| Objective IL-4,IL-5,leukocyte differentiation antigen ligand(CD40L),vascular cell adhesion molecule-1(VCAM-1)Level comparison,analyze the correlation between Ig E and lung function and IL-4,IL-5,CD40 L,VCAM-1,and explore the mechanism of MP infection-induced asthma.Establish receiver operating characteristic(ROC)curve,analyze the value of serum IL-4,IL-5,CD40 L,VCAM-1 in the diagnosis of MP-infected asthma,and provide a reference for the diagnosis and treatment of childhood asthma.Methods Using prospective research,80 children with bronchial asthma who were admitted to the Pediatric Department of Chaoyang Second Hospital from January 2019 to December 2019 were divided into two groups based on whether they were associated with Mycoplasma pneumonia(MP)infection.Forty children with MP infection were in the simple asthma group,and 40 children with MP infection were in the MP infection group.At the same time,40 children with healthy physical examination during the same period were selected as the control group,and fasting venous blood was drawn for IL-4 and IL-5.CD40 L and VCAM-1 levels;compare the levels of IL-4,IL-5,CD40 L and VCAM-1 in each group.The children in the MP infection group were further divided into low-titer,medium-titer and high-titer groups according to their MP-Ig M titer levels,and the levels of Ig E,lung function,IL-4,IL-5,CD40 L and VCAM-1 in each group were compared.Pearson analysis was used to analyze the correlation between IL-4,IL-5,CD40 L,VCAM-1 and Ig E in children with MP infection and asthma.Establish receiver operating characteristic(ROC)curve to analyze the diagnostic value of serum IL-4,IL-5,CD40 L,VCAM-1 to MP infection.Results1.The average age,height,body mass index(BMI),gender,place of residence,family history,environmental tobacco smoke,and dust exposure environmental composition ratios of children in each group were not statistically different(P>0.05).There was no statistically significant difference in the proportion of children in the three subgroups of MP infection in age,height,body mass index(BMI),gender,residence,family history,environmental tobacco smoke,and dust exposure environment(P>0.05).2.IL-4,IL-5,CD40 L,and VCAM-1 in the MP infection group were(177.92±22.73)pg/ml,(35.17±5.91 pg/ml,(2.76±0.63)ng/ml,(640.71±110.74),respectively)Ng/ml,higher than the asthma group(132.08±19.38)pg/ml,(34.82±5.60)pg/ml,(2.35±0.74)ng/ml,(559.11±122.26)ng/ml;MP infection group and The levels of IL-4,IL-5,CD40 L,and VCAM-1 in the asthma group were higher than those in the control group(79.04±12.49)pg/ml,(1.42±0.17)pg/ml,(2.06±0.73)ng/ml,(445.57±116.63)ng/ml,the difference was statistically significant(P<0.05).3.FEV1,FVC,PEF and MVV in the MP infection group were(63.87±6.28)%,(205.94±22.57)m L,(54.19±5.18)L/min,and(174.36±15.51)L/min,respectively,which were lower than those in the asthma group(72.36±9.27)%,(241.82±29.65)m L,(69.20±7.59)L/min,(198.57±17.58)L/min,FEV1,FVC,PEF,MVV of MP infection group and asthma group were lower than those of the control group(86.47±12.58)%,(275.48±36.94)m L,(93.47±14.21) L/min,(248.37±31.82)L/min,the difference was statistically significant(P<0.05).4.The serum Ig E of children in the MP infection group was(343.28±42.76)IU/L,which was significantly higher than that of the asthma group(238.39±19.38)IU/L,and the difference was statistically significant(P<0.05).5.IL-4,IL-5,CD40 L and VCAM-1 in the high titer group were(192.48±24.81)pg/ml,(86.72±6.48)pg/ml,(3.01±0.35)ng/ml,(843.25)±100.56)ng/ml,higher than the middle titer group(177.35±22.50)pg/ml,(65.04±5.93)pg/ml,(2.74±0.33)ng/ml,(647.61±96.34)ng/ml;The levels of IL-4,IL-5,CD40 L and VCAM-1 in the high titer group and the medium titer group were higher than those in the low titer group(159.63±19.83)pg/ml,(42.11±5.14)pg/ml,(2.50±0.42)ng/ml,(600.57±98.37)ng/ml;the differences were statistically significant(P<0.05).6.Ig E in the high titer group was(393.70±43.19)IU/L,higher than that in the medium titer group(345.96±42.83)IU/L,and the Ig E levels in the high titer group and the medium titer group were higher than the low titer group The group’s(292.85±41.64)IU/L,the difference was statistically significant(P<0.05).7.IL-4,IL-5,CD40 L,VCAM-1 and Ig E in children with MP infection and asthma were all positively correlated(r=0.429,0.580,0.488,0.541,P=0.026,0.012,0.022,0.019).CD40 L was negatively correlated with FEVl,FVC,PEF,and MVV(r=-0.182,-0.376,-0.357,-0.390,P=0.042,0.026,0.031,0.023).VCAM-1 was negatively correlated with FEVl,FVC,PEF,and MVV(r=-0.168,-0.351,-0.319,-0.377,P=0.045,0.032,0.038,0.026).8.The best cut-off values of CD40 L and VCAM-1 are 2.80 ng/m L and662.75 ng/m L,and the area under the curve(AUC)for predicting asthma combined with MP infection is 0.663(95%CI=0.664-0.893)and 0.701(95 %CI=0.715-0.957),the sensitivity is 55.00%,50.00%,and the specificity is75.00%,87.50%.The best cut-off values of IL-4 and IL-5 are 193.47 pg/m L and36.98 pg/m L,and the area under the curve(AUC)for predicting asthma combined with MP infection is 0.397(95%CI=0.573-0.907)and 0.428(95 %CI=0.617-0.893),the sensitivity is 50.00%,35.00%,and the specificity is72.50%,77.50%.Conclusions1.MP mediates airway type I allergy by stimulating the body to produce Ig E,causing airway damage.And compared with non-MP-infected children with asthma,children with MP infection have worse lung function,indicating that MP infection can aggravate airway changes and airway obstructive ventilation dysfunction.2.The abnormally elevated levels of IL-4,IL-5,CD40 L,and VCAM-1 in children with MP infection with asthma indicate that IL-4,IL-5,CD40 L,and VCAM-1 are all involved in the pathological process of asthma caused by MP infection.3.The levels of IL-4,IL-5,CD40 L,and VCAM-1 in children with MP infection were significantly higher than those in the simple asthma group,and the serum Ig E levels were higher than those in the simple asthma group.Inflammatory reaction and respiratory tract reactivity,thereby aggravating asthma.4.There is a positive correlation between IL-4,IL-5,CD40 L,VCAM-1 and serum Ig E in children with MP infection.It is suggested that monitoring the changes of serum IL-4,IL-5,CD40 L,VCAM-1 levels in children with asthma has certain guiding value for the diagnosis of MP infection,the judgment of the severity of the disease,the dynamic grasp of the changes of the disease and the effect of disease control. |
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