Serum Interferon-γ Is Associated With Refractory Mycoplasma pneumoniae Pneumonia in Children
Abstract
Background: Mycoplasma pneumoniae (MP) infection is associated with refractory severe clinical course, and steroid therapy has been suggested as an effective treatment for refractory MP pneumonia.
Methods: A total of 53 patients with MP pneumonia and 9 patients with viral pneumonia patients were enrolled. Point mutations at residues 2063, 2064, and 2067 in domain V of 23S rRNA gene were analyzed, and serum levels of interferon (IFN)-γ, interleukin (IL)-6, TNF-α, IL-10, and IL-1β were measured before and after steroid treatment.
Results: There was no significant difference in serum cytokine concentrations between the MP pneumonia group and the viral pneumonia group. The A2063G point mutation was identified in 72% (18/25) of tested MP pneumonia patients. IFN-γ and IL-6 levels showed significant positive correlations with the duration of hospitalization, fever after admission and duration of steroid treatment. The macrolide-resistant MP (MRMP) group tended to have higher IFN-γ levels than the macrolide-sensitive MP group (P = 0.055). Notably, all patients (n = 9) with the highest IFN-γ levels (ranked in descending order) belonged to the MRMP group. Steroid treatment significantly reduced IFN-γ and IL-6 levels, suggesting effective modulation of excessive immune responses. LDH and AST levels were also correlated with IFN-γ and IL-6.
Conclusion: Therefore, IFN-γ may serve as a valuable biomarker for predicting a refractory clinical course of MP pneumonia. In addition, LDH and AST…
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