, pulmonary rales and X-ray shadow, and clinical treatment efficiency. Sequential erythromycin therapy combined with azithromycin in the treatment of MP can effectively inhibit high inflammatory reactions, control the disease in a timely manner, improve lung function and produce fewer adverse reactions.