Background

Mycoplasma pneumoniae is one of the major pathogens causing community-acquired pneumonia in children. Although usually self-limited, Mycoplasma pneumoniae pneumonia (MPP) may lead to complicated morbidity that can even be life-threatening. Upon MPP infection, alveolar macrophage becomes attracted and activated and will induce subsequent cytokine and chemokine reaction. Refractory Mycoplasma pneumoniae pneumonia (RMPP) is manifested by clinical or radiological deterioration despite proper antibiotic therapy. RMPP is characterized with excessive inflammation and may need subsequent glucocorticoid treatment. Aim: The aim of this study was to investigate the change of plasma chemokines in non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) and RMPP before and after antibiotic or methylprednisolone treatment.

Method

A total of 42 children with MPP were enrolled in this study. Plasma specimens were collected at admission and one to two weeks after antibiotic or methylprednisolone treatment with declined fever. Plasma specimens were then indicated to chemokines detection.

Results

Mycoplasma pneumoniae pneumonia altered the chemokine profile through the observation of decreased plasma M1 related chemokines (CCL2, CCL8 and CXCL10) and increased M2 related chemokines (CCL17 and CCL22) after treatment.When the patients were divided into RMPP and NRMPP groups and the chemokines before treatment were compared, the RMPP group showed higher CXCL10 but lower CCL3 and CCL11 than the NRMPP group.

Conclusion

Unique changes in macrophage related chemokines is observed in the course of MPP infection. NRMPP and RMPP infection in children showed distinct manifestation in chemokine profiles.

中文翻译：

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难治性肺炎支原体肺炎感染儿童趋化因子谱的改变

背景

肺炎支原体是引起儿童社区获得性肺炎的主要病原体之一。虽然通常是自限性的，但肺炎支原体肺炎(MPP) 可能会导致复杂的发病率，甚至可能危及生命。MPP 感染后，肺泡巨噬细胞被吸引和激活，并诱导随后的细胞因子和趋化因子反应。尽管进行了适当的抗生素治疗，难治性肺炎支原体肺炎(RMPP) 仍表现为临床或放射学恶化。RMPP 的特点是炎症过度，可能需要后续的糖皮质激素治疗。目的：本研究旨在探讨非难治性肺炎支原体血浆趋化因子的变化。 抗生素或甲基强的松龙治疗前后的肺炎 (NRMPP) 和 RMPP。

方法

本研究共招募了 42 名患有 MPP 的儿童。在入院时和抗生素或甲基强的松龙治疗退烧后 1 至 2 周收集血浆标本。然后将血浆标本用于趋化因子检测。

结果

肺炎支原体肺炎通过观察治疗后血浆 M1 相关趋化因子（CCL2、CCL8 和 CXCL10）减少和 M2 相关趋化因子（CCL17 和 CCL22）增加而改变趋化因子谱。治疗进行比较，RMPP 组比 NRMPP 组显示更高的 CXCL10 但更低的 CCL3 和 CCL11。

结论

在 MPP 感染过程中观察到巨噬细胞相关趋化因子的独特变化。儿童的 NRMPP 和 RMPP 感染在趋化因子谱中表现出不同的表现。