The Clinical Significance Of Proinflammatory/Anti-inflammatory Levels In Children With Mycoplasma Pneumonia

ObjectiveMycoplasma pneumoniae pneumonia(MPP) is a common pediatric respiratorydiseases. It is mainly manifested as cough, fever, fine crackles and respiratorydifficulties. Infants usually have shortness of breath, wheezing, auscultation andsputum. Imaging of MPP shows diversity, patchy shadows common in infants andyoung children, segmental, large patchy shadows common in school-age children. Thedisease usually has relatively protracted course during the treatment process, and it isdifficult to cure, and accompanied by repeated attacks and cause seriouscomplications sometimes. If this disease progresses rapidly and severely it will causedeath in children.The pathogenesis of MPP is not fully understood, and includes the followingtheories at present: airway epithelial cell adhesion theory, direct invasion ofMycoplasma theory, immunological pathogenesis theory, doctrine and otherneurotoxic effects. One of the important theory-immunity mechanism mainly refersthat the invasion of Mycoplasma pneumoniae in respiratory tract cause acorresponding activation of cellular immunity and humoral immune system, asMycoplasma pneumoniae antigen stimulates the body to produce an immune responsewith specific IgG and IgM generation complement and immune cells activation. Thenthe inflammatory cytokines including IL-2, IL-6, IL8and IL-13response, andimmune cells activate mediated by T and B cell activation, proliferation anddifferentiation which plays an important role in the process.The IL-2and IL-13levels of the acute phase and recovery phase in children withmycoplasma pneumoniae pneumonia(MPP) were detected in this study. Throughmonitoring the dynamic changes of IL-2and IL-13, the role of cytokines in thepathogenesis of MPP and MPP immunological pathogenesis was confirmed in orderto provide guidance and candidate targets for diagnostics and treatment for MPP.Methods30cases of children with MPP,30cases of children with non-MP pneumonia and30healthy children were included. Their venous blood were obtained and the serumIL-2, IL-13levels were determinated by a double antibody sandwich enzyme-linkedimmunosorbent assay (ELISA). The SPSS13.0software for statistical analysis wasused.ResultsSerum levels of IL-2in MPP acute phase were decreased, compared with thoseof the non-MP pneumonia and the healthy control group, and the difference was significant (P <0.05). Serum levels of IL-2in MPP relieved phase were increasedcompared with those of the acute phase, but still lower than that of the healthy controlgroup, The differences were significant (P <0.05). Compared with those of thenon-MP pneumonia and the healthy control group，the serum IL13level of MPP wereincreased, and the difference is significant（P＜0.05）. The serum IL13-level of MPPof the relieved stage is lower than that of acute phase MPP but higher than that ofnon-MP pneumonia group and the healthy control group (P <0.05).Conclusion1. The results show that the level of IL-2in the acute phase of MPP decreased.As IL-2play a catalytic role in the proliferation of activated T cells, the decreasedIL-2may induce inhibited T cell proliferation and lead to reduced immune functionwhich further aggravate pulmonary symptoms.2. This study also showed that the levels of serum IL-13in children withmycoplasma pneumonia before treatment were significantly higher than those ofhealthy group (P <0.01) and MPP relieved stage(P <0.05).3. The levels of IL-2and IL-13increased signifantly in the MPP, compared withother pneumonia, which indicated that these cytokines are the candidate index forMPP diagnosis and therapy effect.