scholarly journals Pathogenic Analysis of the Bronchoalveolar Lavage Fluid Samples With Pediatric Refractory Mycoplasma pneumoniae Pneumonia

Author(s):  
Fei Zhao ◽  
Jinrong Liu ◽  
Di Xiao ◽  
Liyong Liu ◽  
Jie Gong ◽  
...  
2005 ◽  
Vol 49 (10) ◽  
pp. 4128-4136 ◽  
Author(s):  
Monica Fonseca-Aten ◽  
Christine M. Salvatore ◽  
Asunción Mejías ◽  
Ana M. Ríos ◽  
Susana Chávez-Bueno ◽  
...  

ABSTRACT Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. We evaluated the efficacy of LBM415, a novel peptide deformylase inhibitor antimicrobial agent, for the treatment of M. pneumoniae pneumonia in a mouse model. Eight-week-old BALB/c mice were intranasally inoculated once with 107 CFU of M. pneumoniae. Groups of mice were treated with LBM415 (50 mg/kg of body weight) or placebo subcutaneously daily for 13 days, starting 24 h after inoculation. Groups of mice were evaluated at the baseline; at days of treatment 1, 3, 6, and 13; and at 7 days after treatment. The MIC of LBM415 against M. pneumoniae was <0.005 μg/ml. LBM415-treated mice had significantly lower bronchoalveolar lavage fluid M. pneumoniae concentrations than placebo-treated mice on days 6 and 13 of treatment. Compared with placebo treatment, therapy with LBM415 significantly decreased lung histopathology scores at days 3, 6, and 13 of treatment and at 7 days after treatment. Airway obstruction was significantly lower in LBM415-treated mice than in placebo-treated mice on days 1, 3, and 6 of treatment and after 7 days of therapy, while airway hyperresponsiveness was significantly lower only on day 3 of therapy. The bronchoalveolar lavage fluid concentrations of tumor necrosis factor alpha, gamma interferon (IFN-γ), interleukin-6 (IL-6), IL-12, KC (functional IL-8), monocyte chemotactic protein 1, macrophage inflammatory protein 1α, monokine induced by IFN-γ, and IFN-inducible protein 10 were significantly reduced in LBM415-treated mice compared with the levels in placebo-treated mice. There were no differences in the bronchoalveolar lavage fluid concentrations of granulocyte-macrophage colony-stimulating factor, IL-1β, IL-2, IL-4, IL-5, and IL-10 between the two groups of mice. LBM415 therapy had beneficial microbiologic, histologic, respiratory, and immunologic effects on acute murine M. pneumoniae pneumonia.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mingyue Yang ◽  
Fanzheng Meng ◽  
Man Gao ◽  
Genhong Cheng ◽  
Xiaosong Wang

AbstractHost immune response may be involved in the pathogenesis of children Mycoplasma pneumoniae pneumonia (MPP). In the current study, we investigated the alterations of cytokines levels among control, mild MPP and severe MPP children to determine whether cytokine signatures associate with MPP and correlate with disease severity. We measured 13 cytokines in bronchoalveolar lavage fluid (BALF) of 88 children with MPP and 26 children with foreign body aspiration (FB) using a Luminex system. Linear discriminant analyses were performed to develop predictive models of mild MPP and severe MPP on these children. We observed nearly complete separations of severe MPP group, mild MPP group and control group in linear discriminant analyses. Eleven cytokines significantly increased in children with MPP, and seven cytokines had statistically significant upward linear trends correlated with MPP severity. In addition, compared to control group, both IFNγ/IL4 ratio and IFNγ/IL13 ratio increased in mild MPP and severe MPP groups. Our results suggest that children MPP can alter BALF cytokines signatures which associate with disease severity and can be characterized by a distinct airway molecular phenotype that has elevated Th1/Th2 ratios.


2022 ◽  
Vol 12 ◽  
Author(s):  
Xi Chen ◽  
Fang Liu ◽  
Baoying Zheng ◽  
Xiaohui Kang ◽  
Xiaolin Wang ◽  
...  

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.


2020 ◽  
Author(s):  
Lianfu Cao ◽  
Haijiao Lin ◽  
Hongjun Yu ◽  
Yongji Wang

Abstract Background: To analyze the relationship between granulocyte-macrophage colony-stimulating factor (GM-CSF) and high mobility group box 1 (HMGB1) level in alveolar lavage fluid with the clinical characteristics and prognosis of children refractory mycoplasma pneumoniae pneumonia (MPP), so as to provide reliable targets for clinical diagnosis and treatment. Methods: A total of 106 children diagnosed with MPP and prepared for bronchoalveolar lavage therapy were selected in this study, which were divided into 2 groups according to clinical diagnosis: those showing clinical and radiological deterioration despite appropriate antibiotic therapy for ≥7 days were classified into refractory MPP group (n=47), while the others were classified into non-refractory MPP group (n=59). The data of physical examination, treatment and outcome were collected. In addition, the GM-CSF and HMGB1 levels in alveolar lavage fluid during each bronchoalveolar lavage therapy were detected by ELISA kits. Results: There was no significant difference in age, sex, course of fever, the highest temperature, WBC, L, PLT, ALT, AST, CK-MB, D-D, CK, IgG, IgA, IgM, C3, and C4 between refractory MMP group and non-refractory MMP group on admission (P>0.05). The levels of N, CRP, PCT, and LDH in refractory MPP group were higher than those in non-refractory MPP group, the difference had statistical significance (P<0.05). Both GM-CSF and HMGB1 levels were positively correlated with traditional indicators N, CRP, PCT and LDH (r=0.611-0.785, P<0.05). ROC analysis results showed that CRP, GM-CSF and HMGB1 had predictive value for refractory MPP attack (AUC=0.636, 0.657, 0.651, P<0.05). Logistic regression analysis results showed GM-CSF and HMGB1 were independent factors for refractory MPP (B>1.0, P<0.05). ROC analysis results showed that GM-CSF and HMGB1 at 2nd bronchoalveolar lavage therapy had predictive value for long hospital stay (>28 d) and poor prognosis of refractory MPP (AUC=0.782-0.825, P < 0.05). Conclusion: The level of GM-CSF and HMGB1 in alveolar lavage fluid is closely related to the occurrence and development of refractory MPP, which can be used as an auxiliary indicator for clinical diagnosis and prognosis evaluation, and has certain guiding significance for its clinical treatment.


2019 ◽  
Author(s):  
Jinrong Liu ◽  
Fei Zhao ◽  
Jie Lu ◽  
Hui Xu ◽  
Hui Liu ◽  
...  

Abstract Background: An increased number of refractory mycoplasma pneumoniae (MP) pneumonia (MPP) cases have been reported. However the duration of MP infection in lower airway and the course of anti-MP treatment remains unclear. Methods: We retrospectively reviewed the medical records of 94 MPP children. Patients were classified into two groups. The long-term group (Group LT) was defined as bronchoalveolar lavage fluid (BALF) remained MP-positive by PCR after 30 days of the disease course. The non-long-term group (Group NLT) was defined as BALF became MP-negative by PCR within 30 days of disease and patients who only needed one bronchoscopy lavage therapy. MP loads, clinical outcomes were analyzed along with other clinical measurements. Results: The average levels of inflammatory markers such as C reactive protein and lactate dehydrogenase in Group LT were significantly higher than those in Group NLT. Airway and lung damage in Group LT were more severe than Group NLT. 28 patients developed necrotizing pneumonia and 8 patients developed pulmonary embolism in Group LT. Mean maximum MP loads in BALF were 10 7.46±0.93 and 10 4.86±0.93 in Groups LT and NLT, respectively. There was persistent MP DNA in Group LT, even lasted for 120 days. One severe MPP patient in Group LT had MP-associated bloodstream infection. After 3 months of follow-up, chest imaging revealed incomplete absorption of pulmonary consolidation in 33 patients of Group LT [including 13 airway obliterans (AO) patients] and in 7 patients of Group NLT (including 2 AO patients). Conclusion: MP loads of BALF were associated with the subsequent duration of MP DNA in lower airway. High MP loads and persistent long-term MP DNA in lower airway were associated with severity of pediatric MPP.


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