The Role Of Cytokines And Costimulatory Molecules In The Development Of Mycoplasma Pneumoniae Pneumonia In Children

Objective: Mycoplasma pneumoniae pneumonia in children is one of the major community acquired pneumonia currently. Its incidence is found in the trend of increasing in recent years. Mycoplasma pneumoniae pneumonia has already become a serious threat to the children’s health. So it has attracted great attention of the medical community for its pulmonary complications and severe pneumonia caused by it. We attempt to provide some viable detection indexes of the estimation and the choice of the immune intervention treatment opportunity and its prognosisa by monitoring the molecular level of the in children with mycoplasma pneumoniae pneumonia during the acute phase and recovery phase and analyzing the relativity between the costimulatory molecules and cytokine so as to evaluate the role they play in the development of mycoplasma pneumoniae pneumonia provides feasible for evaluating the detection index, the condition of Mycoplasma.Methods: Collected some children with confirmed mycoplasma pneumoniae pneumonia in the Second Affiliated Hospital of Hebei North University from October 2013 to October 2014 and divided them into a mild MPP group with 30 cases, a severe MPP group with 8 cases and a control group with 12 cases. And collected double blood samples from the MPP children in acute phase and recovery phase; and collected one blood sample from the children in the control group during the same period. Then mensurated the level of IL-4, IFN-γ, IL-17, IL-18 and s B7-H3 in the serum by enzyme-linked immunosorbent assay(ELISA) and analyze the correlation between the phase of s B7-H3 in serum and IL-4, IFN-γ, IL-17, IL-18 MPP in children with acute attack. From the statistical analysis of the patients the groups of acute phase and recovery phase and two groups of patients and control group by monitoring the indicators, there is significant difference between the results by P<0.05.Results: 1 Comparison of the General Situation of the Three GroupsControl subjects of 12 cases, age 7.21±2.82; mild MPP group 30 cases, age 6.87±2.61;severe MPP Group 8 cases, age 7.13±3.14. The three age groups compared no significant difference(P>0.05). 2 Three Groups of children cytokines and costimulatory molecules levels 2.1The level of IL-4 the serum in the control group is 20.09±7.22 pg/ml. The level of IFN-γ is 24.95±5.74pg/ml. The level of IL-17 is 12.85±5.21 pg/ml. The level of IL-18 is 103.23±35.59 pg/ml. The level of s B7-H3 is 1134.8±450.8 pg/ml. 2.2 In the Mild MPP group of acute stage and recovery stage, the levels of IL-4 are 67.28±20.27pg/ml and 23.79±11.26 pg/ml. The levels during the acute phase is significantly higher than that in the control group(P<0.05). The levels of IFN- gamma are 167.79±51.17 pg/ml and 24.31±11.31pg/ml, which are higher than those in control group(P<0.05); the levels of IL-17 are 54.75 ±16.19 pg/ml and 34.54±14.01pg/ml, which are higher than those in control group(P<0.05); the levels of IL-18 are 116.21±26.89 pg/ml, 198.33± 51.04pg/ml, which are higher than those in control group(P<0.05) and the level in the recovery phase is significantly higher than that in control group(P<0.05); the levels of s B7-H3 are 3075.63±878.01 and 1594.09± 502.32pg/ml, the acute phase is significantly higher than that in control group(P<0.05). 2.3 In the severe MPP group of acute stage and recovery stage, the levels of IL-4 are 77.89±23.27pg/ml and 47.01±18.94pg/ml, which are significantly higher than those in the control group; the levels of IFN-γ are 366.52±123.48 pg/ml and 52.51±23.42pg/ml, which are higher than those in control group(P<0.05); the levels of IL-17 are 148.58±63.46 pg/ml and 26.03±12.2pg/ml, which are higher than those in control group(P<0.05); the levels of IL-18 are 146.29±33.78 pg/ml and 330.53±127.11pg/ml, which are higher than those in control group(P<0.05); the levels of s B7-H3 are 4608.2±1207.19 pg/ml and 1500.06±541.03pg/ml, the acute phase is significantly higher than that in control group(P<0.05). 3 Comparison of serum Cytokines levels and s B7-h3 levels at acute phase in mild MPP group and severe MPP groupComparison of serum IL-4level at acute phase in mild MPP group and severe MPP group, had no significant difference(P=0.24). comparison of serum IL-18 level at acute phase in mild MPP group and severe MPP group, had no significant difference(P=0.057), comparison of serum IL-17, IFN-γ and s B7- H3 levels at acute phase in mild MPP group and severe MPP group, severe group IL-17, IFN-γ and s B7- H3 levels were higher than mild group(P < 0.05, P< 0.05, P< 0.05). 4 Comparison of serum Cytokines levels and s B7-h3 levels at recovery phase in mild MPP group and severe MPP groupComparison of serum IL-4level at recovery phase in mild MPP group and severe MPP group, had no significant difference(P=0.0063). comparison of serum IL-18 level at recovery phase in mild MPP group and severe MPP group, had no signify ant difference(P=0.329). comparison of serum IL-4 and 18 levels at recovery phase in mild MPP group and severe MPP group, were higher than mild group(P < 0.05,P<0.05).Comparison of serum IFN-γ level at recovery phase in mild MPP group and severe MPP group, was significantly higher(P < 0.01). 5 At acute phase in MPP s B7-H3 and IL-4, IFN-γ, IL-17, IL-18 correlation analysis 5.1 The correlation between IL-4 level and s B7-H3 level at acute phase in mild MPP group,the correlation coefficient is 0.037(r=0.037, P=0.306); The correlation between IL-17 level and s B7-H3 level at acute phase in mild MPP group,the correlation coefficient is 0.0007(r=0.0007, P=0.888); The correlation between IL-18 level and s B7-H3 level at acute phase in mild MPP group,the correlation coefficient is- 0.019(r=-0.019, P=0.466); The correlation between IFN-γ level and s B7-H3 level at acute phase in mild MPP group,the correlation coefficient of 0.2429(r=0.2429, P< 0.05).Conclusion :1 Cytokines IL-4,IL-17,IL-18,IFN-γ and costimulatory molecule s B7-H3 are both involved in Mycoplasma pneumoniae pneumonia.2 With the disease is more and more serious, the levels of IL-17,IFN-γ and Co-stimulatory Molecule s B7-H3 increase gradually, which relate to the severity of Mycoplasma pneumoniae pneum-onia.3 In the process of pathogenesis of Mycoplasma pneumoniae pneumonia, s B7-H3 promotes the expression of IFN-γ but has no relation with IL-4,IL-17 and IL-18.