Predictive value of chemokines (CCL 2) in bronchoalveolar lavage fluid for refractory mycoplasma pneumonia in children.
Bronchoalveolar lavage fluid
CCL2
Children
Mycoplasma pneumoniae pneumonia
Refractory
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
23 Sep 2023
23 Sep 2023
Historique:
received:
28
03
2023
accepted:
08
09
2023
medline:
25
9
2023
pubmed:
23
9
2023
entrez:
22
9
2023
Statut:
epublish
Résumé
There are relatively few studies investigating C-C motif chemokine ligand 2 (CCL2) level in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP), and the relationship between CCL2 level in BALF and refractory mycoplasma pneumoniae pneumonia (RMPP) is unclear. This study aims to explore the relationship between chemokine CCL2 level in BALF and clinical characteristics and clinical outcome in children with MPP. A total of 51 children with confirmed acute MPP and requiring bronchoalveolar lavage in Department of Pediatrics, Huanghe Sanmenxia Hospital and The First Clinical College of Xinxiang Medical University from October 2021 to February 2023 were selected as the study group. And 11 children with bronchial foreign body were selected as the control group. The study group was divided into the non-refractory mycoplasma pneumoniae pneumonia (NRMPP) group and the RMPP group based on the response to treatment. BALF and clinical data of the patients were collected. And CCL2 levels were tested in the patients. Differences in CCL2 level in BALF and clinical characteristics were tested and compared. The CCL2 level in BALF of the study group was higher than that of the control group, with significant difference (P < 0.05). With ROC curve, the area under the curve (AUC) of CCL2 in BALF predicting RMPP was 0.94, the cut-off value was 0.645 ng/ml, the sensitivity was 85%, and the specificity was 94%, and the diagnostic value was better than that of serum CRP and LDH. Logistic regression analysis was used to build the RMPP prediction model, and CCL2 showed good predictive value. The level of CCL2 in BALF was high in children with MPP and had a high predictive value for RMPP. CCL2 can be used as one of the biomarkers for predicting RMPP.
Sections du résumé
BACKGROUND
BACKGROUND
There are relatively few studies investigating C-C motif chemokine ligand 2 (CCL2) level in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP), and the relationship between CCL2 level in BALF and refractory mycoplasma pneumoniae pneumonia (RMPP) is unclear. This study aims to explore the relationship between chemokine CCL2 level in BALF and clinical characteristics and clinical outcome in children with MPP.
METHODS
METHODS
A total of 51 children with confirmed acute MPP and requiring bronchoalveolar lavage in Department of Pediatrics, Huanghe Sanmenxia Hospital and The First Clinical College of Xinxiang Medical University from October 2021 to February 2023 were selected as the study group. And 11 children with bronchial foreign body were selected as the control group. The study group was divided into the non-refractory mycoplasma pneumoniae pneumonia (NRMPP) group and the RMPP group based on the response to treatment. BALF and clinical data of the patients were collected. And CCL2 levels were tested in the patients. Differences in CCL2 level in BALF and clinical characteristics were tested and compared.
RESULTS
RESULTS
The CCL2 level in BALF of the study group was higher than that of the control group, with significant difference (P < 0.05). With ROC curve, the area under the curve (AUC) of CCL2 in BALF predicting RMPP was 0.94, the cut-off value was 0.645 ng/ml, the sensitivity was 85%, and the specificity was 94%, and the diagnostic value was better than that of serum CRP and LDH. Logistic regression analysis was used to build the RMPP prediction model, and CCL2 showed good predictive value.
CONCLUSION
CONCLUSIONS
The level of CCL2 in BALF was high in children with MPP and had a high predictive value for RMPP. CCL2 can be used as one of the biomarkers for predicting RMPP.
Identifiants
pubmed: 37740208
doi: 10.1186/s13052-023-01528-2
pii: 10.1186/s13052-023-01528-2
pmc: PMC10517484
doi:
Substances chimiques
Chemokines
0
Dimercaprol
0CPP32S55X
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
125Subventions
Organisme : Sanmenxia Science and Technology Research Project
ID : No. 2022002088
Organisme : Science and Technology Project of China Water Resources and Hydropower Eleventh Engineering Bureau Co., Ltd.
ID : Science and Technology Project of China Water Resources and Hydropower Eleventh Engineering Bureau Co., Ltd.
Informations de copyright
© 2023. Società Italiana di Pediatria.
Références
Respiratory Group of Pediatrics Branch of Chinese Medical Association. Editorial Board of Chinese Journal of practical pediatrics. Expert consensus on diagnosis and treatment of mycoplasma pneumoniae pneumonia in children (2015). J Appl Clin Pediatr. 2015;30(17):1304–8. https://doi.org/10.3760/cma.j.issn.2095-428X .
doi: 10.3760/cma.j.issn.2095-428X
Chaudhry R, Ghosh A, Chandolia A. Pathogenesis of Mycoplasma pneumoniae: an update. Indian J Med Microbiol 2016 Jan-Mar;34(1):7–16. https://doi.org/10.4103/0255-0857.174112 .
Tong L, Huang S, Zheng C, et al. Refractory Mycoplasma pneumoniae Pneumonia in Children: early recognition and management. J Clin Med. 2022;11(10):2824. https://doi.org/10.3390/jcm11102824 .
doi: 10.3390/jcm11102824
pubmed: 35628949
pmcid: 9144103
National Health Commission of the People’s Republic of China. Guideline for diagnosis and treatment of community-acquired pneumonia in children (2019 version). Chin Practical J Rural Doctor. 2019;26(04):6–13. https://doi.org/10.3969/j.issn.1672-7185.2019.04.003 .
doi: 10.3969/j.issn.1672-7185.2019.04.003
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86(5):408–16. https://doi.org/10.2471/blt.07.048769 .
doi: 10.2471/blt.07.048769
pubmed: 18545744
pmcid: 2647437
Liu JR, Lu J, Dong F, et al. Low bacterial coinfection invalidates the early use of nonantimycoplasma pneumoniae antibiotics in pediatric refractory mycoplasma pneumoniae pneumonia patients. Front Pediatr. 2018;6:296. https://doi.org/10.3389/fped.2018.00296 .
doi: 10.3389/fped.2018.00296
pubmed: 30416990
pmcid: 6212475
Lee KY, Lee HS, Hong JH, et al. Role of prednisolone treatment in severe Mycoplasma pneumoniae pneumonia in children. Pediatr Pulmonol. 2006;41(3):263–8. https://doi.org/10.1002/ppul.20374 .
doi: 10.1002/ppul.20374
pubmed: 16437541
Zhou Y, Wang J, Chen W, et al. Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2020;20(1):633. https://doi.org/10.1186/s12879-020-05356-1 .
doi: 10.1186/s12879-020-05356-1
pubmed: 32847534
pmcid: 7447613
Gong H, Sun B, Chen Y, et al. The risk factors of children acquiring refractory mycoplasma pneumoniae pneumonia: a meta-analysis. Med (Baltim). 2021;100(11):e24894. https://doi.org/10.1097/MD.0000000000024894 .
doi: 10.1097/MD.0000000000024894
Chen P, Huang Z, Chen L, et al. The relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia in children. Sci Rep. 2021;11(1):2059. https://doi.org/10.1038/s41598-021-81853-w .
doi: 10.1038/s41598-021-81853-w
pubmed: 33479472
pmcid: 7820231
Koster MJ, Broekhuizen BD, Minnaard MC, Balemans WA, Hopstaken RM, de Jong PA, Verheij TJ. Diagnostic properties of C-reactive protein for detecting pneumonia in children. Respir Med. 2013;107(7):1087-93. https://doi.org/10.1016/j.rmed.2013.04.012 . Epub 2013 May 11. PMID: 23672994.
Shen F, Dong C, Zhang T, et al. Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children. Front Pediatr. 2022;10:813614. https://doi.org/10.3389/fped.2022.813614 .
doi: 10.3389/fped.2022.813614
pubmed: 35281240
pmcid: 8916609
Lu A, Wang C, Zhang X, et al. Lactate Dehydrogenase as a Biomarker for Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children. Respir Care. 2015;60(10):1469–75. https://doi.org/10.4187/respcare.03920 .
doi: 10.4187/respcare.03920
pubmed: 26060318
Dyer DP. Understanding the mechanisms that facilitate specificity, not redundancy, of chemokine-mediated leukocyte recruitment. Immunology. 2020;160(4):336–44. https://doi.org/10.1111/imm.13200 .
doi: 10.1111/imm.13200
pubmed: 32285441
pmcid: 7370109
Xue D, Zheng Y, Wen J, et al. Role of chemokines in hepatocellular carcinoma (review). Oncol Rep. 2021;45(3):809–23. https://doi.org/10.3892/or.2020.7906 .
doi: 10.3892/or.2020.7906
pubmed: 33650640
Hughes CE, Nibbs RJB. A guide to chemokines and their receptors. FEBS J. 2018;285(16):2944–71. https://doi.org/10.1111/febs.14466 .
doi: 10.1111/febs.14466
pubmed: 29637711
pmcid: 6120486
He YS, Yang M, Qian SY. Predictive role of cytokines in children with refractory mycoplasma pneumoniae pneumonia. Chin J Pediatr. 2021;59(05):422–5. https://doi.org/10.3760/cma.j.cn112140-20201125-01056 .
doi: 10.3760/cma.j.cn112140-20201125-01056
Mao ZM, Zhou RD. Research Developments of Monocyte chemoattractant Protein-1 in inflammatory reaction. Med Recapitulate. 2013;19(06):964–6. https://doi.org/10.3969/j.issn.1006-2084.2013.06.002 .
doi: 10.3969/j.issn.1006-2084.2013.06.002
Hue E, Orard M, Toquet MP, et al. Asymmetrical pulmonary cytokine profiles are linked to Bronchoalveolar Lavage Fluid Cytology of horses with mild Airway Neutrophilia. Front Vet Sci. 2020;7:226. https://doi.org/10.3389/fvets.2020.00226 .
doi: 10.3389/fvets.2020.00226
pubmed: 32391392
pmcid: 7193537
Pediatric Respiratory Endoscopy Diagnosis and Treatment Technical Expert Group of Talent Exchange Service Center of National Health Commission, Endoscopy Professional Committee of Pediatric Physician Branch of Chinese Medical Doctor Association, Pediatric Respiratory Endoscopy Professional Committee of Endoscopist Branch of Chinese Medical Doctor Association, Pediatrics of Minimally Invasive Branch of China Maternal and Child Health Care Association Interventional Pulmonology Group. Guideline of pediatric flexible bronchoscopy in China (2018 version). Chin J Appl Clin Pediatr. 2018;33(13):983–9. https://doi.org/10.3760/cma.j.issn.2095-428X.2018.13.006 . Chinese Medical Association Pediatrics Branch Respiratory Group Bronchoscopy Collaborative Group.
doi: 10.3760/cma.j.issn.2095-428X.2018.13.006
Pediatrics Group, Otorhinolaryngology-Head and Neck Surgery Branch, Chinese Medical Association. Experts consensus on diagnosis and treatment of tracheobronchial foreign bodies in children. Chin J Otorhinolaryngol Head Neck Surg. 2018;53(05):325–38. https://doi.org/10.3760/cma.j.issn.1673-0860.2018.05.002 .
doi: 10.3760/cma.j.issn.1673-0860.2018.05.002
Yang M, Meng F, Gao M, et al. Cytokine signatures associate with disease severity in children with Mycoplasma pneumoniae pneumonia. Sci Rep. 2019;9(1):17853. https://doi.org/10.1038/s41598-019-54313-9 .
doi: 10.1038/s41598-019-54313-9
pubmed: 31780733
pmcid: 6882793
Ding Y, Chu C, Li Y, et al. High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2018;18(1):439. https://doi.org/10.1186/s12879-018-3346-8 .
doi: 10.1186/s12879-018-3346-8
pubmed: 30157804
pmcid: 6116361
Fu BB, Zhong LL, Ye TT, et al. Value of autotaxin in predicting refractory Mycoplasma pneumoniae pneumonia in children and its correlation with inflammatory cytokines. Zhongguo Dang Dai Er Ke Za Zhi. 2022;24(7):765–70. https://doi.org/10.7499/j.issn.1008-8830.2203030 .
doi: 10.7499/j.issn.1008-8830.2203030
pubmed: 35894191
Zhang Y, Mei S, Zhou Y, et al. Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children. Sci Rep. 2016;6:37037. https://doi.org/10.1038/srep37037 .
doi: 10.1038/srep37037
pubmed: 27833154
pmcid: 5105141
Betakova T, Kostrabova A, Lachova V, et al. Cytokines Induced during Influenza Virus infection. Curr Pharm Des. 2017;23(18):2616–22. https://doi.org/10.2174/1381612823666170316123736 .
doi: 10.2174/1381612823666170316123736
pubmed: 28302021
Chen X, Liu F, Zheng B, et al. Exhausted and apoptotic BALF T cells in Proinflammatory Airway Milieu at Acute phase of severe Mycoplasma Pneumoniae Pneumonia in Children. Front Immunol. 2022;12:760488. https://doi.org/10.3389/fimmu.2021.760488 .
doi: 10.3389/fimmu.2021.760488
pubmed: 35111152
pmcid: 8801936
Huang W, Xu X, Zhao W, et al. Refractory Mycoplasma pneumonia in children: a systematic review and Meta-analysis of Laboratory features and predictors. J Immunol Res. 2022;2022:9227838. https://doi.org/10.1155/2022/9227838 .
doi: 10.1155/2022/9227838
pubmed: 35795531
pmcid: 9251082
Keller K, Beule J, Balzer JO, et al. D-Dimer and thrombus burden in acute pulmonary embolism. Am J Emerg Med. 2018;36(9):1613–8. https://doi.org/10.1016/j.ajem.2018.01.048 .
doi: 10.1016/j.ajem.2018.01.048
pubmed: 29371044
Jin X, Zhu Y, Zhang Y, et al. Assessment of levels of D-dimer and interferon-γ in pediatric patients with Mycoplasma pneumoniae pneumonia and its clinical implication. Exp Ther Med. 2018;16(6):5025–30. https://doi.org/10.3892/etm.2018.6873 .
doi: 10.3892/etm.2018.6873
pubmed: 30546408
pmcid: 6256836
Huang X, Li D, Liu F, et al. Clinical significance of D-dimer levels in refractory Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2021;21(1):14. https://doi.org/10.1186/s12879-020-05700-5 .
doi: 10.1186/s12879-020-05700-5
pubmed: 33407216
pmcid: 7787414
Wang M, Wang Y, Yan Y, et al. Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children. Int J Infect Dis. 2014;29:18–23. https://doi.org/10.1016/j.ijid.2014.07.020 .
doi: 10.1016/j.ijid.2014.07.020
pubmed: 25449230
Zhang Y, Zhou Y, Li S, et al. The clinical characteristics and predictors of Refractory Mycoplasma pneumoniae Pneumonia in Children. PLoS ONE. 2016;11(5):e0156465. https://doi.org/10.1371/journal.pone.0156465 .
doi: 10.1371/journal.pone.0156465
pubmed: 27227519
pmcid: 4882022
Zhai YY, Wu SZ, Yang Y, et al. An analysis of 20 clinical cases of refractory mycoplasma pneumonia in children. Ann Palliat Med. 2020;9(5):2592–9. https://doi.org/10.21037/apm-19-497 .
doi: 10.21037/apm-19-497
pubmed: 32921097
Khalil BA, Elemam NM, Maghazachi AA. Chemokines and chemokine receptors during COVID-19 infection. Comput Struct Biotechnol J. 2021;19:976–88. https://doi.org/10.1016/j.csbj.2021.01.034 .
doi: 10.1016/j.csbj.2021.01.034
pubmed: 33558827
pmcid: 7859556
Lee YC, Chang CH, Lee WJ, et al. Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children. J Microbiol Immunol Infect. 2021;54(4):673–9. https://doi.org/10.1016/j.jmii.2020.03.030 .
doi: 10.1016/j.jmii.2020.03.030
pubmed: 32299786
Hue Erika O, Marie T, Marie-Pierre, et al. Asymmetrical pulmonary cytokine profiles are linked to Bronchoalveolar Lavage Fluid Cytology of horses with mild Airway Neutrophilia. [J] Front Vet Sci. 2020;7:226.
doi: 10.3389/fvets.2020.00226