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Serum IL-17A and IL-6 in paediatric Mycoplasma pneumoniae pneumonia: implications for different endotypes
Heng Wang1, Yanli Zhang2, Chengsong Zhao3
1Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
Abstract:
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a heterogeneous disease with a diverse spectrum of clinical phenotypes. No studies have demonstrated the relationship between underlying endotypes and clinical phenotypes as well as prognosis about this disease. Thus, we conducted a multicentre prospective longitudinal study on children hospitalized for MPP between June 2021 and March 2023, with the end of follow-up in August 2023. Blood samples were collected and processed at multiple time points. Multiplex cytokine assay was performed to characterize serum cytokine profiles and their dynamic changes after admission. Cluster analysis based on different clinical phenotypes was conducted. Among the included 196 patients, the levels of serum IL-17A and IL-6 showed remarkable variabilities. Four cytokine clusters based on the two cytokines and four clinical groups were identified. Significant elevation of IL-17A mainly correlated with diffuse bronchiolitis and lobar lesion by airway mucus hypersecretions, while that of IL-6 was largely associated with lobar lesion which later developed into lung necrosis. Besides, glucocorticoid therapy failed to inhibit IL-17A, and markedly elevated IL-17A and IL-6 levels may correlate with lower airway obliterans. Our study provides critical relationship between molecular signatures (endotypes) and clustered clinical phenotypes in paediatric patients with MPP.
Insights
This study reveals distinct molecular patterns in pediatric Mycoplasma pneumoniae pneumonia (MPP), linking specific cytokine levels to varied clinical outcomes and disease progression in children.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Immunology
Background:
- Pediatric Mycoplasma pneumoniae pneumonia (MPP) presents with diverse clinical features.
- The relationship between molecular endotypes and clinical phenotypes in pediatric MPP remains unclear.
- Understanding these links is crucial for predicting prognosis and guiding treatment.
Purpose of the Study:
- To investigate the association between serum cytokine profiles and clinical phenotypes in pediatric MPP.
- To identify distinct molecular endotypes within pediatric MPP.
- To explore the correlation between endotypes, clinical manifestations, and disease outcomes.
Main Methods:
- A multicenter prospective longitudinal study involving 196 hospitalized children with MPP.
- Serum samples analyzed using multiplex cytokine assays to measure IL-17A and IL-6 levels over time.
- Cluster analysis performed on cytokine data and clinical phenotypes to identify distinct groups.
Main Results:
- Four distinct cytokine clusters and four clinical phenotype groups were identified.
- Elevated IL-17A correlated with diffuse bronchiolitis and mucus hypersecretion.
- Elevated IL-6 was associated with lobar lesions, lung necrosis, and potentially lower airway obliterans.
- Glucocorticoid therapy did not inhibit IL-17A.
Conclusions:
- Specific cytokine profiles (IL-17A, IL-6) are linked to distinct clinical phenotypes in pediatric MPP.
- These molecular signatures offer insights into disease heterogeneity and potential prognostic markers.
- Further research is needed to elucidate the role of these cytokines in disease pathogenesis and therapeutic strategies.
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