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Ma K, Liu X, Wu XT, Wang TJ, Li KL, Wang DB, Li SJ. The correlation between the level of cellular classification in bronchoalveolar lavage fluid of children with severe Mycoplasma pneumoniae and clinical characteristics. Eur J Pediatr 2024:10.1007/s00431-024-05700-6. [PMID: 39093423 DOI: 10.1007/s00431-024-05700-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024]
Abstract
Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory tract infection disease in children. To date, there have been few studies on the relationship between cytological changes in bronchoalveolar lavage fluid (BALF) and clinical features. The objective of this study is to investigate the correlation between changes in the proportion of cell classifications in BALF and the clinical features in children with severe MPP (SMPP). In total, the study included 64 children with SMPP requiring bronchoalveolar lavage who were admitted to our hospital between March and September 2022 (study group) and 11 children with bronchial foreign bodies without co-infection (control group), who were admitted during the same period. The proportion of cell classifications in BALF was determined by microscopic examination after performing Wright-Giemsa staining. Patients were grouped according to different clinical characteristics, and between-group comparisons were made regarding the variations in the proportion of cell classifications in BALF. The levels of blood routine neutrophil percentage (GRA%), C-reactive protein, D-dimer and lactate dehydrogenase in the study group were higher than those in the control group (P < 0.05). There were differences in the GRA% and macrophage percentage in the BALF between the two groups (P < 0.05). The GRA% and blood lymphocyte percentage were associated with pleural effusion. Multiple indicators correlated with extrapulmonary manifestations (P < 0.05). Moreover, the percentage of lymphocytes in the BALF correlated with pleural effusion, extrapulmonary manifestations and refractory MPP (RMPP) (P < 0.05). Logistic regression showed that BALF lymphocytes were protective factors for RMPP, while serum amyloid A and extrapulmonary manifestations were risk factors (P < 0.05). CONCLUSION The BALF of children with SMPP is predominantly neutrophilic. A lower percentage of lymphocytes is related to a higher incidence of pleural effusion, extrapulmonary manifestations and progression to RMPP, as well as a longer length of hospitalisation. WHAT IS KNOWN • Mycoplasma pneumonia in children is relatively common in clinical practice. Bronchoalveolar lavage (BAL) is a routine clinical procedure. WHAT IS NEW However, there are relatively few studies focusing on the cytomorphological analysis of cells in BAL fluid.
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Affiliation(s)
- Kun Ma
- Department of Pediatrics, People's Hospital of Zhecheng County, Shangqiu, 476200, China
| | - Xue Liu
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, 453100, Henan Province, China
| | - Xiang-Tao Wu
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, 453100, Henan Province, China
| | - Tuan-Jie Wang
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, 453100, Henan Province, China
| | - Kai-Li Li
- Department of Pediatrics, People's Hospital of Zhecheng County, Shangqiu, 476200, China
| | - Dao-Bin Wang
- Department of Pediatrics, People's Hospital of Zhecheng County, Shangqiu, 476200, China
| | - Shu-Jun Li
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, 453100, Henan Province, China.
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Yang S, Liu X, Wang H, Wang H, Sun D, Han Y, Li H, Li X. Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials. Front Pharmacol 2024; 15:1329516. [PMID: 38633618 PMCID: PMC11021718 DOI: 10.3389/fphar.2024.1329516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Objective: This study constitutes a pioneering systematic review and meta analysis delving into the clinical efficacy and safety of the combined therapy involving Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients. Methods: This study conducted a comprehensive computerized search, covering 6 Chinese databases and 6 English databases, to collect randomized controlled trials related to the combined use of Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients. The search was extended until August 2023. Two independent researchers were involved in literature screening, data extraction, and bias risk assessment. Meta-analysis was performed using Stata 14.0 and RevMan 5.4 software. Additionally, meta-regression analysis and subgroup analysis were carried out on primary outcomes to identify potential sources of heterogeneity and confounding factors. Results: A total of 22 randomized controlled trials involving 2,026 patients were included in this study. The combined therapy of Wuhu Decoction and azithromycin demonstrated superior efficacy compared to azithromycin alone (RR = 1.17, 95% CI [1.13, 1.21], p < 0.00001; low certainty of evidence). Additionally, patients receiving the combination therapy experienced significantly reduced the disappearance time of fever (MD = -1.42, 95% CI [-1.84, -1.00], p < 0.00001; very low certainty of evidence), disappearance time of cough (MD = -2.08, 95% CI [-2.44, -1.71], p < 0.00001; very low certainty of evidence), disappearance of pulmonary rales (MD = -1.97, 95% CI [-2.31, -1.63], p < 0.00001; very low certainty of evidence), and disappearance time of wheezing (MD = -1.47, 95% CI [-1.72, -1.22], p < 0.00001; very low certainty of evidence). Meta-regression analysis suggested that course of disease, sample size, and age might be sources of heterogeneity. Subgroup and sensitivity analyses reaffirmed the stability of these results. Furthermore, analyses of secondary outcomes such as T lymphocytes, serum inflammatory factors, and the incidence rate of adverse reactions consistently favored the combination therapy of WHD and azithromycin over azithromycin alone, with statistically significant differences. Conclusion: Based on our meta-analysis findings, the combined therapy of Wuhu Decoction and azithromycin for treating pediatric Mycoplasma pneumoniae pneumonia exhibited superior overall efficacy in comparison to azithromycin monotherapy. However, in the included 22 studies, the majority of evaluated factors showed unclear bias risks, and a persistent bias risk was consistently present within one category. Moreover, due to the low quality of evidence, interpreting these results should be approached with caution. Hence, we emphasize the necessity for future high-quality, multicenter, and large-sample clinical randomized controlled trials. These trials are essential to provide more robust data for evidence-based research and to establish higher-quality evidence support. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023465606.
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Affiliation(s)
- Shuo Yang
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xinying Liu
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Huizhe Wang
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Haokai Wang
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Dan Sun
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yaowei Han
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Huanmin Li
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xinmin Li
- Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Liu X, Zhang Q, Chen H, Hao Y, Zhang J, Zha S, Zhou B, Yi Y, Xiao R, Hu K. Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections. BMC Pulm Med 2024; 24:107. [PMID: 38439032 PMCID: PMC10910824 DOI: 10.1186/s12890-024-02922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae infections have increased in China recently, causing some evidence of familial clustering. The purpose of this study was to compare the clinical features of parents and children in cases of familial clustering of Mycoplasma pneumoniae infection. METHODS A retrospective analysis was performed on the cases of familial clustering of Mycoplasma pneumoniae infection, and the clinical characteristics of parents and children were compared. RESULTS We identified 63 families, of these, 57 (65.5%) adults and 65 (94.2%) children required hospitalization. Fifty-seven adults (mean age 35.1 ± 4.6 years, 80.7% female) and 55 children (mean age 6.3 ± 3.9 years, 54.5% female) were included in the analysis. The incidence of mycoplasma infection in adults had increased gradually over the past year, while the rate in children had spiked sharply since June 2023. The clinical symptoms were similar in the two groups, mainly fever and cough. The peak temperature of children was higher than that of adults (39.1 ± 0.7℃ vs 38.6 ± 0.7℃, p = 0.004). Elevated lactate dehydrogenase was more common in children than in adults (77.8% vs 11.3%, p < 0.001). Bronchial pneumonia and bilateral involvement were more common in children, while adults usually had unilateral involvement. Three (60%) adults and 21 (52.5%) children were macrolide-resistant Mycoplasma pneumoniae infected. Children were more likely to be co-infected (65.5% vs 22.8%, p < .001). Macrolides were used in most children and quinolones were used in most adults. Ten (18.2%) children were diagnosed with severe Mycoplasma pneumoniae pneumonia, whereas all adults had mild disease. Children had a significantly longer fever duration than adults ((5.6 ± 2.2) days vs (4.1 ± 2.2) days, p = 0.002). No patient required mechanical ventilation or died. CONCLUSIONS Mycoplasma pneumoniae infection shows a familial clustering epidemic trend at the turn of summer and autumn, with different clinical characteristics between parents and children.
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Affiliation(s)
- Xu Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yueying Hao
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingyi Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Shiqian Zha
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Beini Zhou
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yaohua Yi
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Rui Xiao
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Haseeb A, Elhusseiny AM, ElSheikh RH, Tahboub MA, Kwan JT, Saeed HN. Ocular involvement in Mycoplasma induced rash and mucositis: A systematic review of the literature. Ocul Surf 2023; 28:1-10. [PMID: 36396020 DOI: 10.1016/j.jtos.2022.11.007] [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: 10/08/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the setting of Mycoplasma infection. Though a clinically distinct disease, MIRM exists on a diagnostic continuum with entities including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and the recently described reactive infectious mucocutaneous eruption (RIME). In this systematic review, we discuss published findings on the epidemiology, clinical manifestations, diagnosis, and management of MIRM, with an emphasis on ocular disease. Lastly, we discuss some of the most recent developments and challenges in characterizing MIRM with respect to the related diagnosis of RIME.
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Affiliation(s)
- Abid Haseeb
- Department of Ophthalmology, Nazareth Hospital, Philadelphia, PA, USA; Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Reem H ElSheikh
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
| | - Mohammad A Tahboub
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - James T Kwan
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Hajirah N Saeed
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Loyola University Medical Center, Maywood, IL, USA.
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5
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Peng QY, Zhang L, Deng H, Ye YM, Huang RL, Liang YQ, Feng SS, Li J, Luo XQ, Peng YL. Poor accuracy of single serological IgM tests in children with suspected acute Mycoplasma pneumoniae infection in Guangzhou, China. J Med Microbiol 2023; 72. [PMID: 36920846 DOI: 10.1099/jmm.0.001673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Introduction. Early and accurate diagnosis of Mycoplasma pneumoniae (MP) infection of children with pneumonia is at the core of treatment in clinical practice.Gap Statement. Serological immunoglobulin M (IgM) tests for MP infection of children in south China have been rarely described.Aim. To assess the diagnostic performance and clinical application of serodiagnosis of MP infection in paediatric pneumonia patients.Methodology. Serum samples from 144 children diagnosed with MP pneumonia were subjected to a particle agglutination (PA)-based IgM assay. Meanwhile, we used an established suspension array as the reference standard method for the detection of MP DNA in bronchoalveolar lavage fluid (BALF) from all patients to assess the reliability of serological assays.Results. When running immunological testing in single serum samples, 80.6 %(79/98) of cases were diagnosed with MP infection, whereas only 55 (56.1 %) cases were positive in MP DNA analysis. Furthermore, single serum tests for IgM during acute MP infection resulted in 85.5 % (47/55) sensitivity and 25.6 % (11/43) specificity. Nevertheless, immunological testing and MP DNA analysis yielded the same results when paired sera were available for MP IgM antibody testing.Conclusion. Paired serological IgM assays are necessary for the determination of an acute MP infection, whereas single serological IgM testing is unreliable. Moreover, even a short interval of two MP serological tests works well.
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Affiliation(s)
- Qiu-Ying Peng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Liang Zhang
- Maternal and Child Health Research Institute, Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, 511400, PR China
| | - Hua Deng
- Maternal and Child Health Research Institute, Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, 511400, PR China
| | - Yu-Ming Ye
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Rui-Lin Huang
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Yao-Qiong Liang
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Su-Shi Feng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Juan Li
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Xue-Qun Luo
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Yan-Li Peng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
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Zhang Z, Dou H, Tu P, Shi D, Wei R, Wan R, Jia C, Ning L, Wang D, Li J, Dong Y, Xin D, Xu B. Serum cytokine profiling reveals different immune response patterns during general and severe Mycoplasma pneumoniae pneumonia. Front Immunol 2022; 13:1088725. [PMID: 36618370 PMCID: PMC9813340 DOI: 10.3389/fimmu.2022.1088725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Mycoplasma pneumoniae (MP) is an important human pathogen that mainly affects children causing general and severe Mycoplasma pneumoniae pneumonia (G/SMPP). In the present study, a comprehensive immune response data (33 cytokines) was obtained in school-age children (3-9 years old) during MPP, aiming to analyze the immune response patterns during MPP. At acute phase, changes of cytokines were both detected in GMPP (24/33) and SMPP (23/33) groups compared to the healthy group (p < 0.05), with 20 identical cytokines. Between MPP groups, the levels of 13 cytokines (IL-2, IL-10, IL-11, IL-12, IL-20, IL-28A, IL-32, IL-35, IFN-α2, IFN-γ, IFN-β, BAFF, and TSLP) were higher and three cytokines (LIGHT, OPN and CHI3L1) were lower in the SMPP group than in the GMPP group (p < 0.05). Function analysis reveals that macrophage function (sCD163, CHI3L1) are not activated in both MPP groups; difference in regulatory patterns of T cells (IL26, IL27, OPN, LIGHT) and defective activation of B cells (BAFF) were detected in the SMPP group compared to the GMPP group. Besides, the level of osteocalcin; sIL-6Rβ and MMP-2 are both decreased in MPP groups at acute and convalescent phases compared to the healthy group, among which the levels of sIL-6Rβ and MMP-2 showed negative correlations (p < 0.1) to the application of bronchial lavage in SMPP group, indicating their roles in the development of MPP. At the convalescent phase, more cytokines recovered in GMPP (18) than SMPP (11), revealing better controlled immune response during GMPP. These results reveal different immune response patterns during GMPP and SMPP. In addition, the differentiated cytokines may serve as potential indicators of SMPP; early intervention on immune response regulations may be helpful in reducing the severity of SMPP.
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Affiliation(s)
- Zhikun Zhang
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haiwei Dou
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Tu
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dawei Shi
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ran Wei
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China,Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Ruijie Wan
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chunmei Jia
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Lihua Ning
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Dongmei Wang
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Jing Li
- Department of Pediatric, Beijing Chang Ping District Hospital of Traditional Chinese Medicine and Western Medicine, Beijing, China
| | - Yan Dong
- Department of Pediatric, Beijing Chang Ping District Hospital of Traditional Chinese Medicine and Western Medicine, Beijing, China
| | - Deli Xin
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China,*Correspondence: Deli Xin, ; Baoping Xu,
| | - Baoping Xu
- Department of Respiratory, Beijing Children’s Hospital, Capital Medical University, Beijing, China,*Correspondence: Deli Xin, ; Baoping Xu,
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Yu H, Chen L, Yue CJ, Xu H, Cheng J, Cornett EM, Kaye AD, Urits I, Viswanath O, Liu H. Effects of propofol and sevoflurane on T-cell immune function and Th cell differentiation in children with SMPP undergoing fibreoptic bronchoscopy. Ann Med 2022; 54:2574-2580. [PMID: 36370066 PMCID: PMC9665898 DOI: 10.1080/07853890.2022.2121416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The potentially different effects of commonly used anaesthetic agents propofol and sevoflurane on T-cell immune function and Th cell differentiation were investigated in patients with severe mycoplasmal pneumonia (SMPP) undergoing fibreoptic bronchoscopy. METHODS Sixty children (2-12 years of age) with SMPP were randomized into the sevoflurane group and the propofol group. Patients in the sevoflurane group were anaesthetised with inhalational sevoflurane and intravenous remifentanil. Patients in the propofol group were anaesthetised with intravenous propofol and remifentanil. Patients in both groups underwent fibreoptic bronchoscopy and lavage therapy. We compared the clinical outcomes, cellular immunity function, and Th cell differentiation into Th1 and Th2 levels in both groups. RESULTS There was no significant difference in clinical outcomes and hospital stay between the two groups (7.94 vs 7.36, p > .05). However, the CD3+ T cells, CD4+ T cells, and CD4+/CD8+ in the propofol group were significantly higher than those in the sevoflurane group (T1 51.96 vs 48.33, T2 58.08 vs 55.31, p < .05). The ratio of Th1/Th2 in the two groups was significantly increased postoperatively in both groups (Sevoflurane 8.53 vs 7.23, Propofol 9.35 vs 7.18), and the propofol group was significantly higher than the sevoflurane group (9.35 vs 8.53, p < .05). CONCLUSIONS Propofol might have a less inhibitory effect on T lymphocytes in children with SMPP than sevoflurane. And propofol may have less impact on the differentiation of Th cells into Th1 cells and better preserving the Th1/Th2 ratio than sevoflurane. KEY MESSAGESThe pathogenesis of SMPP is still unclear, likely through alveolar infiltration with neutrophils and lymphocytes, lymphocyte/plasma cell infiltrates in the peri-bronchovascular area, and immune dysfunction.Recent experimental and clinical studies showed that sevoflurane might have immunosuppressive effects, and multiple studies confirmed that the immune function of children with SMPP had been reduced.This study found that propofol administered in children with SMPP had a less inhibitory effect on T lymphocytes than inhalational sevoflurane, had little inhibitory effect on the differentiation of Th cells into Th1 cells, and better preserve Th1/Th2 ratio and maintain the balanced immune function.
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Affiliation(s)
- Hui Yu
- Department of Anesthesiology, Hubei Women and Children's Hospital, Tongji Medical College, Huazhong University Science & Technology, Wuhan, Hubei, China
| | - Lin Chen
- Department of Anesthesiology, Hubei Women and Children's Hospital, Tongji Medical College, Huazhong University Science & Technology, Wuhan, Hubei, China
| | - Cheng-Jin Yue
- Department of Anesthesiology, Hubei Women and Children's Hospital, Tongji Medical College, Huazhong University Science & Technology, Wuhan, Hubei, China
| | - Heng Xu
- Department of Anesthesiology, Hubei Women and Children's Hospital, Tongji Medical College, Huazhong University Science & Technology, Wuhan, Hubei, China
| | - Jing Cheng
- Department of Anesthesiology, Hubei Women and Children's Hospital, Tongji Medical College, Huazhong University Science & Technology, Wuhan, Hubei, China
| | - Elyse M Cornett
- Departments of Anesthesiology and Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, Shreveport, LA, USA
| | - Alan D Kaye
- Departments of Anesthesiology and Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, Shreveport, LA, USA
| | - Ivan Urits
- Departments of Anesthesiology and Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, Shreveport, LA, USA.,Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA, USA
| | - Omar Viswanath
- Departments of Anesthesiology and Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, Shreveport, LA, USA.,University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.,Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA.,Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, USA
| | - Henry Liu
- Department of Anesthesiology & Perioperative Medicine, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
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Risk Factors for the Development of Post-Infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:pathogens11111268. [PMID: 36365019 PMCID: PMC9696236 DOI: 10.3390/pathogens11111268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Post-infectious bronchiolitis obliterans (PIBO), one of the major complications of respiratory tract infection, is commonly underdiagnosed. To identify the risk groups that may develop PIBO and avoid misdiagnoses, we investigated the risk factors associated with the development of PIBO. We searched PubMed, Embase, and MEDLINE databases for studies that included risk factors for the development of PIBO published from inception to 13 June 2022. We limited our search to studies that reported the estimates of odds ratio (OR), hazard ratio (HR), or relative risks for developing PIBO. A fixed-effect and a random-effect model were used. We included seven studies reporting data on the risk factors for PIBO in 344 children with PIBO and 1310 control children. Twenty-two variables, including sex, age, respiratory pathogens, symptoms, laboratory and radiologic findings, and mechanical ventilation, were mentioned in at least one study. The significant risk factors mentioned in two or more studies included elevated lactate dehydrogenase levels, pleural effusion, hypoxemia, sex, and mechanical ventilation. The significance of the duration of hospitalization and fever as risk factors for PIBO differed when the studies were classified according to the statistical method. In addition, the risk factors differed according to respiratory infection pathogens. This meta-analysis identified potential risk factors associated with the development of PIBO. The results of this study highlight the importance of avoiding misdiagnosis and help establish management strategies for patients at a high risk of developing PIBO.
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The Diagnostic Value of High-Resolution Computed Tomography Features Combined with Mycoplasma Pneumoniae Ribonucleic Acid Load Detection for Refractory Mycoplasma Pneumonia. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:6460865. [PMID: 35601566 PMCID: PMC9095367 DOI: 10.1155/2022/6460865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/24/2022]
Abstract
The aim of this study was to investigate the value of high-resolution computed tomography (CT) images and mycoplasma pneumoniae (MP) ribonucleic acid (RNA) load detection in the early diagnosis of refractory mycoplasma pneumoniae (RMP) and provide more methods for the diagnosis and treatment of RMP. Seventy children with MP were divided into the RMP group (H1 group, 31 cases) and the MP group (H2 group, 39 cases) according to pathological findings, and all of them underwent CT scanning. MP-RNA load and genotype distribution were analyzed in both groups, and the diagnostic efficacy of CT combined with MP-RNA load for RMP was calculated. The sensitivity of children in the H1 group to erythromycin (59.17% vs 71.56%) and clarithromycin (53.21% vs 67.03%) was lower than that in the H2 group, and the resistance rate of children in the H1 group to erythromycin (71.43% vs 67.53%) and clarithromycin (64.24% vs 50.37%) was higher than that in the H2 group (P < 0.05); the regression coefficients between lactate dehydrogenase (LDH) and the MPLI value of RMP were −0.064 and −0.413, respectively, which were significantly negatively correlated (P < 0.05); the accuracy (96.5%), sensitivity (92.5%), and specificity (88%) of CT + MP-RNA in the diagnosis of RMP were significantly higher than those of CT alone (91%, 88%, and 82%) and MP-RNA alone (88%, 84.5%, and 74%), which were significantly different (P < 0.05). The results of high MP-RNA load detection can be used as an indicator to predict RMP, and the diagnostic efficacy is significantly improved after combination with high-resolution CT, with high clinical application value.
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Dawood A, Algharib SA, Zhao G, Zhu T, Qi M, Delai K, Hao Z, Marawan MA, Shirani I, Guo A. Mycoplasmas as Host Pantropic and Specific Pathogens: Clinical Implications, Gene Transfer, Virulence Factors, and Future Perspectives. Front Cell Infect Microbiol 2022; 12:855731. [PMID: 35646746 PMCID: PMC9137434 DOI: 10.3389/fcimb.2022.855731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022] Open
Abstract
Mycoplasmas as economically important and pantropic pathogens can cause similar clinical diseases in different hosts by eluding host defense and establishing their niches despite their limited metabolic capacities. Besides, enormous undiscovered virulence has a fundamental role in the pathogenesis of pathogenic mycoplasmas. On the other hand, they are host-specific pathogens with some highly pathogenic members that can colonize a vast number of habitats. Reshuffling mycoplasmas genetic information and evolving rapidly is a way to avoid their host's immune system. However, currently, only a few control measures exist against some mycoplasmosis which are far from satisfaction. This review aimed to provide an updated insight into the state of mycoplasmas as pathogens by summarizing and analyzing the comprehensive progress, current challenge, and future perspectives of mycoplasmas. It covers clinical implications of mycoplasmas in humans and domestic and wild animals, virulence-related factors, the process of gene transfer and its crucial prospects, the current application and future perspectives of nanotechnology for diagnosing and curing mycoplasmosis, Mycoplasma vaccination, and protective immunity. Several questions remain unanswered and are recommended to pay close attention to. The findings would be helpful to develop new strategies for basic and applied research on mycoplasmas and facilitate the control of mycoplasmosis for humans and various species of animals.
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Affiliation(s)
- Ali Dawood
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
- Hubei Hongshan Laboratory, Wuhan, China
| | - Samah Attia Algharib
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, HZAU, Wuhan, China
- Department of Clinical Pathology, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Gang Zhao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Tingting Zhu
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Mingpu Qi
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Kong Delai
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhiyu Hao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Marawan A. Marawan
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Infectious Diseases, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Ihsanullah Shirani
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Para-Clinic Department, Faculty of Veterinary Medicine, Jalalabad, Afghanistan
| | - Aizhen Guo
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
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11
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Chen M, Deng H, Zhao Y, Miao X, Gu H, Bi Y, Zhu Y, Guo Y, Shi S, Xu J, Zhao D, Liu F. Toll-Like Receptor 2 Modulates Pulmonary Inflammation and TNF-α Release Mediated by Mycoplasma pneumoniae. Front Cell Infect Microbiol 2022; 12:824027. [PMID: 35372108 PMCID: PMC8968444 DOI: 10.3389/fcimb.2022.824027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the roles that Toll-like receptors (TLRs) play in lung inflammation mediated by Mycoplasma pneumoniae (MP). Methods The changes in TLRs and tumor necrosis factor alpha (TNF-α) in peripheral blood of children with M. pneumoniae pneumonia (MPP) were monitored, and the interactions of signaling molecules regulating TNF-α release in A549 cells and neutrophils after M. pneumoniae stimulation were investigated. In TLR2 knockout (TLR2-/-) mice, the levels of TNF-α in bronchial alveolar lavage fluid (BALF) and peripheral blood after mycoplasma infection and the pathological changes in the lung tissue of mice were detected. Results TNF-α levels in peripheral blood of children with MPP were higher than those in non-infected children, and children with refractory MPP had the highest levels of TNF-α and TLR2. TNF-α secretion and TLR2, myeloid differentiation primary response 88 (MyD88) and phospho-p65(p-p65) levels were increased in stimulated cells. TNF-α secretion was suppressed upon siRNA-mediated TLR2 silencing. Pharmacological inhibition of nuclear factor-kappa B (NF-κB) and MyD88 effectively reduced TNF-α expression. Compared with wild-type mice, the TNF-α in serum and BALF decreased, and lung pro-inflammatory response was partially suppressed in TLR2-/- mice. Conclusion We concluded that TLR2 regulates M. pneumoniae-mediated lung inflammation and TNF-α release through the TLR2-MyD88-NF-κB signaling pathway.
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Affiliation(s)
- Ming Chen
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Huan Deng
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Zhao
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xueqing Miao
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Haiyan Gu
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Bi
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yifan Zhu
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Guo
- Department of Respiratory Medicine, The Affiliated Wuxi Children’s Hospital of Nanjing Medical University, Wuxi, China
| | - Shuang Shi
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jiejing Xu
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Deyu Zhao
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Deyu Zhao, ; Feng Liu,
| | - Feng Liu
- Department of Respiratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Deyu Zhao, ; Feng Liu,
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12
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Kim CH, Lee J. Mycoplasma pneumoniae Pleural Effusion in Adults. J Clin Med 2022; 11:jcm11051281. [PMID: 35268372 PMCID: PMC8911427 DOI: 10.3390/jcm11051281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022] Open
Abstract
Parapneumonic effusions often complicate Mycoplasma pneumoniae (MP) pneumonia, contrary to the notion that they are a rare feature of MP infection. Increased research and evidence on MP parapneumonic effusions (MPPE) can help elucidate its clinical significance as one of the variable manifestations of MP infection. This article aims to summarize the existing literature about the clinical characteristics of MPPE in adults and discuss its diagnostic implications from the perspective of pleural fluid analysis. Approximately 20–25% of adult patients with MP pneumonia develop MPPE, and its frequency in children and adults seems to be similar. Although the pathogenesis of MPPE remains to be elucidated, MP-induced cell-mediated immune mechanisms might be partially associated with the development of MPPE. MPPE usually shows mononuclear leukocyte predominance with elevated adenosine deaminase (ADA) activity, similar to tuberculous pleural effusion (TPE). The degree of increase in pleural fluid ADA levels and serum inflammatory biomarkers may help differentiate between MPPE and TPE. During the acute phase, a single positive IgM and positive polymerase chain reaction results allow for a precise and reliable MP infection diagnosis. The mainstay of treatment is the selection of adequate anti-mycoplasma antibiotics with or without corticosteroid, based on the local epidemiologic data on macrolide resistance.
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Affiliation(s)
| | - Jaehee Lee
- Correspondence: ; Tel.: +82-53-200-5536; Fax: +82-53-426-2046
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13
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Chen X, Liu F, Zheng B, Kang X, Wang X, Mou W, Zhang H, Jiao A, Zhao S, Gui J. Exhausted and Apoptotic BALF T Cells in Proinflammatory Airway Milieu at Acute Phase of Severe Mycoplasma Pneumoniae Pneumonia in Children. Front Immunol 2022; 12:760488. [PMID: 35111152 PMCID: PMC8801936 DOI: 10.3389/fimmu.2021.760488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
Severe mycoplasma pneumoniae pneumonia (MPP) in children presents with serious clinical complications. Without proper and prompt intervention, it could lead to deadly consequences. Dynamics of the inflammatory airway milieu and activation status of immune cells were believed to be the hallmark of the pathogenesis and progress of the disease. In this study, by employing the T-cell sorting and mRNA microarray, we were able to define the main feature of the chemokine/cytokine expression and the unique characteristics of T cells in the bronchoalveolar lavage fluid (BALF) from severe MPP patients at acute phase. Our study for the first time delineated the molecular changes in isolated BALF T cells in severe MPP children with respect to the cytokine/chemokine expression, cell activation, exhaustion, and apoptosis. By comparing the BALF aqueous expression of cytokines/chemokines with that in sorted T cells, our data give a preliminary clue capable of finishing out the possible cell source of the proinflammatory cytokines/chemokines from the BALF mixture. Meanwhile, our data provide a distinctively pellucid expression profile particularly belonging to the isolated BALF T cells demonstrating that in the inflammatory airway, overactivated T cells were exhausted and on the verge of apoptotic progress.
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Affiliation(s)
- Xi Chen
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to the Capital Medical University, National Center for Children's Health, Beijing, China
| | - Fang Liu
- Department of Interventional Pulmonology, Beijing Children's Hospital affiliated to the Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Baoying Zheng
- Department of Pulmonology, The Children's Hospital Affiliated to the Capital Institute of Pediatrics, Beijing, China
| | - Xiaohui Kang
- Department of Pulmonology, The Children's Hospital Affiliated to the Capital Institute of Pediatrics, Beijing, China
| | - Xiaolin Wang
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to the Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wenjun Mou
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to the Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hui Zhang
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to the Capital Medical University, National Center for Children's Health, Beijing, China
| | - Anxia Jiao
- Department of Interventional Pulmonology, Beijing Children's Hospital affiliated to the Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Shunying Zhao
- Department of Respiratory Diseases, Beijing Children's Hospital affiliated to the Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Jingang Gui
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital affiliated to the Capital Medical University, National Center for Children's Health, Beijing, China
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14
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Fu YS, Duan XQ, Cheng KR, Yan-Yan-Fei, Liu L, Duan HD, Hu Q, Xia SL, Wang XR, Cheng ZF. Geraniol relieves mycoplasma pneumonia infection-induced lung injury in mice through the regulation of ERK/JNK and NF-κB signaling pathways. J Biochem Mol Toxicol 2022; 36:e22984. [PMID: 35038199 DOI: 10.1002/jbt.22984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/08/2021] [Accepted: 12/09/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Pneumonia is a serious pediatric lung injury disease caused by Mycoplasma pneumoniae (M. pneumoniae) with increasing global prevalence every year. The WHO has reported that nearly 19% of children die due to pneumonia worldwide. OBJECTIVE The present research was conducted to discover the ameliorative properties of geraniol against M. pneumoniae-provoked pneumonia in mice through the modulation of inflammatory responses. METHODOLOGY The pneumonia was provoked in the male Swiss albino mice via infecting animals with 100 µl of M. pneumoniae for 2 days and supplemented concurrently with 20 mg/kg of geraniol for 3 days. 100 mg/kg of azithromycin was used as a standard drug. The nitric oxide (NO) level and MPO activity were measured using kits. The SOD activity, GSH, and MDA levels were studied using standard methods. The polymerase chain reaction (PCR) study was performed to examine the M. pneumoniae DNA load. The inflammatory cytokines status was assessed by assay kits. The ERK1/2, JNK1/2, and NF-κB expressions were studied by reverse-transcription (RT-PCR). The lung tissues were analyzed microscopically to investigate the histological alterations. RESULTS Geraniol treatment effectively reduced lung weight, NO level, and MPO activity in the pneumonia mice. The total cells and M. pneumoniae DNA load were also decreased by the geraniol. The SOD activity and GSH level were improved and MDA was decreased by the geraniol treatment. The IL-1, IL-6, IL-8, TNF-α, and TGF status were appreciably depleted by the geraniol in the pneumonia mice. Geraniol also suppressed the ERK1/2 and NF-κB expressions in the lung tissues. Histological findings also suggest the therapeutic roles of geraniol against pneumonia in mice. CONCLUSION In summary, our results proved the beneficial roles of geraniol against the M. pneumoniae-provoked pneumonia. Geraniol could be a hopeful therapeutic agent to treat pneumonia in the future.
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Affiliation(s)
- Yang-Shan Fu
- Department of Emergency Medicine, Affiliated Hospital of Yunnan University, Kunming, China
| | - Xue-Qiong Duan
- Department of Emergency Medicine, Affiliated Hospital of Yunnan University, Kunming, China
| | - Ke-Run Cheng
- Department of Clinical Medicine, Sichuan University School of Clinical Medicine, Chengdu, China
| | - Yan-Yan-Fei
- Department of Radiation Oncology, The third affiliated hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, China
| | - Lin Liu
- Department of Emergency Medicine, Affiliated Hospital of Yunnan University, Kunming, China
| | - Hong-Dan Duan
- Department of Emergency Medicine, Affiliated Hospital of Yunnan University, Kunming, China
| | - Qin Hu
- Emergency Department, Kunming Second People's Hospital, Kunming, China
| | - Shuang-Li Xia
- Research centre of Pharmacology and Application of Traditional Chinese Medicine, School of Chinese Materia Medica, Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Xin-Ru Wang
- Research on the Prevention and Treatment of Emergency in the Department of Internal Medicine of Traditional Chinese Medicine, the First Clinical School of Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Zhong-Feng Cheng
- Department of Emergency Medicine, Affiliated Hospital of Yunnan University, Kunming, China
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Qiu J, Ge J, Cao L. D-dimer: The Risk Factor of Children's Severe Mycoplasma Pneumoniae Pneumonia. Front Pediatr 2022; 10:828437. [PMID: 35498793 PMCID: PMC9039299 DOI: 10.3389/fped.2022.828437] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Mycoplasma Pneumoniae (MP) is an important cause of community-acquired pneumonia in children, which can cause serious consequences. There has been some research into predicting Severe Mycoplasma Pneumoniae Pneumonia (SMPP) primarily focused on pre-treatment time by macrolide, pre-hospital course, CRP and LDH et.al. while seldom reporting on concoagulation status. We designed this retrospective study to compare the difference between SMPP and Non-severe MPP (NSMPP) with an attempt to find the risk factors, with a special focus on concoagulation status. METHOD We performed a retrospective study of 786 MPP patients who were hospitalized from January 1, 2016 to December 31, 2018, age ranging from 28 days to 18 years old. All patients were divided into SMPP group and NSMPP group. A univariate analysis was conducted between both groups. The factors with statistical differences were included in logistic regression analysis to summarize the predictors of SMPP. Next, the predictive value of each risk factor was calculated from the receiver operating characteristic curve (ROC curve). Patients who had D-dimer records were divided into the elevated D-dimer group (D-dimer > 308ug/L) and the control group (D-dimer ≤ 308ug/L), and the clinical manifestations were compared. RESULTS There was no significant difference in gender, age, pre-treatment time by macrolide, the white blood cell counts (WBC), Fibrinogen (FIB), Activated Partial Prothrombin Time (APTT), Prothrombin Time (PT) and Thrombin Time (TT) between SMPP and NSMPP. Compared with NSMPP, the pre-hospital course of SMPP was longer (P < 0.05), the neutrophil ratio (N%), platelet Count (PLT), C-reactive Protein (CRP), Lactate Dehydrogenase (LDH) and D-dimer were significantly higher (P < 0.01). The binary logistic regression analysis showed that the N%, PLT, CRP, LDH and D-dimer were the key predictors for SMPP, the N% > 67%, OR = 3.233, PLT > 445 × 109 /L, OR = 2.589, LDH > 354U/L, OR = 4.335 and D-dimer level > 403 ug/L, OR = 7.316. The D-dimer possessed the best predictive value. The incidence of complications such as pleural effusion, myocardial and liver damage of MPP was higher in the elevated D-dimer group than that in the control group (P < 0.05). CONCLUSION The N%, PLT, CRP, LDH and D-dimer were risk factors for SMPP. D-dimer was the best predictor among them. MPP patients with D-dimer > 308ug/L had more complications such as pleural effusion, myocardial and liver damage. More attention should be given in the treatment for this group.
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Affiliation(s)
- Juan Qiu
- Children's Hospital, Shandong University, Shandong, China.,Jinan Children's Hospital, Shandong, China.,Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Jin Ge
- Children's Hospital, Shandong University, Shandong, China
| | - Ling Cao
- Children's Hospital, Shandong University, Shandong, China
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16
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SARS-CoV-2, Zika viruses and mycoplasma: Structure, pathogenesis and some treatment options in these emerging viral and bacterial infectious diseases. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166264. [PMID: 34481867 PMCID: PMC8413106 DOI: 10.1016/j.bbadis.2021.166264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/22/2021] [Accepted: 08/30/2021] [Indexed: 01/28/2023]
Abstract
The molecular evolution of life on earth along with changing environmental, conditions has rendered mankind susceptible to endemic and pandemic emerging infectious diseases. The effects of certain systemic viral and bacterial infections on morbidity and mortality are considered as examples of recent emerging infections. Here we will focus on three examples of infections that are important in pregnancy and early childhood: SARS-CoV-2 virus, Zika virus, and Mycoplasma species. The basic structural characteristics of these infectious agents will be examined, along with their general pathogenic mechanisms. Coronavirus infections, such as caused by the SARS-CoV-2 virus, likely evolved from zoonotic bat viruses to infect humans and cause a pandemic that has been the biggest challenge for humanity since the Spanish Flu pandemic of the early 20th century. In contrast, Zika Virus infections represent an expanding infectious threat in the context of global climate change. The relationship of these infections to pregnancy, the vertical transmission and neurological sequels make these viruses highly relevant to the topics of this special issue. Finally, mycoplasmal infections have been present before mankind evolved, but they were rarely identified as human pathogens until recently, and they are now recognized as important coinfections that are able to modify the course and prognosis of various infectious diseases and other chronic illnesses. The infectious processes caused by these intracellular microorganisms are examined as well as some general aspects of their pathogeneses, clinical presentations, and diagnoses. We will finally consider examples of treatments that have been used to reduce morbidity and mortality of these infections and discuss briefly the current status of vaccines, in particular, against the SARS-CoV-2 virus. It is important to understand some of the basic features of these emerging infectious diseases and the pathogens involved in order to better appreciate the contributions of this special issue on how infectious diseases can affect human pregnancy, fetuses and neonates.
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Zhang Z, Wang H, Xie X, Chen R, Li J, Ni B, Yu P, Liu Z, Shao G, Xiong Q, Wei Y, Liu B, Feng Z, Zhou X, Zhang C. Long-Residence Pneumonia Vaccine Developed Using PEG-Grafted Hybrid Nanovesicles from Cell Membrane Fusion of Mycoplasma and IFN-γ-Primed Macrophages. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2101183. [PMID: 34270853 DOI: 10.1002/smll.202101183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/09/2021] [Indexed: 06/13/2023]
Abstract
CD8+ T cell responses play a critical regulatory role in protection against mycoplasma infection-related respiratory diseases. Nanovesicles derived from cell membranes have been shown to induce CD8+ T cell responses. Moreover, the short residence time of mycoplasma membrane-related vaccines in local lymph nodes limits the efficacy of current mycoplasma vaccines. Here, a long-residence pneumonia vaccine is developed using nanovesicles prepared by cell membrane fusion of Mycoplasma hyopneumoniae and interferon-γ (IFN-γ )-primed macrophages, which are grafted with polyethylene glycol to increase residence time in the lymph nodes. Upregulation of intercellular adhesion molecule-1 (ICAM-1) on the membrane of IFN-γ-primed macrophages increases the targeting of the hybrid nanovesicle vaccine to the local lymph nodes, with increased CD8+ T cell activation. A mechanistic study reveals that CD8+ T cell activation is achieved via a pathway involving upregulation of C-C motif chemokine ligand 2/3 expression by E26 transformation-specific sequences, followed by increased immune-stimulatory activity of dendritic cells. In vivo, prophylactic testing reveals that the hybrid nanovesicle vaccine triggers a long-term immune response, as evidenced by a memory CD8+ T cell response against mycoplasma infection. The current study provides a new design strategy for mycoplasma vaccines that involves a hybrid method using biological sources and artificial modification.
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Affiliation(s)
- Zhenzhen Zhang
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Haiyan Wang
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Xing Xie
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Rong Chen
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Jun Li
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Bo Ni
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Pei Yu
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 210009, China
| | - Zunfeng Liu
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Functional Polymer Materials, College of Pharmacy, Nankai University, Tianjin, 300071, China
| | - Guoqing Shao
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Qiyan Xiong
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Yanna Wei
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Beibei Liu
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Zhixin Feng
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China
| | - Xiang Zhou
- Department of Science, China Pharmaceutical University, Nanjing, 211198, China
| | - Chao Zhang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 210009, China
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18
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Zhang H, Li X, Wang J, Cheng Q, Shang Y, Wang G. Baicalin relieves Mycoplasma pneumoniae infection‑induced lung injury through regulating microRNA‑221 to inhibit the TLR4/NF‑κB signaling pathway. Mol Med Rep 2021; 24:571. [PMID: 34109422 PMCID: PMC8201456 DOI: 10.3892/mmr.2021.12210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
Mycoplasma pneumoniae (MP) is a common pathogen that can cause respiratory infections. MP pneumonia (MPP) leads to numerous complications, including lung injury and even death. The present study aimed to investigate the protective effects of Baicalin treatment on MP infection‑induced lung injury and the molecular mechanism underlying these effects. Briefly, after mice were infected intranasally by MP and treated with Baicalin (80 mg/kg), serum levels of MP‑immunoglobulin M (IgM) were detected by ELISA. The expression levels of C‑reactive protein (CRP) in lung tissue were detected by immunohistochemistry and the bronchoalveolar lavage fluid (BALF) was examined by ELISA. Inflammatory factors and inflammatory cells in the BALF were assessed. The expression levels of microRNA (miR)‑221 in lung tissue were examined by reverse transcription‑quantitative PCR and pathological changes in lung tissue were detected by H&E staining. Cell apoptosis was evaluated by TUNEL assay and the protein expression levels of TLR4, MyD88 and NF‑κB were detected by western blotting. Baicalin treatment significantly reduced serum levels of MP‑IgM and CRP expression in lung tissue during MP infection. In addition, Baicalin decreased the levels of IL‑1β, IL‑6, IL‑18 and TNF‑α in the BALF, and the number of inflammatory cells. Baicalin also reduced the inflammatory infiltration in lung tissue induced by MP infection, improved the pathological changes detected in lung tissue, reduced apoptosis, and downregulated the protein expression levels of TLR4, MyD88 and NF‑κB. Furthermore, Baicalin treatment downregulated the expression of miR‑221 and the protective effects of Baicalin were attenuated by miR‑221 overexpression. In conclusion, Baicalin has a therapeutic effect on mice with MP infection‑induced lung injury, which may be related to inhibition of miR‑221 expression and regulation of the TLR4/NF‑κB signaling pathway.
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Affiliation(s)
- Han Zhang
- Department of Paediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Xiang Li
- Department of Paediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Juan Wang
- Department of Paediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Qi Cheng
- Department of Paediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Yunxiao Shang
- Department of Paediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Guizhen Wang
- Department of Microbiology and Parasitology, China Medical University, Shenyang, Liaoning 110001, P.R. China
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Absence of Association between Previous Mycoplasma pneumoniae Infection and Subsequent Myasthenia Gravis: A Nationwide Population-Based Matched Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147677. [PMID: 34300128 PMCID: PMC8306290 DOI: 10.3390/ijerph18147677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 02/05/2023]
Abstract
Mycoplasma pneumoniae (M. pneumoniae) is not only one of the most common pathogenic bacteria for respiratory infection but also a trigger for many autoimmune diseases. Its infection process shared many similarities with the pathogenesis of myasthenia gravis (MG) at cellular and cytokine levels. Recent case reports demonstrated patients present with MG after M. pneumoniae infection. However, no epidemiological studies ever looked into the association between the two. Our study aimed to investigate the relationship between M. pneumoniae infection and subsequent development of MG. In this population-based retrospective cohort study, the risk of MG was analyzed in patients who were newly diagnosed with M. pneumoniae infection between 2000 and 2013. A total of 2428 M. pneumoniae patients were included and matched with the non-M. pneumoniae control cohort at a 1:4 ratio by age, sex, and index date. Cox proportional hazards regression analysis was applied to analyze the risk of MG development after adjusting for sex, age, and comorbidities, with hazard ratios and 95% confidence intervals. The incidence rates of MG in the non-M. pneumoniae and M. pneumoniae cohorts were 0.96 and 1.97 per 10,000 person-years, respectively. Another case-control study of patients with MG (n = 515) was conducted to analyze the impact of M. pneumoniae on MG occurrence as a sensitivity analysis. The analysis yielded consistent absence of a link between M. pneumoniae and MG. Although previous studies have reported that M. pneumoniae infection and MG may share associated immunologic pathways, we found no statistical significance between M. pneumoniae infection and subsequent development of MG in this study.
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20
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Shuanghuanglian oral preparations combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2021; 16:e0254405. [PMID: 34255785 PMCID: PMC8277054 DOI: 10.1371/journal.pone.0254405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
Background Mycoplasma pneumoniae is one of the main causes of community-acquired pneumonia. Due to the imperfect immune system of children, this also causes Mycoplasma pneumoniae pneumonia (MPP) to be more common in children. Globally, the incidence of MPP in children is gradually increasing. This study was the first to systematically review the clinical efficacy and safety of Shuanghuanglian (SHL) oral preparations combined with azithromycin in the treatment of MPP in children. Methods This study fully retrieved 3 Chinese databases and 5 English databases to search the randomized controlled trials (RCTs) of SHL oral preparations combined with azithromycin in the treatment of children with MPP. The search time is from the inception to September 2020. Data extraction and risk bias evaluation were performed independently by two researchers. We conducted a Meta-analysis of all the outcome indicators. Besides, Meta-regression, subgroup analysis, and heterogeneity analysis were used for the primary outcomes to find the possible potential confounding factors. Results Finally, we included 27 RCTs involving 2884 patients. SHL oral preparations combined with azithromycin were better than azithromycin alone in response rate (RR = 1.14, 95% CI[1.11, 1.18]; low certainty evidence), disappearance time of fever(MD = -1.72, 95% CI[-2.47, -0.97]; low certainty evidence), disappearance time of cough (MD = -2.95, 95% CI[-3.55, -2.34]; low certainty evidence), and disappearance time of pulmonary rales (MD = -2.13, 95% CI[-2.88, -1.38]; low certainty evidence). The Meta-regression results showed that the course of disease, age, and method of administration may be the source of heterogeneity. Subgroup analysis and sensitivity analysis have found that the results were stable. For other related clinical symptoms, T lymphocytes, and Serum inflammatory factors, SHL oral preparations combined with azithromycin was better than azithromycin alone, and the difference was statistically significant. For adverse events with low certainty evidence, safety needs further verification. Conclusion Based on the results of meta-analysis with low certainty evidence, we believed that SHL oral preparations combined with azithromycin likely be effectively improved clinical symptoms compared with azithromycin alone. Low certainty evidence showed that SHL may safety with no serious adverse events. Due to these limitations, the safety needs further verification. More high-quality, multicenter, and large-sample RCTs should be tested and verified in the future.
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21
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Mahmood M, Javaid A, Shahid F, Ashfaq UA. Rational design of multimeric based subunit vaccine against Mycoplasma pneumonia: Subtractive proteomics with immunoinformatics framework. INFECTION GENETICS AND EVOLUTION 2021; 91:104795. [PMID: 33667723 DOI: 10.1016/j.meegid.2021.104795] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/14/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023]
Abstract
Mycoplasma pneumoniae is the prevalent cause of acquired respiratory infections around the globe. A multi-epitope vaccine (MEV) must be developed to combat infections of M. pneumoniae because there is no specific disease-modifying treatment or vaccination is present. The objective of this research is to design a vaccine that targets M. pneumoniae top five highly antigenic proteins using a combination of immunological techniques and molecular docking. T-cell (HTL & CTL), B-cell, and IFN-γ of target proteins were forecasted and highly conservative epitopes were chosen for further study. For designing of final vaccine, 4LBL, 7CTL, and 5HTL epitopes were joined by linkers of KK, AAY, and GPGPG. The N-end of the vaccine was linked to an adjuvant (Cholera enterotoxin subunit B) with a linker named EAAAK to enhance immunogenicity. After the addition of adjuvants and linkers, the size of the construct was 395 amino acids. The epitopes of IFN-γ and B-cells illustrate that the model construct is optimized for cell-mediated immune or humoral responses. To ensure that the final design is safer and immunogenic, properties like non-allergens, antigenicity, and various physicochemical properties were evaluated. Molecular docking of the vaccine with the toll-like receptor 4 (TLR4) was conducted to check the compatibility of the vaccine with the receptor. Besides, in-silico cloning was utilized for validation of the credibility and proper expression of the vaccine. Furthermore, to confirm that the multi-epitope vaccine created is protective and immunogenic, this research requires experimental validation.
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Affiliation(s)
- Marvah Mahmood
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Anam Javaid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Farah Shahid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan.
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22
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Rodríguez F, Ramírez AS, Castro P, Poveda JB. Pathological and Immunohistochemical Studies of Experimental Mycoplasma pneumoniae in Gerbils (Meriones unguiculatus). J Comp Pathol 2021; 184:37-43. [PMID: 33894876 DOI: 10.1016/j.jcpa.2021.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/05/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
Mycoplasma pneumoniae (Mp) is a leading cause of human community-acquired pneumonia. To investigate the pathogenesis of the infection, 36 gerbils were intranasally inoculated with Mp culture (30 animals) or sterile mycoplasma broth (6 animals) and euthanized from 1 to 5 weeks post infection. A morphological and immunohistochemical study was carried out in all animals to determine the cellular populations present in lung parenchyma. Polyclonal and monoclonal antibodies were used to detect antigens of Mp and CD3, CD4, CD8 and CD79 lymphocytes, as well as cells containing S100 and major histocompatibility complex class II (MHC-II) antigens. There was progressive infiltration of mononuclear cells in the lamina propria of bronchi and bronchioles, and hyperplasia of the bronchus-associated lymphoid tissue (BALT) in the infected animals. BALT contained dendritic cells immunopositive to S100 and MHC-II and numerous CD3, CD4 and CD79 lymphocytes. The immunohistochemical results showed that T lymphocytes, particularly CD4 and CD79 cells, may play a role in the immune response of gerbils against Mp. This experimental model is valuable for investigation of the pathogenesis of Mp infection and may assist in the development of therapeutic strategies.
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Affiliation(s)
- Francisco Rodríguez
- Institute for Animal Health, Veterinary School, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain.
| | - Ana S Ramírez
- Institute for Animal Health, Veterinary School, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain
| | - Pedro Castro
- Institute for Animal Health, Veterinary School, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain
| | - José B Poveda
- Institute for Animal Health, Veterinary School, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain
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23
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Mycoplasma pneumoniae Infections: Pathogenesis and Vaccine Development. Pathogens 2021; 10:pathogens10020119. [PMID: 33503845 PMCID: PMC7911756 DOI: 10.3390/pathogens10020119] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 12/16/2022] Open
Abstract
Mycoplasma pneumoniae is a major causative agent of community-acquired pneumonia which can lead to both acute upper and lower respiratory tract inflammation, and extrapulmonary syndromes. Refractory pneumonia caused by M. pneumonia can be life-threatening, especially in infants and the elderly. Here, based on a comprehensive review of the scientific literature related to the respective area, we summarize the virulence factors of M. pneumoniae and the major pathogenic mechanisms mediated by the pathogen: adhesion to host cells, direct cytotoxicity against host cells, inflammatory response-induced immune injury, and immune evasion. The increasing rate of macrolide-resistant strains and the harmful side effects of other sensitive antibiotics (e.g., respiratory quinolones and tetracyclines) in young children make it difficult to treat, and increase the health risk or re-infections. Hence, there is an urgent need for development of an effective vaccine to prevent M. pneumoniae infections in children. Various types of M. pneumoniae vaccines have been reported, including whole-cell vaccines (inactivated and live-attenuated vaccines), subunit vaccines (involving M. pneumoniae protein P1, protein P30, protein P116 and CARDS toxin) and DNA vaccines. This narrative review summarizes the key pathogenic mechanisms underlying M. pneumoniae infection and highlights the relevant vaccines that have been developed and their reported effectiveness.
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24
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Wang J, Mao J, Chen G, Huang Y, Zhou J, Gao C, Jin D, Zhang C, Wen J, Sun J. Evaluation on blood coagulation and C-reactive protein level among children with mycoplasma pneumoniae pneumonia by different chest imaging findings. Medicine (Baltimore) 2021; 100:e23926. [PMID: 33545964 PMCID: PMC7837868 DOI: 10.1097/md.0000000000023926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 11/28/2020] [Indexed: 12/13/2022] Open
Abstract
Mycoplasma pneumoniae infection may induce a systemic hypercoagulable abnormality, like organ embolism and infarction. Indexes of blood coagulation and C-reactive protein (CRP) have been reported different between healthy people and mycoplasma pneumoniae pneumonia (MPP) patients, but this difference in MPP patients with different chest imaging findings has rarely been reported.We performed a retrospective study of 101 children with MPP and 119 controls, combined with radiological examination and blood tests, to compare the blood coagulation and CRP level among MPP children with different chest imaging findings.For the MPP children with different chest imaging findings, there were significant differences in CRP, fibrinogen (FIB) and D-dimer (D-D) levels among subgroups (P = .004, P = .008 and P < .001 respectively). The CRP level in group of interstitial pneumonia was significantly higher than that in groups of bronchopneumonia and hilar shadow thickening (P = .003 and P = .001 respectively). And the FIB and D-D values in group of lung consolidation were significantly higher than that in the other 3 groups (all P < .05). When compared with controls, the white blood cell, CRP, FIB, and D-D levels in MPP children were significantly higher, and the activated partial thromboplastin time and thrombin time levels were significantly lower (all P < .05).Our results showed that CRP level changed most significantly in group of interstitial pneumonia, whereas FIB, D-D levels changed most significantly in the lung consolidation group.
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Affiliation(s)
| | | | | | | | | | | | | | - Chenying Zhang
- Department of Respiratory, the First People's Hospital of Lianyungang, Lianyungang, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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Tamiya S, Yoshikawa E, Suzuki K, Yoshioka Y. Susceptibility Analysis in Several Mouse Strains Reveals Robust T-Cell Responses After Mycoplasma pneumoniae Infection in DBA/2 Mice. Front Cell Infect Microbiol 2021; 10:602453. [PMID: 33520736 PMCID: PMC7839406 DOI: 10.3389/fcimb.2020.602453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/27/2020] [Indexed: 02/03/2023] Open
Abstract
Mycoplasma pneumoniae (Mp) is a highly contagious respiratory pathogen responsible for human community-acquired pneumonia. The number of antibiotic-resistant Mp strains is increasing; therefore, to develop novel therapeutics, it is crucial to precisely understand the pathogenesis of mycoplasma pneumonia. Herein, we examined the susceptibility and response to Mp among eight inbred mouse strains. Following infection, the bacterial load in the bronchoalveolar lavage fluid (BALF) from DBA/2 mice was higher than that in the other tested strains such as BALB/c mice, which are frequently used in Mp research. In contrast, the numbers of CD45+ immune cells and neutrophils in BALF were comparable between BALB/c and DBA/2 mice, with lower numbers observed in C57BL/6J and CBA/N mice than in BALB/c mice. Among the tested strains, the BALF level of interleukin 12 subunit p40 was highest in DBA/2 mice; however, significant differences in other cytokines levels were not observed between BALB/c and DBA/2 mice. After Mp infection, Mp-specific Th1 and Th17 responses were significantly enhanced in DBA/2 mice when compared with BALB/c mice. Furthermore, prior infection with Mp increased the number of neutrophils in BALF after the reinfection of DBA/2 mice through an Mp-specific CD4+ T cell-dependent mechanism. Thus, DBA/2 may be an appropriate strain for evaluating Mp infection. Moreover, a comparison of responses revealed by various inbred mouse strains could be useful for elucidating the pathogenesis of Mycoplasma pneumonia.
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Affiliation(s)
- Shigeyuki Tamiya
- Laboratory of Nano-design for innovative drug development, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Eisuke Yoshikawa
- Laboratory of Nano-design for innovative drug development, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Koichiro Suzuki
- The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
| | - Yasuo Yoshioka
- Laboratory of Nano-design for innovative drug development, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan.,Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.,The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan.,Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan
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彭 力, 钟 礼, 黄 振, 黎 燕, 张 兵. [Clinical features of children with Mycoplasma pneumoniae pneumonia and peripheral lymphocytopenia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:74-77. [PMID: 33476541 PMCID: PMC7818155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 08/06/2024]
Abstract
OBJECTIVE To study the clinical features of children with Mycoplasma pneumoniae pneumonia (MPP) and peripheral lymphocytopenia. METHODS A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome. RESULTS Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and Mycoplasma pneumoniae DNA copies in bronchoalveolar lavage fluid (P < 0.05). Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly higher incidence rates of intrapulmonary consolidation, extrapulmonary complications, and serious lesions under bronchoscopy (erosion or sputum bolt) and a significantly higher proportion of patients with severe MPP (P < 0.05). CONCLUSIONS Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.
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Affiliation(s)
- 力 彭
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 礼立 钟
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 振 黄
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 燕 黎
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 兵 张
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
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27
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彭 力, 钟 礼, 黄 振, 黎 燕, 张 兵. [Clinical features of children with Mycoplasma pneumoniae pneumonia and peripheral lymphocytopenia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:74-77. [PMID: 33476541 PMCID: PMC7818155 DOI: 10.7499/j.issn.1008-8830.2009012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the clinical features of children with Mycoplasma pneumoniae pneumonia (MPP) and peripheral lymphocytopenia. METHODS A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome. RESULTS Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and Mycoplasma pneumoniae DNA copies in bronchoalveolar lavage fluid (P < 0.05). Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly higher incidence rates of intrapulmonary consolidation, extrapulmonary complications, and serious lesions under bronchoscopy (erosion or sputum bolt) and a significantly higher proportion of patients with severe MPP (P < 0.05). CONCLUSIONS Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.
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Affiliation(s)
- 力 彭
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 礼立 钟
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 振 黄
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 燕 黎
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 兵 张
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
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Abstract
The major pathogens that cause atypical pneumonia are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Community-acquired pneumonia (CAP) caused by M. pneumoniae or C. pneumoniae is common in children and presents as a relatively mild and self-limiting disease. CAP due to L. pneumophila is very rare in children and progresses rapidly, with fatal outcomes if not treated early. M. pneumoniae, C. pneumoniae, and L. pneumophila have no cell walls; therefore, they do not respond to β-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant M. pneumoniae that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant M. pneumoniae pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without M. pneumoniae epidemics, may not provide additional benefits over β-lactam monotherapy and can increase the risk of MRMP.
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Affiliation(s)
- Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University of Medicine, Seoul, Korea
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29
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Sakuma A, Sugawara S, Hidaka H, Nakajo M, Suda Y, Shimazu T, Rose MT, Urakawa M, Zhuang T, Zhao G, Watanabe K, Nochi T, Kitazawa H, Katoh K, Suzuki K, Aso H. IL-12p40 gene expression in lung and hilar lymph nodes of MPS-resistant pigs. Anim Sci J 2020; 91:e13450. [PMID: 32881233 DOI: 10.1111/asj.13450] [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: 05/08/2020] [Revised: 07/06/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Abstract
Mycoplasma pneumonia of swine (MPS) is caused by Mycoplasma hyopneumoniae (M.hp) and is a common chronic respiratory disease of pigs. Recently, a genetically selected variant of the Landrace pig (Miyagino L2) has a lower incidence of pulmonary MPS lesions. We investigated the pathological and immunological characteristics of MPS resistance in these pigs (n = 24) by comparing with the normal landrace pig (control: n = 24). The pathological MPS lung lesion score in MPS-selected landrace pigs was significantly lower than in the control. The gene expression of interleukin (IL)-12p40, which acts as a chemoattractant and a component of the bioactive cytokines IL-12 and IL-23, was significantly higher at the hilar lymph nodes, lung, and spleen in MPS-selected landrace pigs than in control landrace pigs, and these were negatively correlated with the macroscopic MPS lung lesion score. In summary, we demonstrate that resistance against MPS in Miyagino L2 pigs is associated with IL-12p40 up-regulation, in comparison with normal landrace pigs without the MPS vaccine. In addition, a comparative study of macroscopic MPS lung lesions and IL-12p40 gene expression in lung and hilar lymph nodes may lead to beneficial selection traits for the genetic selection for MPS resistance in pigs.
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Affiliation(s)
- Akiko Sakuma
- Miyagi Livestock Experimental Station, Osaki, Japan.,Miyagi Prefectural Sendai Livestock Hygiene Service Center, Sendai, Japan.,International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Shizuka Sugawara
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Hikaru Hidaka
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | | | - Yoshihito Suda
- Department of Food, Agriculture and Environment, Miyagi University, Sendai, Japan
| | - Tomoyuki Shimazu
- Department of Food, Agriculture and Environment, Miyagi University, Sendai, Japan
| | - Michael T Rose
- Tasmanian Institute of Agriculture, University of Tasmania, Sandy Bay, TAS, Australia
| | - Megumi Urakawa
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Tao Zhuang
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Guoqi Zhao
- Institute of Animal Culture Collection and Application, College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Kouichi Watanabe
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Tomonori Nochi
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Haruki Kitazawa
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Kazuo Katoh
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Keiichi Suzuki
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Hisashi Aso
- International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai, Japan.,Laboratory of Animal Health Science, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
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Interleukin-17 mediates lung injury by promoting neutrophil accumulation during the development of contagious caprine pleuropneumonia. Vet Microbiol 2020; 243:108651. [PMID: 32273025 DOI: 10.1016/j.vetmic.2020.108651] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/05/2020] [Accepted: 03/17/2020] [Indexed: 02/07/2023]
Abstract
Contagious caprine pleuropneumonia (CCPP) is a highly contagious infectious disease of goats caused by Mycoplasma capricolum subspecies capripneumoniae (Mccp). CCPP outbreaks usually result in high morbidity and mortality of the affected goats, making this disease a major cause of economic losses to goat producers globally. However, the pathogenesis of CCPP remains unclear. Here, we show that IL-17-driven neutrophil accumulation is involved in the lung damage in CCPP goats. During CCPP development, intense inflammatory infiltrates could be observed in the injured lungs. Specifically, neutrophils were observed to be present within the alveoli. Increased IL-17 release drove the excessive influx of neutrophils into the lung, as IL-17 effectively stimulated the production of neutrophil chemoattractants from lung epithelial cells following Mccp infection. Our data highlight a critical role of IL-17-driven neutrophil accumulation in the pathogenesis of CCPP and suggest that IL-17 may potentially be a useful immunotherapeutic target for the treatment of CCPP.
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31
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Mi YM, Qi Q, Zhang L, Wang XF, Chen ZM, Hua CZ. Assessment of serum sialic acid correlated with C3 in children with Mycoplasma pneumoniae pneumonia. J Clin Lab Anal 2020; 34:e23078. [PMID: 31907994 PMCID: PMC7083476 DOI: 10.1002/jcla.23078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/23/2019] [Accepted: 07/14/2019] [Indexed: 11/25/2022] Open
Abstract
Background Different from the diagnosis of bacterial infections, Mycoplasma pneumoniae pneumonia (MPP) is still lacking of convenient non‐specific laboratory parameters. Method A total of 125 children with MPP were included in the MPP group and 89 children with Mycoplasma‐negative pneumonia were included in the control group, and the sera were collected from the children at both the acute and recovery stages in the two groups. Results The sialic acid and C3 in the MPP group were significantly higher than those in the control group both at the acute and at the recovery stage. On the other hand, the sialic acid and C3 at the acute stage were significantly higher than those at the recovery stage in the MPP group. However, in the control group, the sialic acid and C3 demonstrated IgG exhibited no significant change between the acute stage and the recovery stage. Lastly, positive correlations between sialic acid level and C3 level were identified in the MPP group at both acute and recovery stages. Conclusion Our study demonstrated that the serum sialic acid correlated with C3 specifically increased in children with MPP, indicating that it might be the important non‐specific parameters in the diagnosis of MPP.
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Affiliation(s)
- Yu-Mei Mi
- Division of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Qi Qi
- Department of Infectious Disease, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Li Zhang
- Division of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Xiao-Fang Wang
- Department of Pediatrics, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Zhi-Min Chen
- Division of Respiration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chun-Zhen Hua
- Division of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Zhang L, Wang L, Xu S, Li H, Chu C, Liu Q, Zhou J, Zhang W, Huang L. Low-Dose Corticosteroid Treatment in Children With Mycoplasma pneumoniae Pneumonia: A Retrospective Cohort Study. Front Pediatr 2020; 8:566371. [PMID: 33330269 PMCID: PMC7720903 DOI: 10.3389/fped.2020.566371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022] Open
Abstract
Background: The clinical value of corticosteroid treatment in Mycoplasma pneumoniae pneumonia (MPP) has been controversial. Our study aimed to identify the effects of low-dose corticosteroids on the recovery of children with MPP. Methods: In this retrospective cohort study, pediatric inpatients with MPP were included from the Shanghai Children's Mycoplasma pneumoniae pneumonia cohort study between August 2014 and July 2019. The multivariable logistic regression and propensity-score matching were used to investigate the effects of low-dose corticosteroid treatment on fever duration after admission, total fever duration, length of hospital stay, C-reactive protein recovery time, and imaging recovery time with the stratification of severe pneumonia, refractory pneumonia, inflammatory biomarkers, pulmonary images, and timing of corticosteroids. Results: There were 548 patients in the corticosteroid group and 337 in the no-corticosteroid group. The corticosteroid group showed severe clinical parameters such as more severe and refractory cases, higher laboratory values, and more abnormal imaging manifestations. The corticosteroid group also showed longer fever duration after admission [odds ratio (OR) = 1.9 (95% CI, 1.2-3.1), P = 0.008], longer total fever duration [OR = 1.6 (95% CI, 1.1-2.3), P = 0.011], longer hospital stay [OR = 2.8 (95% CI, 1.9-4.0), P < 0.001], and longer C-reactive protein (CRP) recovery time [OR = 2.1 (95% CI, 1.1-3.9), P = 0.021] in the regression model after the adjustment for severity. Although low-dose corticosteroids were associated with shortened imaging recovery time in patients with high level laboratory values, pulmonary imaging could be completely recovered in both groups. The trend of these results was consistent even after stratifications and a propensity scores matching analysis. Conclusions: Low-dose corticosteroids may not be beneficial in children inpatients with MPP, and further studies on proper treatment modality are needed in the MRMP era.
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Affiliation(s)
- Liya Zhang
- Pediatric Infectious Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijun Wang
- Pediatric Infectious Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanshan Xu
- Pediatric Infectious Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huajun Li
- Pediatric Infectious Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caiting Chu
- Radiological Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanhua Liu
- Pediatric Respiratory Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Zhou
- Department of Pharmacy, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Lisu Huang
- Pediatric Infectious Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Dai W, Wang H, Zhou Q, Li D, Feng X, Yang Z, Wang W, Qiu C, Lu Z, Xu X, Lyu M, Xie G, Li Y, Bao Y, Liu Y, Shen K, Yao K, Feng X, Yang Y, Zhou K, Li S, Zheng Y. An integrated respiratory microbial gene catalogue to better understand the microbial aetiology of Mycoplasma pneumoniae pneumonia. Gigascience 2019; 8:giz093. [PMID: 31367746 PMCID: PMC6669060 DOI: 10.1093/gigascience/giz093] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/31/2019] [Accepted: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The imbalanced respiratory microbiota observed in pneumonia causes high morbidity and mortality in childhood. Respiratory metagenomic analysis demands a comprehensive microbial gene catalogue, which will significantly advance our understanding of host-microorganism interactions. RESULTS We collected 334 respiratory microbial samples from 171 healthy children and 76 children with pneumonia. The respiratory microbial gene catalogue we established comprised 2.25 million non-redundant microbial genes, covering 90.52% of prevalent genes. The major oropharyngeal microbial species found in healthy children were Prevotella and Streptococcus. In children with Mycoplasma pneumoniae pneumonia (MPP), oropharyngeal microbial diversity and associated gene numbers decreased compared with those of healthy children. The concurrence network of oropharyngeal microorganisms in patients predominantly featured Staphylococcus spp. and M. pneumoniae. Functional orthologues, which are associated with the metabolism of various lipids, membrane transport, and signal transduction, accumulated in the oropharyngeal microbiome of children with pneumonia. Several antibiotic resistance genes and virulence factor genes were identified in the genomes of M. pneumoniae and 13 other microorganisms reconstructed via metagenomic data. Although the common macrolide/β-lactam resistance genes were not identified in the assembled M. pneumoniae genome, a single-nucleotide polymorphism (A2063G) related to macrolide resistance was identified in a 23S ribosomal RNA gene. CONCLUSIONS The results of this study will facilitate exploration of unknown microbial components and host-microorganism interactions in studies of the respiratory microbiome. They will also yield further insights into the microbial aetiology of MPP.
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Affiliation(s)
- Wenkui Dai
- Department of Computer Science, City University of Hong Kong, Hong Kong 999077, China
| | - Heping Wang
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
| | - Qian Zhou
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Dongfang Li
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, No. 1037 Luoyu Road, Wuhan 430074, China
| | - Xin Feng
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Zhenyu Yang
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Wenjian Wang
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
| | - Chuangzhao Qiu
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Zhiwei Lu
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
| | - Ximing Xu
- Institute of Statistics, Nankai University, No. 94 Weijin Road, Tianjin 300071, China
| | - Mengxuan Lyu
- Department of Computer Science, City University of Hong Kong, Hong Kong 999077, China
| | - Gan Xie
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
| | - Yinhu Li
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Yanmin Bao
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
| | - Yanhong Liu
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
| | - Kunling Shen
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
- Department of Respiratory Diseases, Beijing Children's Hospital, Beijing 100045, China
| | - Kaihu Yao
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
- Department of Respiratory Diseases, Beijing Children's Hospital, Beijing 100045, China
| | - Xikang Feng
- Department of Computer Science, City University of Hong Kong, Hong Kong 999077, China
| | - Yonghong Yang
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
- Department of Microbial Research, WeHealthGene Institute, Shenzhen 518000, China
- Department of Respiratory Diseases, Beijing Children's Hospital, Beijing 100045, China
| | - Ke Zhou
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, No. 1037 Luoyu Road, Wuhan 430074, China
| | - Shuaicheng Li
- Department of Computer Science, City University of Hong Kong, Hong Kong 999077, China
| | - Yuejie Zheng
- Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen 518026, China
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Vilela Rodrigues TC, Jaiswal AK, de Sarom A, de Castro Oliveira L, Freire Oliveira CJ, Ghosh P, Tiwari S, Miranda FM, de Jesus Benevides L, Ariston de Carvalho Azevedo V, de Castro Soares S. Reverse vaccinology and subtractive genomics reveal new therapeutic targets against Mycoplasma pneumoniae: a causative agent of pneumonia. ROYAL SOCIETY OPEN SCIENCE 2019; 6:190907. [PMID: 31417766 PMCID: PMC6689572 DOI: 10.1098/rsos.190907] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/04/2019] [Indexed: 05/03/2023]
Abstract
Pneumonia is an infectious disease caused by bacteria, viruses or fungi that results in millions of deaths globally. Despite the existence of prophylactic methods against some of the major pathogens of the disease, there is no efficient prophylaxis against atypical agents such as Mycoplasma pneumoniae, a bacterium associated with cases of community-acquired pneumonia. Because of the morphological peculiarity of M. pneumoniae, which leads to an increased resistance to antibiotics, studies that prospectively investigate the development of vaccines and drug targets appear to be one of the best ways forward. Hence, in this paper, bioinformatics tools were used for vaccine and pharmacological prediction. We conducted comparative genomic analysis on the genomes of 88 M. pneumoniae strains, as opposed to a reverse vaccinology analysis, in relation to the capacity of M. pneumoniae proteins to bind to the major histocompatibility complex, revealing seven targets with immunogenic potential. Predictive cytoplasmic proteins were tested as potential drug targets by studying their structures in relation to other proteins, metabolic pathways and molecular anchorage, which identified five possible drug targets. These findings are a valuable addition to the development of vaccines and the selection of new in vivo drug targets that may contribute to further elucidating the molecular basis of M. pneumoniae-host interactions.
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Affiliation(s)
| | - Arun Kumar Jaiswal
- Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Minas Gerais, Brazil
- Department of Genetics, Ecology and Evolution, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Alissa de Sarom
- Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Minas Gerais, Brazil
| | - Letícia de Castro Oliveira
- Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Minas Gerais, Brazil
- Department of Genetics, Ecology and Evolution, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Carlo José Freire Oliveira
- Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Minas Gerais, Brazil
| | - Preetam Ghosh
- Department of Computer Science, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sandeep Tiwari
- Department of Genetics, Ecology and Evolution, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Fábio Malcher Miranda
- Department of Genetics, Ecology and Evolution, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Leandro de Jesus Benevides
- Bioinformatics Laboratory - LABINFO, National Laboratory of Scientific Computation - LNCC/MCTI, Rio de Janeiro, Brazil
| | | | - Siomar de Castro Soares
- Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Minas Gerais, Brazil
- Author for correspondence: Siomar de Castro Soares e-mail:
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Li N, Mu YP, Chen J, Li B. [Value of absolute counts of lymphocyte subsets in the early prediction of refractory Mycoplasma pneumoniae pneumonia in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:511-516. [PMID: 31208501 PMCID: PMC7389588 DOI: 10.7499/j.issn.1008-8830.2019.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/19/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To study the value of absolute counts of lymphocyte subsets in the early prediction of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. METHODS A retrospective analysis was performed for the clinical data of 244 children with Mycoplasma pneumoniae pneumonia (MPP). Among these children, 166 had MPP, and 58 had RMPP. The two groups were compared in terms of clinical features and laboratory markers such as lymphocyte subsets, lactate dehydrogenase, C-reactive protein, procalcitonin and immunoglobulin E (IgE). The receiver operating characteristic (ROC) curve was used to evaluate the specific indices for predicting RMMP. RESULTS There were significant differences between the two groups in the absolute counts of CD3+, CD4+, CD19+, and CD56+ lymphocytes and the serum levels of lactate dehydrogenase, C-reactive protein, and IgE (P<0.05). The ROC curve analysis showed that the absolute counts of CD3+, CD4+ and CD19+ lymphocytes had an area under the ROC curve (AUC) of 0.866, 0.900 and 0.842 respectively in the differential diagnosis of RMPP and MPP, with a sensitivity of 86%, 90% and 82% respectively and a specificity of 75%, 70% and 80% respectively. CONCLUSIONS The absolute counts of CD3+, CD4+ and CD19+ lymphocytes can be used to predict RMPP in children.
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Affiliation(s)
- Na Li
- Department of Pediatric Neurology & Rehabilitation Medicine, Shenyang Children's Hospital, Shenyang 110032, China.
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Shi S, Zhang X, Zhou Y, Tang H, Zhao D, Liu F. Immunosuppression Reduces Lung Injury Caused by Mycoplasma pneumoniae Infection. Sci Rep 2019; 9:7147. [PMID: 31073201 PMCID: PMC6509254 DOI: 10.1038/s41598-019-43451-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/23/2019] [Indexed: 12/31/2022] Open
Abstract
The underlying mechanisms of Mycoplasma pneumoniae pneumonia (MPP) pathogenesis are not clearly understood. This study aimed to investigate the correlation between immune response and lung injury in MPP. The clinical characteristics of MPP were compared between patients treated with and without immunosuppressive chemotherapy, and demographic, clinical, and laboratory data were compared between patients with severe and mild MPP. To determine the effect of immune response on lung lesions, mouse MPP and immunosuppression models were established by intranasal inoculation of M129 and intraperitoneal injection of cyclophosphamide, respectively. Myeloperoxidase and oxidant-antioxidant enzyme activities were evaluated for mechanism studies. The immunosuppressant group had a lower incidence of MPP and fewer cases of severe MPP than the non-immunosuppressant group. The severe MPP group had a greater incidence of severe immune disorders than the mild MPP group. Relative to immunosuppressed mice, wild mice exhibited more severe inflammatory infiltration and lung injury as well as a significant increase in myeloperoxidase and malondialdehyde levels and a decrease in superoxide dismutase level after MP infection. In conclusion, immunological responses likely play a vital role in MPP pathogenesis. Lung injury occurring after MP infection-which might be caused by oxidant-antioxidant imbalance-can be reduced by immunosuppression.
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Affiliation(s)
- Shuang Shi
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China.,Department of Respiratory Medicine, Shanghai Children's Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, 200333, China
| | - Xiuqing Zhang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Yao Zhou
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Heng Tang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Deyu Zhao
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China.
| | - Feng Liu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China.
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Mycoplasma pneumoniae and toll-like receptors: A mutual avenue. Allergol Immunopathol (Madr) 2018; 46:508-513. [PMID: 29331619 DOI: 10.1016/j.aller.2017.09.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023]
Abstract
Mycoplasma pneumoniae is an intracellular bacterium leading to several complications in humans. M. pneumoniae is cleared in some cases and induces complications in others. The main responsible mechanisms regarding the controversy are yet to be cleared. Toll-like receptors (TLRs) are the important cell membrane and intracellular receptors which recognize a wide range of microbial macromolecules. The roles of TLRs in the eradication of several pathogens and also induction of their related complications have been demonstrated. This review article presents recent data about the roles of TLRs in the induction of immune responses which lead to M. pneumoniae eradication and related complications.
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Valade S, Biard L, Lemiale V, Argaud L, Pène F, Papazian L, Bruneel F, Seguin A, Kouatchet A, Oziel J, Rouleau S, Bele N, Razazi K, Lesieur O, Boissier F, Megarbane B, Bigé N, Brulé N, Moreau AS, Lautrette A, Peyrony O, Perez P, Mayaux J, Azoulay E. Severe atypical pneumonia in critically ill patients: a retrospective multicenter study. Ann Intensive Care 2018; 8:81. [PMID: 30105627 PMCID: PMC6089852 DOI: 10.1186/s13613-018-0429-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/02/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure. METHODS Adults admitted between 2000 and 2015 to 20 French ICUs with proven atypical pneumonia were retrospectively described. Patients with MP were compared to Streptococcus pneumoniae (SP) pneumonia patients admitted to ICUs. RESULTS A total of 104 patients were included, 71 men and 33 women, with a median age of 56 [44-67] years. MP was the causative agent for 76 (73%) patients and CP for 28 (27%) patients. Co-infection was documented for 18 patients (viruses for 8 [47%] patients). Median number of involved quadrants on chest X-ray was 2 [1-4], with alveolar opacities (n = 61, 75%), interstitial opacities (n = 32, 40%). Extra-pulmonary manifestations were present in 34 (33%) patients. Mechanical ventilation was required for 75 (72%) patients and vasopressors for 41 (39%) patients. ICU length of stay was 16.5 [9.5-30.5] days, and 11 (11%) patients died in the ICU. Compared with SP patients, MP patients had more extensive interstitial pneumonia, fewer pleural effusion, and a lower mortality rate [6 (8%) vs. 17 (22%), p = 0.013]. According MCA analysis, some characteristics at admission could discriminate MP and SP. MP was more often associated with hemolytic anemia, abdominal manifestations, and extensive chest radiograph abnormalities. SP-P was associated with shock, confusion, focal crackles, and focal consolidation. CONCLUSION In this descriptive study of atypical bacterial pneumonia requiring ICU admission, mortality was 11%. The comparison with SP pneumonia identified clinical, laboratory, and radiographic features that may suggest MP or CP pneumonia.
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Affiliation(s)
- S. Valade
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
| | - L. Biard
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
- AP-HP, DBIM, Hôpital Saint-Louis, Paris, France
| | - V. Lemiale
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
| | - L. Argaud
- Hôpital Edouard Herriot, Service de Réanimation Médicale, Hospices Civils de Lyon, Lyon, France
| | - F. Pène
- AP-HP, Réanimation médicale, Hôpital Cochin, Paris, France
| | - L. Papazian
- Réanimation des Détresses Respiratoires et Infections Sévères, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - F. Bruneel
- Service de Réanimation, Centre Hospitalier de Versailles, Le Chesnay, France
| | - A. Seguin
- Department of Medical Intensive Care, CHU de Caen, Caen, France
| | - A. Kouatchet
- Service de Réanimation Médicale et Médecine Hyperbare, Hôpital Angers, Angers, France
| | - J. Oziel
- AP-HP, Medical-Surgical Intensive Care Unit, Avicenne University Hospital, Bobigny, France
| | - S. Rouleau
- Service de Réanimation polyvalente, Angoulême, France
| | - N. Bele
- Intensive Care Unit, Draguignan Hospital, Draguignan, France
| | - K. Razazi
- AP-HP, Groupe Henri Mondor-Albert Chenevier, Service de Réanimation Médicale, Hôpital Henri Mondor, Créteil, France
| | - O. Lesieur
- Service de Réanimation, CH Saint-Louis, La Rochelle, France
| | - F. Boissier
- AP-HP, Réanimation médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - B. Megarbane
- AP-HP, Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris, France
| | - N. Bigé
- AP-HP, Medical Intensive Care Unit, Hôpital Saint-Antoine, Paris, France
| | - N. Brulé
- Medical Intensive Care Unit, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - A. S. Moreau
- Centre de réanimation, Hôpital Salengro, CHU-Lille, Lille, France
| | - A. Lautrette
- Service de Réanimation Médicale Polyvalente, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - O. Peyrony
- AP-HP, Service des urgences, Hôpital Saint-Louis, Paris, France
| | - P. Perez
- Service de Réanimation médicale, Hôpital Brabois, Nancy, France
| | - J. Mayaux
- AP-HP, Pneumology and Critical Care Medicine Department, Universitary Hospital La Pitié Salpêtrière-Charles Foix, Paris, France
| | - E. Azoulay
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
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Liu Y, Zhang X, Wang Y, Zhu C, Fan M, Dou X, Hao C, Yan Y, Ji W, Gu G, Lou J, Chen Z. The role of granulocyte macrophage colony stimulating factor in hospitalized children with Mycoplasma pneumoniae pneumonia. J Infect Chemother 2018; 24:789-794. [PMID: 30007865 DOI: 10.1016/j.jiac.2018.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 12/28/2017] [Accepted: 06/09/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inappropriate inflammatory response in children with M. pneumoniae infection might be associated with disease severity. The role of Granulocyte macrophage colony stimulating factor (GM-CSF) in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP) has not been fully discussed. METHODS Clinical and laboratory data of a total 40 children with MPP were collected. GM-CSF and myeloperoxidase (MPO) were detected by ELISAs. Meanwhile, normal human bronchial epithelium was infected by M. pneumoniae and neutrophils were stimulated by GM-CSF to explore GM-CSF and MPO release in supernatant, respectively. RESULTS Compared to control group, a significant increased percentage of neutrophils and decreased percentage of macrophages in bronchoalveolar lavage fluid of children with MPP was observed (P < 0.05). Children with MPP had significantly higher levels of GM-CSF (P = 0.0047) and MPO (P = 0.0002) in BALF compared to the controls. Level of GM-CSF in BALF was associated with duration of fever (r = 0.42, P = 0.007) and strongly correlated with level of MPO (r = 0.075, P = 0.0005). Levels of GM-CSF and MPO significantly decreased (both P < 0.05) after treatment. In vitro, M. pneumoniae induced GM-CSF expression in a time-dependent manner during a 72-h period (P < 0.05) and MPO secretion significantly increased by recombinant human GM-CSF stimulation at 24h (P < 0.05). CONCLUSION GM-CSF could be induced by M. pneumoniae infection in vivo and vitro. Childen with high level GM-CSF had longer duration of fever. GM-CSF probably plays a vital role in neutrophil inflammation in M. pneumoniae infection.
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Affiliation(s)
- Yang Liu
- Department of Child Care, Children's Hospital of Soochow University, Soochow University, Suzhou, China; Department of Pediatrics, The Second Affiliated Hospital to Nanchang University, Nanchang, 330006, China
| | - Xinxing Zhang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Mingyue Fan
- Department of Ophthalmology and Otorhinolaryngology, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Xunwu Dou
- Department of Ophthalmology and Otorhinolaryngology, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Wei Ji
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Guixiong Gu
- Department of Child Care, Children's Hospital of Soochow University, Soochow University, Suzhou, China
| | - Jiangyan Lou
- Department of Child Care, Children's Hospital of Soochow University, Soochow University, Suzhou, China; Department of Pediatrics, Zhejiang Provincial People's Hospital, China.
| | - Zhengrong Chen
- Department of Respiratory Disease, Children's Hospital of Soochow University, Soochow University, Suzhou, China.
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Gao M, Wang K, Yang M, Meng F, Lu R, Zhuang H, Cheng G, Wang X. Transcriptome Analysis of Bronchoalveolar Lavage Fluid From Children With Mycoplasma pneumoniae Pneumonia Reveals Natural Killer and T Cell-Proliferation Responses. Front Immunol 2018; 9:1403. [PMID: 29967623 PMCID: PMC6015898 DOI: 10.3389/fimmu.2018.01403] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 06/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background Mycoplasma pneumoniae pneumonia (MPP) is one of the most common community-acquired pneumonia; this study is to explore the immune-pathogenesis of children MPP. Methods Next-generation transcriptome sequencing was performed on the bronchoalveolar lavage fluid cells from six children with MPP and three children with foreign body aspiration as control. Some of the results had been validated by quantitative real-time PCR in an expanded group of children. Results Results revealed 810 differentially expressed genes in MPP group comparing to control group, of which 412 genes including RLTPR, CARD11 and RASAL3 were upregulated. These upregulated genes were mainly enriched in mononuclear cell proliferation and signaling biological processes. Kyoto encyclopedia of genes and genomes pathway analysis revealed that hematopoietic cell linage pathway, natural killer cell-mediated cytotoxicity pathway, and T cell receptor signaling pathway were significantly upregulated in MPP children. In addition, significant alternative splicing events were found in GNLY and SLC11A1 genes, which may cause the differential expressions of these genes. Conclusion Our results suggest that NK and CD8+ T cells are over activated and proliferated in MPP children; the upregulated IFNγ, PRF1, GZMB, FASL, and GNLY may play important roles in the pathogenesis of children MPP.
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Affiliation(s)
- Man Gao
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Kuo Wang
- Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, China
| | - Mingyue Yang
- Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, China
| | - Fanzheng Meng
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Ruihua Lu
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Huadong Zhuang
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Genhong Cheng
- Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, China.,Department of Microbiology Immunology and Molecular Genetics, University of California Los Angeles, Los Angeles, CA, United States
| | - Xiaosong Wang
- Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, China
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Saraya T, Ohkuma K, Tsukahara Y, Watanabe T, Kurai D, Ishii H, Kimura H, Goto H, Takizawa H. Correlation between clinical features, high-resolution computed tomography findings, and a visual scoring system in patients with pneumonia due to Mycoplasma pneumoniae. Respir Investig 2018; 56:320-325. [PMID: 29764747 DOI: 10.1016/j.resinv.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 03/01/2018] [Accepted: 03/07/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Mycoplasma pneumoniae (MP) is the primary cause of community-acquired pneumonia. We aimed to evaluate the correlation between clinical features, with special reference to hypoxemia and the total affected area obtained using high-resolution computed tomography (HRCT). METHODS Medical records of MP pneumonia patients > 15 years of age at Kyorin University Hospital between January 2006 and November 2013 were reviewed retrospectively and compared to patients with Streptococcus pneumoniae pneumonia, diagnosed between January 2013 and September 2014. RESULTS We identified 65 and 32 patients with MP- and S. pneumoniae pneumonia, respectively. HRCT data were available for 42 and 32 patients with MP- and S. pneumoniae pneumonia, respectively. Data were available for all hypoxemic patients. Hypoxemia was significantly higher in patients with S. pneumoniae (14/32, p = 0.008) than those with MP (5/39). Total visual score on HRCT correlated significantly with hypoxemia in both groups, but showed significantly higher scores with MP- than with S pneumoniae pneumonia in hypoxemic patients. MP pneumonia showed significant positive correlation between the total visual score and serum inflammatory markers (C-reaction protein [r = 0.43, p = 0.025] and lactate dehydrogenase [r = 0.466, p = 0.016]). In both groups, individual scores in the middle and lower lung fields were significantly higher than in the upper field, suggesting zonal predominance. CONCLUSIONS This study provides the first evidence that the total affected area on lung HRCT was more with MP compared to S. pneumoniae pneumonia in hypoxemic patients and positively correlated with hypoxemia and serum inflammatory markers.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan.
| | - Kosuke Ohkuma
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Yayoi Tsukahara
- Department of Radiology, Kyorin University School of Medicine, Japan
| | - Takayasu Watanabe
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Daisuke Kurai
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Hajime Goto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Hajime Takizawa
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
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Namkoong H, Yamazaki M, Ishizaki M, Endo I, Harada N, Aramaki M, Tanaka Y, Kaburagi S, Ichikawa M, Ohata T, Sakaguchi S, Saito F, Nakao A, Yuki H, Mitamura K. Clinical Evaluation of the Immunochromatographic System Using Silver Amplification for the Rapid Detection of Mycoplasma pneumoniae. Sci Rep 2018; 8:1430. [PMID: 29362380 PMCID: PMC5780467 DOI: 10.1038/s41598-018-19734-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/08/2018] [Indexed: 11/10/2022] Open
Abstract
Mycoplasma pneumoniae infection is conventionally diagnosed using serum antibody testing, microbial culture, and genetic testing. Recently, immunochromatography-based rapid mycoplasma antigen test kits have been developed and commercialised for rapid diagnosis of M. pneumoniae infection. However, as these kits do not provide sufficient sensitivity and specificity, a rapid test kit with improved accuracy is desired. The present prospective study evaluated a rapid M. pneumoniae diagnostic system utilizing a newly developed silver amplification immunochromatography (SAI) system. We performed dilution sensitivity test and the prospective clinical study evaluating the SAI system. The subjects of the clinical study included both children and adults. All patients suspected to have mycoplasma pneumonia (169 patients) were sequentially enrolled. Twelve patients did not agree to participate and 157 patients were enrolled in the study. The results demonstrate excellent performance of this system with 90.4% sensitivity and 100.0% specificity compared with real-time polymerase chain reaction. When compared with loop-mediated isothermal amplification (LAMP) methods, the results also demonstrate a high performance of this system with 93.0% sensitivity and 100.0% specificity. The SAI system uses a dedicated device for automatic analysis and reading, making it highly objective, and requires less human power, supporting its usefulness in clinical settings.
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Affiliation(s)
- Ho Namkoong
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan. .,Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
| | | | | | - Ikumi Endo
- Clinical Laboratory, Eiju General Hospital, Tokyo, Japan
| | - Noriaki Harada
- Clinical Laboratory, Eiju General Hospital, Tokyo, Japan
| | - Megumi Aramaki
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
| | - Yuko Tanaka
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
| | | | | | - Takanori Ohata
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Shinji Sakaguchi
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Ayumi Nakao
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
| | - Hideki Yuki
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
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Copete AR, Aguilar YA, Rueda ZV, Vélez LA. Genotyping and macrolide resistance of Mycoplasma pneumoniae identified in children with community-acquired pneumonia in Medellín, Colombia. Int J Infect Dis 2017; 66:113-120. [PMID: 29155089 PMCID: PMC7129344 DOI: 10.1016/j.ijid.2017.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 01/19/2023] Open
Abstract
The majority of the Mycoplasma pneumoniae isolates obtained from the children with community-acquired pneumonia in this study were a variant of type 2. There was an absence of the mutations in the 23S rRNA gene related to macrolide resistance. Induced sputum sample has higher percentage of positive PCR to diagnose Mycoplasma pneumoniae compared to nasopharyngeal swab.
Objectives The aim of this study was to describe the genotypes and the main characteristics of community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae in hospitalized children in Medellín and neighboring municipalities during the period 2011–2012. Methods The M. pneumoniae genotype was determined by PCR and sequencing of the p1 and 23S rRNA genes from induced sputum samples and nasopharyngeal swabs (NPS). Samples were obtained from children with CAP who were hospitalized in 13 healthcare centers. In addition, a spatio-temporal analysis was performed to identify the potential risk areas and clustering of the cases over time. Results A variant of type 2 was the dominant genotype in the induced sputum (96.1%) and NPS (89.3%) samples; the type 1 variant was identified in 3.9% and 10.7% of these samples, respectively. No strains with mutations in the 23S rRNA gene associated with macrolide resistance were found. The cases in Medellín were mainly concentrated in the northeastern areas and western districts. However, no temporal relationship was found among these cases. Conclusions A variant of type 2 of M. pneumoniae prevailed among children with CAP during the study period. No strains with mutations associated with macrolide resistance were found.
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Affiliation(s)
- Angela Rocio Copete
- Research Group of Problems in Infectious Diseases (GRIPE), School of Medicine, Universidad de Antioquia UdeA, Medellín, Colombia.
| | - Yudy Alexandra Aguilar
- Research Group of Problems in Infectious Diseases (GRIPE), School of Medicine, Universidad de Antioquia UdeA, Medellín, Colombia.
| | | | - Lázaro Agustín Vélez
- Research Group of Problems in Infectious Diseases (GRIPE), School of Medicine, Universidad de Antioquia UdeA, Medellín, Colombia; Unit of Infectious Diseases, Hospital Universitario San Vicente Fundación, Medellín, Colombia.
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Saraya T, Watanabe T, Tsukahara Y, Ohkuma K, Ishii H, Kimura H, Yan K, Goto H, Takizawa H. The Correlation between Chest X-ray Scores and the Clinical Findings in Children and Adults with Mycoplasma pneumoniae Pneumonia. Intern Med 2017; 56:2845-2849. [PMID: 28943541 PMCID: PMC5709625 DOI: 10.2169/internalmedicine.8500-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objective To compare the radiological and laboratory data of children and adults with Mycoplasma pneumoniae pneumonia (MPP) and to evaluate the correlation between the total affected lung area and the clinical findings. Methods We retrospectively examined the data from MPP patients who visited our hospital during the period from April 2006 to July 2014. All data were retrieved at the time of the diagnosis of MPP and were analyzed to investigate the correlation between the clinical findings and the total affected lung area using a chest X-ray scoring system. Results We identified 71 children and 54 adults with MPP. The incidence of consolidation, which was the most common chest X-ray finding in both groups, was similar (children: n = 62, 87.3%; adults: n = 45, 83.3%). In contrast, air bronchogram, bronchial thickening, and atelectasis were observed significantly more frequently among children than among adults. In both groups, a chest X-ray scoring system revealed a zonal predominance of the affected area (middle-to-lower lung fields). The body temperature and serum data such as the C-reactive protein level, white blood cell count, and lactate dehydrogenase level were significantly higher in the child group than in the adult group. The total score did not significantly correlate with the above-mentioned inflammatory markers or the presence of hypoxemia in either group. Conclusion This study showed the first evidence of a correlation between the extent of lung abnormalities on chest X-ray (calculated as a total score) and the clinical findings, including the presence of hypoxemia, in children and adults with MPP.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Takayasu Watanabe
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Yayoi Tsukahara
- Department of Radiology, Kyorin University School of Medicine, Japan
| | - Kosuke Ohkuma
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Kunimasa Yan
- Department of Pediatrics, Kyorin University School of Medicine, Japan
| | - Hajime Goto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan
| | - Hajime Takizawa
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
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Wang Z, Li YC, Zhou XJ, Wu JY. Prediction of Refractory Mycoplasma Pneumoniae Pneumonia in Pediatric Patients. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2017. [DOI: 10.1089/ped.2016.0732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Zhen Wang
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ya-Chun Li
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiao-Jian Zhou
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jia-Ying Wu
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
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In Vitro Activities and Spectrum of the Novel Fluoroquinolone Lascufloxacin (KRP-AM1977). Antimicrob Agents Chemother 2017; 61:AAC.00120-17. [PMID: 28320717 DOI: 10.1128/aac.00120-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/12/2017] [Indexed: 11/20/2022] Open
Abstract
Lascufloxacin exhibited a broad spectrum of activity against various clinical isolates. Furthermore, lascufloxacin showed the most potent activity against Gram-positive bacteria among the quinolones tested and incomplete cross-resistance against existing quinolone-resistant strains. Enzymatic analysis indicated that lascufloxacin had potent inhibitory activity against both wild-type and mutated target enzymes. These results suggest that lascufloxacin may be useful in treating infections caused by various pathogens, including quinolone-resistant strains.
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Saraya T. Mycoplasma pneumoniae infection: Basics. J Gen Fam Med 2017; 18:118-125. [PMID: 29264006 PMCID: PMC5689399 DOI: 10.1002/jgf2.15] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/05/2016] [Indexed: 01/08/2023] Open
Abstract
Mycoplasma pneumoniae (Mp) is one of the leading causes of community‐acquired pneumonia and can cause a number of extrapulmonary manifestations in the absence of pneumonia. In this regard, primary care physicians should know how to suspect, diagnose, and manage patients with Mp infection. This review gives a general overview of the basic clinical aspects of Mp infection with special reference to pneumonia, which will help further understanding of the disease.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine Kyorin University School of Medicine Tokyo Japan
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Inostroza E, Pinto R. NEUMONÍA POR AGENTES ATÍPICOS EN NIÑOS. REVISTA MÉDICA CLÍNICA LAS CONDES 2017. [DOI: 10.1016/j.rmclc.2017.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gomes C, Martínez-Puchol S, Palma N, Horna G, Ruiz-Roldán L, Pons MJ, Ruiz J. Macrolide resistance mechanisms in Enterobacteriaceae: Focus on azithromycin. Crit Rev Microbiol 2016; 43:1-30. [DOI: 10.3109/1040841x.2015.1136261] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Cláudia Gomes
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic ? Universitat de Barcelona, Spain
| | - Sandra Martínez-Puchol
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic ? Universitat de Barcelona, Spain
| | - Noemí Palma
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic ? Universitat de Barcelona, Spain
| | - Gertrudis Horna
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic ? Universitat de Barcelona, Spain
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Maria J Pons
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Joaquim Ruiz
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic ? Universitat de Barcelona, Spain
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Yamamoto T, Kida Y, Sakamoto Y, Kuwano K. Mpn491, a secreted nuclease ofMycoplasma pneumoniae, plays a critical role in evading killing by neutrophil extracellular traps. Cell Microbiol 2016; 19. [DOI: 10.1111/cmi.12666] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Takeshi Yamamoto
- Division of Microbiology, Department of Infectious Medicine; Kurume University School of Medicine; Kurume 830-0011 Japan
| | - Yutaka Kida
- Division of Microbiology, Department of Infectious Medicine; Kurume University School of Medicine; Kurume 830-0011 Japan
| | - Yuichi Sakamoto
- Division of Microbiology, Department of Infectious Medicine; Kurume University School of Medicine; Kurume 830-0011 Japan
| | - Koichi Kuwano
- Division of Microbiology, Department of Infectious Medicine; Kurume University School of Medicine; Kurume 830-0011 Japan
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