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Published on: August 7, 2017

Inflammatory Mediation of the Association Between Latent Clinical Phenotypes and Multidimensional Outcomes in

Jing Wang1, Ling Chen1, Song Mao1

  • 1Department of Pediatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

Journal of Inflammation Research
|August 11, 2026
PubMed

Insights

In pediatric community-acquired pneumonia, specific clinical phenotypes like older-full term-Mycoplasma pneumoniae infection are linked to severe outcomes. Inflammation, including C-reactive protein and Interleukin-6, plays a mediating role in these associations.

Area of Science:

  • Pediatric infectious diseases
  • Respiratory medicine
  • Clinical immunology

Background:

  • Community-acquired pneumonia (CAP) in children presents diverse clinical trajectories.
  • Understanding latent clinical phenotypes is crucial for predicting multidimensional outcomes.
  • The role of inflammatory markers in mediating these associations requires further investigation.

Purpose of the Study:

  • To identify distinct clinical phenotypes of pediatric CAP using latent class analysis.
  • To analyze the association between these phenotypes and multidimensional outcomes (e.g., severe pneumonia, organ injury, disease duration).
  • To evaluate the mediating role of inflammation (C-reactive protein [CRP] and Interleukin-6 [IL-6]) in the relationship between CAP phenotypes/pathogens and outcomes.

Main Methods:

  • Retrospective observational cohort study of 700 hospitalized children with CAP.
  • Latent class analysis to identify clinical phenotypes.
  • Assessment of associations between CAP subgroups, pathogens, and outcomes, including inflammatory markers (CRP, IL-6) using mediation analyses.

Main Results:

  • The older-full term-Mycoplasma pneumoniae infection subgroup exhibited higher risks of severe pneumonia and kidney injury, and longer disease duration.
  • CRP and IL-6 partially mediated the effects of the older-full term-Mycoplasma pneumoniae infection subgroup on severe pneumonia and kidney injury.
  • Mycoplasma pneumoniae and adenovirus infections were associated with specific adverse outcomes, with inflammation mediating some of these effects.

Conclusions:

  • Specific pediatric CAP phenotypes, particularly those involving Mycoplasma pneumoniae in older, full-term infants, are associated with unfavorable outcomes.
  • Inflammatory markers like CRP and IL-6 partially explain the link between CAP phenotypes/pathogens and adverse outcomes.
  • Phenotype-based risk stratification, considering inflammatory mediators, can improve management of pediatric CAP.
Abstract

Keywords:
clinical phenotypescommunity-acquired pneumoniaoutcomerespiratory pathogen

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