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Koenen MH, de Groot RCA, de Steenhuijsen Piters WAA, Chu MLJN, Arp K, Hasrat R, de Bruijn ACJM, Estevão SC, van der Vries E, Langereis JD, Boes M, Bogaert D, van Rossum AMC, Unger WWJ, Verhagen LM. Mycoplasma pneumoniae carriage in children with recurrent respiratory tract infections is associated with a less diverse and altered microbiota. EBioMedicine 2023; 98:104868. [PMID: 37950996 PMCID: PMC10679896 DOI: 10.1016/j.ebiom.2023.104868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and can be preceded by asymptomatic carriage. However, its role in recurrent respiratory tract infections is unclear. We studied the prevalence of M.pneumoniae carriage in children with recurrent respiratory infections and identified associated factors. METHODS We tested M.pneumoniae carriage by qPCR in children with recurrent infections and their healthy family members in a cross-sectional study. Serum and mucosal total and M.pneumoniae-specific antibody levels were measured by ELISA and nasopharyngeal microbiota composition was characterized by 16S-rRNA sequencing. FINDINGS Prevalence of M.pneumoniae carriage was higher in children with recurrent infections (68%) than their family members without infections (47% in siblings and 27% in parents). M.pneumoniae carriage among family members appeared to be associated with transmission within the household, likely originating from the affected child. In logistic regression corrected for age and multiple comparisons, IgA (OR 0.16 [0.06-0.37]) and total IgG deficiency (OR 0.15 [0.02-0.74]) were less prevalent in M.pneumoniae carriers (n = 78) compared to non-carriers (n = 36). In multivariable analysis, the nasopharyngeal microbiota of M.pneumoniae carriers had lower alpha diversity (OR 0.27 [0.09-0.67]) and a higher abundance of Haemophilus influenzae (OR 45.01 [2.74-1608.11]) compared to non-carriers. INTERPRETATION M.pneumoniae carriage is highly prevalent in children with recurrent infections and carriers have a less diverse microbiota with an overrepresentation of disease-associated microbiota members compared to non-carriers. Given the high prevalence of M.pneumoniae carriage and the strong association with H. influenzae, we recommend appropriate antibiotic coverage of M.pneumoniae and H. influenzae in case of suspected pneumonia in children with recurrent respiratory tract infections or their family members. FUNDING Wilhelmina Children's Hospital Research Fund, 'Christine Bader Stichting Irene KinderZiekenhuis', Sophia Scientific Research Foundation, ESPID Fellowship funded by Seqirus, Hypatia Fellowship funded by Radboudumc and The Netherlands Organisation for Health Research and Development (ZonMW VENI grant to LM Verhagen).
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Affiliation(s)
- Mischa H Koenen
- Center of Translational Immunology, UMC Utrecht, Utrecht, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Ruben C A de Groot
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Wouter A A de Steenhuijsen Piters
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Center for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Mei Ling J N Chu
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Kayleigh Arp
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Raïza Hasrat
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Ad C J M de Bruijn
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Silvia C Estevão
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Erhard van der Vries
- Department of Research & Development, GD Animal Health, Deventer, the Netherlands
| | - Jeroen D Langereis
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marianne Boes
- Center of Translational Immunology, UMC Utrecht, Utrecht, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Debby Bogaert
- Center for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Annemarie M C van Rossum
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Wendy W J Unger
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Lilly M Verhagen
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands; Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
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2
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Liu J, He R, Zhang X, Zhao F, Liu L, Wang H, Zhao S. Clinical features and “early” corticosteroid treatment outcome of pediatric mycoplasma pneumoniae pneumonia. Front Cell Infect Microbiol 2023; 13:1135228. [PMID: 37082710 PMCID: PMC10110948 DOI: 10.3389/fcimb.2023.1135228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/10/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundMany children with mycoplasma pneumoniae (MP) pneumonia (MPP) developed sequelae such as bronchiolitis/bronchitis obliterans (BO). Early corticosteroid therapy might prevent disease progression. This study aimed to use “early” corticosteroid and observe the treatment outcome in patients with MPP.MethodsPatients who had pulmonary infiltrations on chest imaging within 5 days of the disease course and were suspected of having MP infection on admission were enrolled. Among them, patients whose disease course was within 10 days on admission were ultimately enrolled. We analyzed their data including the clinical features, the starting time and dose of corticosteroid therapy, and the treatment outcome. According to chest imaging, we divided patients into two groups (Group A: bronchiolitis-associated lesions or ground-glass opacities; Group B: pulmonary segmental/lobar consolidation).ResultsA total of 210 patients with confirmed MPP were ultimately enrolled. There were 59 patients in Group A and 151 patients in Group B. Patients in Group A were more prone to have allergy histories, hypoxemia, wheezing sound, and wet rales on auscultation than those in Group B. Corticosteroid treatment was initiated between 5 and 10 days of disease onset in all patients and 6–7 days in most patients. Methylprednisolone was prescribed in all patients within 10 days of disease onset, and the highest prescribed dose was at least 2 mg/kg/day. In Group A, methylprednisolone >2 mg/kg/day was prescribed in 22 patients, and among them, 8 patients with diffuse bronchiolitis-associated lesions received high-dose methylprednisolone therapy. After 3 months, lung CT revealed slightly segmental ground-glass opacity in three patients. In Group B, methylprednisolone >2 mg/kg/day was prescribed in 76 patients, and among them, 20 patients with pulmonary lobar consolidation received high-dose methylprednisolone therapy. After 3 months, chest imaging revealed incomplete absorption of pulmonary lesions in seven patients. Among them, five patients with consolidation in more than one pulmonary lobe ultimately had slight BO.ConclusionIn hospitalized patients with MPP, particularly severe MPP, the ideal starting time of corticosteroid treatment might be 5–10 days, preferably 6–7 days, after disease onset. The initial dosage of corticosteroid therapy should be decided according to the severity of the disease. MPP patients with diffuse bronchiolitis-associated lesions/whole lobar consolidation on imaging might require high-dose corticosteroid therapy.
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Affiliation(s)
- Jinrong Liu
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
- *Correspondence: Shunying Zhao, ; Jinrong Liu,
| | - Ruxuan He
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Xiaoyan Zhang
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Fei Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and Control, Beijing, China
| | - Liyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and Control, Beijing, China
| | - Heng Wang
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Shunying Zhao
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
- *Correspondence: Shunying Zhao, ; Jinrong Liu,
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3
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Gavitt TD, Mara AB, Goodridge ML, Ozyck RG, Reinhardt E, Miller JM, Hunte M, Tulman ER, Frasca Jr S, Silbart LK, Geary SJ, Szczepanek SM. B cells oppose Mycoplasma pneumoniae vaccine enhanced disease and limit bacterial colonization of the lungs. NPJ Vaccines 2022; 7:130. [PMID: 36310317 PMCID: PMC9618410 DOI: 10.1038/s41541-022-00556-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022] Open
Abstract
Development of an effective vaccine for Mycoplasma pneumoniae has been hindered by reports of Vaccine Enhanced Disease (VED) in test subjects vaccinated and challenged in studies conducted in the 1960s. The exact mechanism of disease exacerbation has yet to be fully described, but host immune responses to Lipid-Associated Membrane Proteins (LAMPs) lipoprotein lipid moieties have been implicated. LAMPs-induced exacerbation appears to involve helper T cell recall responses, due in part to their influence on neutrophil recruitment and subsequent inflammatory responses in the lung. Herein, we characterized the functions of host B cell responses to M. pneumoniae LAMPs and delipidated-LAMPs (dLAMPs) by conducting passive transfer and B cell depletion studies to assess their contribution to disease exacerbation or protection using a BALB/c mouse model. We found that antibody responses to M. pneumoniae LAMPs and dLAMPs differ in magnitude, but not in isotype or subclass. Passive transfer, dLAMP denaturation, and monoclonal antibody studies indicate that antibodies do not cause VED, but do appear to contribute to control of bacterial loads in the lungs. Depletion of B cells prior to LAMPs-vaccination results in significantly enhanced pathology in comparison to B cell competent controls, suggesting a possible regulatory role of B cells distinct from antibody secretion. Taken together, our findings suggest that B cell antibody responses to M. pneumoniae contribute to, but are insufficient for protection against challenge on their own, and that other functional properties of B cells are necessary to limit exacerbation of disease in LAMPs-vaccinated mice after infection.
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Affiliation(s)
- Tyler D. Gavitt
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
| | - Arlind B. Mara
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
| | - Meagan L. Goodridge
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA
| | - Rosemary Grace Ozyck
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA
| | - Emily Reinhardt
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,Connecticut Veterinary Medical Diagnostic Laboratory, Storrs, CT 06238 USA
| | - Jeremy M. Miller
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
| | - Morgan Hunte
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,grid.417555.70000 0000 8814 392XPresent Address: Sanofi, Meriden, CT 06450 USA
| | - Edan R. Tulman
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
| | - Salvatore Frasca Jr
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA
| | - Lawrence K. Silbart
- grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Department of Allied of Health Sciences, University of Connecticut, Storrs, CT 06238 USA
| | - Steven J. Geary
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
| | - Steven M. Szczepanek
- grid.63054.340000 0001 0860 4915Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06238 USA ,grid.63054.340000 0001 0860 4915Center of Excellence for Vaccine Research, University of Connecticut, Storrs, CT 06238 USA ,US Animal Vaccinology Research Coordination Network, Storrs, CT 06238 USA
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Metagenomic next-generation sequencing restores the diagnosis of a rare infectious complication of B cell depletion. Eur J Clin Microbiol Infect Dis 2022; 41:1269-1273. [PMID: 36001207 DOI: 10.1007/s10096-022-04484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
A 45-year-old female patient receiving rituximab for B cell non-Hodgkin follicular lymphoma presented unexplained recurrent fever, abdominal discomfort, and pollakiuria. We performed shotgun metagenomic sequencing from peri-kidney collection that identified a co-infection with Mycoplasma hominis and Ureaplasma urealyticum. The patient recovered with sequelae after appropriate antibiotic treatment was given.
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Poddighe D, Demirkaya E, Sazonov V, Romano M. Mycoplasma pneumoniae Infections and Primary Immune Deficiencies. Int J Clin Pract 2022; 2022:6343818. [PMID: 35855053 PMCID: PMC9286979 DOI: 10.1155/2022/6343818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/11/2022] [Indexed: 11/17/2022] Open
Abstract
Mycoplasma pneumoniae (M. pneumoniae) is one of the leading causes of community-acquired pneumonia in children and is also implicated in a variety of reactive extrapulmonary diseases. Recurrent and/or severe respiratory infections are one of the most frequent manifestations of several types of primary immunodeficiency. Here, we reviewed the medical literature to assess the potential relevance of M. pneumoniae in the infections observed in children affected with combined, humoral, and innate primary immune deficiencies. M. pneumoniae does not result to be epidemiologically prevalent as a cause of pneumonia in children affected by primary immunodeficiencies, but this infection can have a persistent or severe course in this category of patients. Indeed, the active search of M. pneumoniae could be useful and appropriate especially in children with humoral immune deficiencies. Indeed, most cases of M. pneumoniae infection in primary immunodeficiencies are described in patients affected by a/hypo-gammaglobulinemia.
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Affiliation(s)
- Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine (Nur-Sultan), Nur-Sultan, Kazakhstan
- Clinical Academic Department of Pediatrics, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Erkan Demirkaya
- Division of Pediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Vitaliy Sazonov
- Department of Biomedical Sciences, Nazarbayev University School of Medicine (Nur-Sultan), Nur-Sultan, Kazakhstan
| | - Micol Romano
- Division of Pediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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6
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Muruganandah V, Kupz A. Immune responses to bacterial lung infections and their implications for vaccination. Int Immunol 2021; 34:231-248. [PMID: 34850883 DOI: 10.1093/intimm/dxab109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/28/2021] [Indexed: 11/14/2022] Open
Abstract
The pulmonary immune system plays a vital role in protecting the delicate structures of gaseous exchange against invasion from bacterial pathogens. With antimicrobial resistance becoming an increasing concern, finding novel strategies to develop vaccines against bacterial lung diseases remains a top priority. In order to do so, a continued expansion of our understanding of the pulmonary immune response is warranted. Whilst some aspects are well characterised, emerging paradigms such as the importance of innate cells and inducible immune structures in mediating protection provide avenues of potential to rethink our approach to vaccine development. In this review, we aim to provide a broad overview of both the innate and adaptive immune mechanisms in place to protect the pulmonary tissue from invading bacterial organisms. We use specific examples from several infection models and human studies to depict the varying functions of the pulmonary immune system that may be manipulated in future vaccine development. Particular emphasis has been placed on emerging themes that are less reviewed and underappreciated in vaccine development studies.
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Affiliation(s)
- Visai Muruganandah
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4878, Australia
| | - Andreas Kupz
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4878, Australia
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7
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de Groot RCA, Cristina Estevão S, Meyer Sauteur PM, Perkasa A, Hoogenboezem T, Spuesens EBM, Verhagen LM, van Rossum AMC, Unger WWJ. Mycoplasma pneumoniae carriage evades induction of protective mucosal antibodies. Eur Respir J 2021; 59:13993003.00129-2021. [PMID: 34561284 PMCID: PMC8989055 DOI: 10.1183/13993003.00129-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/05/2021] [Indexed: 11/21/2022]
Abstract
Background Mycoplasma pneumoniae is the most common bacterial cause of pneumonia in children hospitalised for community-acquired pneumonia (CAP). Prevention of infection by vaccines may be an important strategy in the presence of emerging macrolide-resistant M. pneumoniae. However, knowledge of immune responses to M. pneumoniae is limited, complicating vaccine design. Methods We studied the antibody response during M. pneumoniae respiratory tract infection and asymptomatic carriage in two different cohorts. Results In a nested case–control study (n=80) of M. pneumoniae carriers and matched controls we observed that carriage by M. pneumoniae does not lead to a rise in either mucosal or systemic M. pneumoniae-specific antibodies, even after months of persistent carriage. We replicated this finding in a second cohort (n=69) and also found that during M. pneumoniae CAP, mucosal levels of M. pneumoniae-specific IgA and IgG did increase significantly. In vitro adhesion assays revealed that high levels of M. pneumoniae-specific antibodies in nasal secretions of paediatric patients prevented the adhesion of M. pneumoniae to respiratory epithelial cells. Conclusions Our study demonstrates that M. pneumoniae-specific mucosal antibodies protect against bacterial adhesion to respiratory epithelial cells, and are induced only during M. pneumoniae infection and not during asymptomatic carriage. This is strikingly different from carriage with bacteria such as Streptococcus pneumoniae where mucosal antibodies are induced by bacterial carriage. Antibodies against M. pneumoniae, the most common bacterial cause of pneumonia in children, are able to prevent adhesion of M. pneumoniae to epithelial cells, but are only induced during infection and not during asymptomatic carriagehttps://bit.ly/3CNdAhM
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Affiliation(s)
- Ruben Cornelis Anthonie de Groot
- Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam - Sophia Children"s Hospital, Rotterdam, The Netherlands
| | - Silvia Cristina Estevão
- Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam - Sophia Children"s Hospital, Rotterdam, The Netherlands
| | - Patrick Michael Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Aditya Perkasa
- Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam - Sophia Children"s Hospital, Rotterdam, The Netherlands
| | - Theo Hoogenboezem
- Department of Pediatrics, Van Weel Bethesda Hospital, Dirksland, The Netherlands
| | - Emiel Benny Margriet Spuesens
- Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam - Sophia Children"s Hospital, Rotterdam, The Netherlands
| | - Lilly Maria Verhagen
- Department of Pediatrics, Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Anna Maria Christiane van Rossum
- Department of Pediatrics, Division of Paediatric Infectious Diseases and Immunology, Erasmus MC University Medical Centre Rotterdam-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Wendy Wilhelmina Josephina Unger
- Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam - Sophia Children"s Hospital, Rotterdam, The Netherlands
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8
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Chen P, Huang Z, Chen L, Zhuang S, Lin H, Xie J, Zheng K. The relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia in children. Sci Rep 2021; 11:2059. [PMID: 33479472 PMCID: PMC7820231 DOI: 10.1038/s41598-021-81853-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
To investigate the relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia (RMPP) in children. Serum levels of LncRNA NNT-AS1 of RMPP and non-RMPP (NRMPP) patients were detected by real-time PCR, and were analyzed together with serum c-reactive protein (CRP) and procalcitonin (PCT). Correlations between LncRNA NNT-AS1 and CRP and PCT were analyzed by Pearson correlation test. The ROC curve was used to analyze the potential of LncRNA NNT-AS1, CRP and PCT as biomarkers for predicting RMPP. Logistic regression crossover model and the Excel compiled by Andersson et al. were used to analyze the interactions among the biomarkers. We found that LncRNA NNT-AS1, CRP and PCT were all highly expressed in patients with RMPP. LncRNA NNT-AS1 could positively correlate with the expressions of CRP and PCT, and jointly promote the occurrence of RMPP. The combined diagnosis of LncRNA NNT-AS1, CRP and PCT could predict the occurrence of RMPP.
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Affiliation(s)
- Ping Chen
- Fujian Children's Hospital, Fujian, China. .,Fujian Maternity and Child Health Hospital, Fujian, China.
| | - Zheng Huang
- Fujian Center for Disease Control and Prevention, Fujian, China
| | - Lumin Chen
- Fujian Maternity and Child Health Hospital, Fujian, China.
| | - Shihao Zhuang
- Fujian Children's Hospital, Fujian, China.,Fujian Maternity and Child Health Hospital, Fujian, China
| | - Hongli Lin
- Fujian Maternity and Child Health Hospital, Fujian, China
| | - Jianfeng Xie
- Fujian Center for Disease Control and Prevention, Fujian, China
| | - Kuicheng Zheng
- Fujian Center for Disease Control and Prevention, Fujian, China
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Nasal Tissue Extraction Is Essential for Characterization of the Murine Upper Respiratory Tract Microbiota. mSphere 2020; 5:5/6/e00562-20. [PMID: 33328347 PMCID: PMC7771231 DOI: 10.1128/msphere.00562-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The nasal microbiota is composed of species that play a role in the colonization success of pathogens, including Streptococcus pneumoniae and Staphylococcus aureus. Murine models provide the ability to explore disease pathogenesis, but little is known about the natural murine nasal microbiota. Respiratory infections are a leading cause of morbidity and mortality worldwide. Bacterial pathogens often colonize the upper respiratory tract (nose or mouth) prior to causing lower respiratory infections or invasive disease. Interactions within the upper respiratory tract between colonizing bacteria and the resident microbiota could contribute to colonization success and subsequent transmission. Human carriage studies have identified associations between pathogens such as Streptococcus pneumoniae and members of the resident microbiota, although few mechanisms of competition and cooperation have been identified and would be aided by the use of animal models. Little is known about the composition of the murine nasal microbiota; thus, we set out to improve assessment, including tissue sampling, composition, and comparison between mouse sources. Nasal washes were efficient in sampling the nasopharyngeal space but barely disrupted the nasal turbinates. Nasal tissue extraction increased the yield of cultivable bacterial compared to nasal washes, revealing distinct community compositions. Experimental pneumococcal colonization led to dominance by the colonizing pathogen in the nasopharynx and nasal turbinates, but the composition of the microbiota, and interactions with resident microbes, differed depending on the sampling method. Importantly, vendor source has a large impact on microbial composition. Bacterial interactions, including cooperation and colonization resistance, depend on the biogeography of the nose and should be considered during research design of experimental colonization with pathogens. IMPORTANCE The nasal microbiota is composed of species that play a role in the colonization success of pathogens, including Streptococcus pneumoniae and Staphylococcus aureus. Murine models provide the ability to explore disease pathogenesis, but little is known about the natural murine nasal microbiota. This study established techniques to allow the exploration of the bacterial members of the nasal microbiota. The mouse nasal microbiota included traditional respiratory bacteria, including Streptococcus, Staphylococcus, and Moraxella species. Analyses were affected by different sampling methods as well as the commercial source of the mice, which should be included in future research design of infectious disease research.
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Toll-Like Receptor 2 (TLR2) and TLR4 Mediate the IgA Immune Response Induced by Mycoplasma hyopneumoniae. Infect Immun 2019; 88:IAI.00697-19. [PMID: 31611272 PMCID: PMC6921651 DOI: 10.1128/iai.00697-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022] Open
Abstract
IgA plays an important role in mucosal immunity against infectious pathogens; however, the molecular mechanism of IgA secretion in response to infection remains largely unknown, particularly in Mycoplasma spp. In this study, we found that the levels of IgA in the peripheral blood serum, bronchoalveolar lavage fluid, nasal mucosa, trachea, hilar lymph nodes, and lung tissues of pigs increased significantly after infection with Mycoplasma hyopneumoniae. IgA plays an important role in mucosal immunity against infectious pathogens; however, the molecular mechanism of IgA secretion in response to infection remains largely unknown, particularly in Mycoplasma spp. In this study, we found that the levels of IgA in the peripheral blood serum, bronchoalveolar lavage fluid, nasal mucosa, trachea, hilar lymph nodes, and lung tissues of pigs increased significantly after infection with Mycoplasma hyopneumoniae. Furthermore, IgA and CD11c were detected in the lungs and hilar lymph nodes by immunohistochemical analysis, and colocalization of these two markers indicates that CD11c+ cells play an important role in IgA mucosal immunity induced by M. hyopneumoniae. To investigate the regulatory mechanism of IgA, we separated mouse dendritic cells (DCs) from different tissues and mouse macrophages from the lungs and then cultured mouse B cells together with either DCs or macrophages in vitro. In the mouse lung-DC/B (LDC/B) cell coculture, IgA secretion was increased significantly after the addition of whole-cell lysates of M. hyopneumoniae. The expression of both Toll-like receptor 2 (TLR2) and TLR4 was also upregulated, as determined by mRNA and protein expression analyses, whereas no obvious change in the expression of TLR3 and TLR7 was detected. Moreover, the IgA level decreased to the same as the control group when TLR2 or TLR4 was inhibited instead of TLR8 or TLR7/9. In conclusion, M. hyopneumoniae can stimulate the response of IgA through TLR2 and TLR4 in a mouse LDC/B cell coculture model, and the coculture model is an ideal tool for studying the IgA response mechanism, particularly that with Mycoplasma spp.
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High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia. BMC Infect Dis 2019; 19:1045. [PMID: 31823740 PMCID: PMC6905005 DOI: 10.1186/s12879-019-4667-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/29/2019] [Indexed: 12/26/2022] Open
Abstract
Background An increased number of refractory mycoplasma pneumoniae (MP) pneumonia (MPP) cases have been reported. However the duration of MP infection in lower airway and the course of anti-MP treatment remains unclear. Methods We retrospectively reviewed the medical records of 94 MPP children. Patients were classified into two groups. The long-term group (Group LT) was defined as bronchoalveolar lavage fluid (BALF) remained MP-positive by PCR after 30 days of the disease course. The non-long-term group (Group NLT) was defined as BALF became MP-negative by PCR within 30 days of disease and patients who only needed one bronchoscopy lavage therapy. MP loads, clinical outcomes were analyzed along with other clinical measurements. Results The average levels of inflammatory markers such as C reactive protein and lactate dehydrogenase in Group LT were significantly higher than those in Group NLT. Airway and lung damage in Group LT were more severe than Group NLT. 28 patients developed necrotizing pneumonia and 8 patients developed pulmonary embolism in Group LT. Mean maximum MP loads in BALF were 107.46 ± 0.93 and 104.86 ± 0.93 in Groups LT and NLT, respectively. There was persistent MP DNA in Group LT, even lasted for 120 days. One severe MPP patient in Group LT had MP-associated bloodstream infection. After 3 months of follow-up, chest imaging revealed incomplete absorption of pulmonary consolidation in 33 patients of Group LT [including 13 airway obliterans (AO) patients] and in 7 patients of Group NLT (including 2 AO patients). Conclusion MP loads of BALF were associated with the subsequent duration of MP DNA in lower airway. High MP loads and persistent long-term MP DNA in lower airway were associated with severity of pediatric MPP.
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Antibodies to Protein but Not Glycolipid Structures Are Important for Host Defense against Mycoplasma pneumoniae. Infect Immun 2019; 87:IAI.00663-18. [PMID: 30396892 DOI: 10.1128/iai.00663-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/28/2018] [Indexed: 11/20/2022] Open
Abstract
Antibody responses to Mycoplasma pneumoniae correlate with pulmonary M. pneumoniae clearance. However, M. pneumoniae-specific IgG antibodies can cross-react with the myelin glycolipid galactocerebroside (GalC) and cause neurological disorders. We assessed whether antiglycolipid antibody formation is part of the physiological immune response to M. pneumoniae We show that antibodies against M. pneumoniae proteins and glycolipids arise in serum of M. pneumoniae-infected children and mice. Although antibodies to M. pneumoniae glycolipids were mainly IgG, anti-GalC antibodies were only IgM. B-1a cells, shown to aid in protection against pathogen-derived glycolipids, are lacking in Bruton tyrosine kinase (Btk)-deficient mice. M. pneumoniae-infected Btk-deficient mice developed M. pneumoniae-specific IgG responses to M. pneumoniae proteins but not to M. pneumoniae glycolipids, including GalC. The equal recovery from M. pneumoniae infection in Btk-deficient and wild-type mice suggests that pulmonary M. pneumoniae clearance is predominantly mediated by IgG reactive with M. pneumoniae proteins and that M. pneumoniae glycolipid-specific IgG or IgM is not essential. These data will guide the development of M. pneumoniae-targeting vaccines that avoid the induction of neurotoxic antibodies.
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Dai W, Wang H, Zhou Q, Feng X, Lu Z, Li D, Yang Z, Liu Y, Li Y, Xie G, Shen K, Yang Y, Zheng Y, Li S. The concordance between upper and lower respiratory microbiota in children with Mycoplasma pneumoniae pneumonia. Emerg Microbes Infect 2018; 7:92. [PMID: 29789582 PMCID: PMC5964150 DOI: 10.1038/s41426-018-0097-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/12/2022]
Abstract
In recent years, the morbidity of Mycoplasma pneumoniae pneumonia (MPP) has dramatically increased in China. An increasing number of studies indicate that an imbalance in the respiratory microbiota is associated with respiratory infection. We selected 28 hospitalized patients infected with M. pneumoniae and 32 healthy children. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from healthy children, whereas NP, OP and bronchoalveolar lavage (BAL) specimens were collected from patients. Microbiota analysis was performed on all microbial samples using 16 S ribosomal RNA (16 S rRNA) sequencing. The NP microbial samples in healthy children were divided into two groups, which were dominated by either Staphylococcus or mixed microbial components. The respiratory microbiota in pneumonia patients harbored a lower microbial diversity compared to healthy children, and both the NP and OP microbiota of patients differed significantly from that of healthy children. Hospitalized MPP children with a higher abundance of Mycoplasma in the BAL fluid (BALF) microbiota tended to suffer longer hospitalization lengths and higher peak fevers and serum C-reactive protein levels. Concordance analysis explained the succession of imbalanced NP microbiota to the OP and lung in diseased children. However, the association of the abundance of Mycoplasma in BALF microbiota with that in NP or OP microbiota varied among individuals, which suggested the sensitivity of BALF in MPP diagnostics, mirroring MPP severity.
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Affiliation(s)
- Wenkui Dai
- Department of Computer Science, City University of Hong Kong, 999077, Hong Kong, China
| | - Heping Wang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, No. 7019, Yitian Road, 518026, Futian District, Shenzhen, China
| | - Qian Zhou
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China
| | - Xin Feng
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China
| | - Zhiwei Lu
- Department of Respiratory Diseases, Shenzhen Children's Hospital, No. 7019, Yitian Road, 518026, Futian District, Shenzhen, China
| | - Dongfang Li
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China.,Institute of Statistics, NanKai University, No. 94 Weijin Road, 300071, Tianjin, China
| | - Zhenyu Yang
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China
| | - Yanhong Liu
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China
| | - Yinhu Li
- Department of Microbial Research, WeHealthGene Institute, 3C19, No. 19 Building, 518000, Dayun Software Town, Shenzhen, China
| | - Gan Xie
- Department of Respiratory Diseases, Shenzhen Children's Hospital, No. 7019, Yitian Road, 518026, Futian District, Shenzhen, China
| | - Kunling Shen
- Department of Respiratory Diseases, Beijing Children's Hospital, 100045, Beijing, China
| | - Yonghong Yang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, No. 7019, Yitian Road, 518026, Futian District, Shenzhen, China
| | - Yuejie Zheng
- Department of Respiratory Diseases, Shenzhen Children's Hospital, No. 7019, Yitian Road, 518026, Futian District, Shenzhen, China.
| | - Shuaicheng Li
- Department of Computer Science, City University of Hong Kong, 999077, Hong Kong, China.
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