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Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children
Yi-Chen Lee1, Chih-Hao Chang2, Wei-Ju Lee3
1Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan.
Background:
Mycoplasma pneumoniae is one of the major pathogens causing community-acquired pneumonia in children. Although usually self-limited, Mycoplasma pneumoniae pneumonia (MPP) may lead to complicated morbidity that can even be life-threatening. Upon MPP infection, alveolar macrophage becomes attracted and activated and will induce subsequent cytokine and chemokine reaction. Refractory Mycoplasma pneumoniae pneumonia (RMPP) is manifested by clinical or radiological deterioration despite proper antibiotic therapy. RMPP is characterized with excessive inflammation and may need subsequent glucocorticoid treatment.
Aim:
The aim of this study was to investigate the change of plasma chemokines in non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) and RMPP before and after antibiotic or methylprednisolone treatment.
Method:
A total of 42 children with MPP were enrolled in this study. Plasma specimens were collected at admission and one to two weeks after antibiotic or methylprednisolone treatment with declined fever. Plasma specimens were then indicated to chemokines detection.
Results:
Mycoplasma pneumoniae pneumonia altered the chemokine profile through the observation of decreased plasma M1 related chemokines (CCL2, CCL8 and CXCL10) and increased M2 related chemokines (CCL17 and CCL22) after treatment.When the patients were divided into RMPP and NRMPP groups and the chemokines before treatment were compared, the RMPP group showed higher CXCL10 but lower CCL3 and CCL11 than the NRMPP group.
Conclusion:
Unique changes in macrophage related chemokines is observed in the course of MPP infection. NRMPP and RMPP infection in children showed distinct manifestation in chemokine profiles.
Insights
Children with Mycoplasma pneumoniae pneumonia (MPP) show altered chemokine profiles. Refractory MPP (RMPP) exhibits distinct chemokine patterns compared to non-refractory MPP (NRMPP), indicating unique inflammatory responses.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Respiratory Medicine
Background:
- Mycoplasma pneumoniae pneumonia (MPP) is a common childhood respiratory infection.
- While often self-limiting, MPP can lead to severe complications and is associated with macrophage activation and cytokine release.
- Refractory MPP (RMPP) signifies clinical deterioration despite antibiotics, often linked to excessive inflammation requiring glucocorticoids.
Purpose of the Study:
- To analyze changes in plasma chemokines in children with non-refractory MPP (NRMPP) and RMPP.
- To compare chemokine profiles before and after treatment with antibiotics or methylprednisolone.
Main Methods:
- Plasma samples were collected from 42 children with MPP at admission and post-treatment.
- Chemokine levels were measured using plasma specimens.
- Patients were categorized into RMPP and NRMPP groups for comparative analysis.
Main Results:
- MPP infection altered chemokine profiles, showing decreased M1-related chemokines (CCL2, CCL8, CXCL10) and increased M2-related chemokines (CCL17, CCL22) post-treatment.
- Before treatment, RMPP patients had higher CXCL10 and lower CCL3 and CCL11 levels compared to NRMPP patients.
- These findings highlight distinct chemokine signatures between RMPP and NRMPP.
Conclusions:
- Macrophage-related chemokines exhibit unique changes during MPP infection.
- Distinct chemokine profiles differentiate NRMPP from RMPP in children.
- Chemokine analysis may aid in understanding and managing MPP severity.
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