摘要
目的研究社区获得性呼吸窘迫综合征毒素(community-acquired respiratory distress syndrome toxin,CARDS Tx)与Nod样受体蛋白3(Nod-like receptor protein 3,NLRP3)/白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-18(interleukin-18,IL-18)通路在儿童重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)中的作用,并评价血清CARDS Tx、NLRP3、IL-1β、IL-18水平对SMPP的预测价值。方法选取2020年10月~2021年9月兰州大学第二医院收治的肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿为研究对象,根据疾病的严重程度将其分为MPP组与SMPP组,并选择同期至兰州大学第二医院体检的健康儿童为对照组。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测3组受检者血清中CARDS Tx、NLRP3、IL-1β、IL-18的水平;收集SMPP组中患儿的患侧与对侧支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF),采用ELISA法检测BALF中CARDS Tx、NLRP3、IL-1β、IL-18的水平。结果血清、BALF中CARDS Tx与NLRP3均呈显著正相关(r>0.45,P<0.01)。患侧组BALF中的CARDS Tx、NLRP3、IL-1β、IL-18水平显著高于对侧组(P<0.001)。血清中CARDS Tx、NLRP3、IL-1β、IL-18水平均为SMPP组>MPP组>对照组(P<0.001)。血清中CARDS Tx、NLRP3、IL-1β、IL-18预测SMPP的受试者操作特征(receiver operating characteristic,ROC)的曲线下面积(area under the curve,AUC)均大于0.7(P<0.001)。结论CARDS Tx不仅存在于损伤肺局部,还可进入血液循环,通过激活机体内NLRP3/IL-1β、IL-18通路介导SMPP的发生与进展,并参与SMPP患儿的局部肺损伤机制。血清CARDS Tx、NLRP3、IL-1β、IL-18水平可有效预测SMPP,动态监测其变化情况对于SMPP的疗效评估可能具有重要价值。
Objective To explore the role of community-acquired respiratory distress syndrome toxin(CARDS Tx)and Nod-like receptor protein 3(NLRP3)/interleukin-1β(IL-1β)and IL-18 pathway in children with severe mycoplasma pneumoniae pneumonia(SMPP)and evaluate the predictive value of serum CARDS Tx,NLRP3,IL-1βand IL-18 levels on SMPP.Methods The children admitted to Lanzhou University second Hospital with mycoplasma pneumoniae pneumonia(MPP)from October 2020 to September 2021 were selected as the research objects,which were divided into MPP group and SMPP group depending on the severity of the disease,and the healthy children who came to Lanzhou University second Hospital for physical examination during the same period were selected as the control group.The serum levels of CARDS Tx,NLRP3,IL-1βand IL-18 in MPP group,SMPP group and control group were tested by enzyme linked immunosorbent assay(ELISA).The bronchoalveolar lavage fluid(BALF)of trouble side and contralateral side of the children in SMPP group were collected,the levels of CARDS Tx,NLRP3,IL-1βand IL-18 in the BALF were tested by ELISA.ResultsThere was a significant positive correlation between CARDS Tx and NLRP3 in serum and BALF(r>0.45,P<0.01).The levels of CARDS Tx,NLRP3,IL-1βand IL-18 in BALF of trouble side were significantly higher than those in the contralateral side(P<0.001).The serum levels of CARDS TX,NLRP3,IL-1β,and IL-18 of the three groups from high to low followed by SMPP group,MPP group and control group.SMPP group is significantly higher than MPP group and control group which is significantly lower than MPP group(P<0.001).The serum CARDS Tx,NLRP3,IL-1βand IL-18 predicted the area under the curve(AUC)of receiver operating characteristic(ROC)curve in SMPP were greater than 0.7(P<0.001).Conclusion CARDS Tx not only exists in the injured lung,but can also enter the blood circulation.CARDS Tx mediates the occurrence and development of SMPP by activating NLRP3/IL-1βand IL-18 pathway,which is involved in the mechanism of local lung injury in Children with SMPP.The serum levels of CARDS Tx,NLRP3,IL-1βand IL-18 can effectively predict SMPP,and dynamic monitoring of their changes may have important value for the efficacy evaluation of SMPP.
作者
曹囡囡
黄莉
焦琼杰
丁霞
燕江雪
倪倩
CAO Nannan;HUANG Li;JIAO Qiongjie(The Second Clinical Medical College of Lanzhou University,Gansu 730000,China)
出处
《医学研究杂志》
2023年第1期61-65,共5页
Journal of Medical Research
基金
甘肃省自然科学基金资助项目(20JR10RA746)
甘肃省兰州市科技发展指导性计划项目(2020-ZD-98)
兰州大学教育发展基金科研项目(第二临床医学院医学事业发展基金资助项目)(071100141)
兰州大学第二医院“萃英科技创新”计划项目(CY-2020-MS13)。
作者简介
通信作者:倪倩,主任医师,硕士生导师,电子信箱:natelieniqian@yeah.net。
