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Published on: February 24, 2023
Ciliary ultrastructural abnormalities in Mycoplasma pneumoniae pneumonia in 22 pediatric patients
Hui Liang1, Wujun Jiang, Qing Han
1Department of Respiratory Medicine, The Affiliated Nanjing Children's Hospital of Nanjing Medical University, No. 72 Guangzhou Road, Nanjing 210008, China.
Abstract:
Mycoplasma pneumoniae pneumonia (MPP) is characterized by ciliary ultrastructural abnormalities that cause abnormal mucociliary function leading to refractory or persistent pneumonia. Herein, we analyzed ciliary ultrastructural defects in 22 children with MPP and determined the association of these defects with prognosis. Ciliary ultrastructural abnormalities occurred in all patients. Ciliated cells with loss of cilia occurred in 15. Cytoplasmic blebbing occurred in eight. Ambiguity of the "9 + 2" microtubule array occurred in six. Transposition or disarray of the peripheral microtubules occurred in five. Compound cilia occurred in three. Central complex defects occurred in three. Squamous metaplasia occurred in two. Compound cilia with multiple axonemes within a single outer sheath occurred in one. Multiple abnormalities occurred in 14. The recovery time in patients with multiple abnormalities was longer than that in patients with single abnormality. Patients with central complex defects required more than 1 month to recover. In conclusion, ciliated cells with loss of cilia, cytoplasmic blebbing, and ambiguity of the "9 + 2" microtubule array were the most commonly encountered abnormal findings in MPP. Multiple abnormalities, especially those associated with central complex defects, may indicate an unfavorable prognosis.
Insights
Pediatric Mycoplasma pneumoniae pneumonia (MPP) involves ciliary defects impacting mucociliary function. Multiple abnormalities, particularly central complex defects, correlate with prolonged recovery and poorer prognosis in children with MPP.
Area of Science:
- Pediatric Pulmonology
- Cell Biology
- Microbiology
Background:
- Mycoplasma pneumoniae pneumonia (MPP) in children often presents with persistent symptoms due to impaired mucociliary clearance.
- Ciliary ultrastructural abnormalities are a known hallmark of MPP, affecting respiratory tract function.
Purpose of the Study:
- To investigate the spectrum of ciliary ultrastructural defects in children diagnosed with MPP.
- To determine the association between specific ciliary defects and the clinical prognosis of MPP.
Main Methods:
- Analysis of ciliary ultrastructural defects using electron microscopy in 22 pediatric patients with MPP.
- Correlation of observed ciliary abnormalities with patient recovery time and clinical outcomes.
Main Results:
- All 22 patients exhibited ciliary ultrastructural abnormalities.
- Common defects included loss of cilia (15 patients), cytoplasmic blebbing (8), and "9+2" microtubule array ambiguity (6).
- Multiple abnormalities were observed in 14 patients, associated with longer recovery times compared to single abnormalities. Central complex defects predicted recovery exceeding one month.
Conclusions:
- Ciliated cell defects, including cilia loss, cytoplasmic blebbing, and "9+2" array ambiguity, are prevalent in pediatric MPP.
- The presence of multiple ciliary abnormalities, especially central complex defects, suggests a potentially unfavorable prognosis in children with MPP.
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