儿童血清白细胞介素-17水平与肺炎支原体肺炎的关系:系统回顾和荟萃分析。

IF 1.5 4区 医学 Q2 PEDIATRICS Translational pediatrics Pub Date : 2024-09-30 Epub Date: 2024-09-26 DOI:10.21037/tp-24-218
Nontaphat Leerach, Sutthirat Sitthisak, Thawatchai Kitti, Nattawat Teerawattanapong, Wiriya Mahikul, Supaporn Lamlertthon, Nathorn Chaiyakunapruk, Kannipa Tasanapak
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引用次数: 0

摘要

背景:肺炎支原体(M:肺炎支原体(M. pneumoniae)是社区获得性肺炎的常见病原体。白细胞介素-17(IL-17)在宿主防御中发挥作用,并在感染中导致疾病的严重程度。本研究旨在探讨肺炎支原体肺炎(MPP)与儿科患者血清中 IL-17 水平变化之间的关联:研究方案已在 PROSPERO(CRD42023489451)上注册。从开始到 2023 年 10 月,在 PubMed、EMBASE、Scopus 和 Web of Science 上进行了文献检索。荟萃分析汇集了患者和对照组之间 IL-17 水平的平均差 (MD) 和 95% 置信区间 (CI)。采用纽卡斯尔-渥太华量表(NOS)评估了发表偏倚和偏倚风险:在 207 条记录中,有 10 项研究被纳入综述,9 项研究被纳入荟萃分析。其中,7 项研究比较了普通 MPP 患者和对照组的 IL-17,6 项研究比较了重度 MPP 患者和轻度 MPP 患者。与对照组相比,普通 MPP 患者的血清 IL-17 水平明显升高(MD =33.94 pg/mL,95% CI:24.66, 43.22 pg/mL,P=0.01,I2=99.07%;P=0.01)。亚组分析显示,使用大环内酯类药物治疗的患者与对照组的血清IL-17水平存在差异(MD=83.96 pg/mL,95% CI:76.62,91.29 pg/mL,P=0.01)。在重度和轻度 MPP 中,IL-17 水平显著升高(MD =19.08 pg/mL,95% CI:11.51, 26.65 pg/mL,P=0.01),并出现异质性(I2=99.39%;P=0.01)。在偏倚风险方面,2项研究在可比性方面具有 "高风险",7项研究被归类为 "低风险 "和 "不明确风险":我们的荟萃分析表明,血清IL-17水平在患有一般和严重MPP的儿科患者中明显升高。IL-17可能是肺炎双球菌所致肺炎的潜在生物标志物或治疗靶点。
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Association of serum interleukin-17 level and Mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis.

Background: Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen of community-acquired pneumonia. Interleukin-17 (IL-17) plays a role in host defense and contributes to disease severity in infection. This present study aims to investigate the association between Mycoplasma pneumoniae pneumonia (MPP) and changes of IL-17 level in the serum of pediatric patients.

Methods: The protocol has been registered in PROSPERO (CRD42023489451). A literature search was conducted in PubMed, EMBASE, Scopus, and Web of Science from inception to October 2023. A meta-analysis was performed to pool the mean difference (MD) with 95% confidence intervals (CIs) of IL-17 levels between patients and controls. Publication bias was assessed, and the risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS).

Results: Out of 207 records, 10 studies were included in the review and 9 studies were included in the meta-analysis. Of these, 7 studies compared IL-17 in general MPP patients with controls, 6 studies compared severe MPP patients with mild MPP patients. Serum IL-17 levels were significantly elevated in general MPP patients compared with control (MD =33.94 pg/mL, 95% CI: 24.66, 43.22 pg/mL, P=0.01, I2=99.07%; P=0.01). Subgroup analyses showed a difference in serum IL-17 levels treated by macrolide between patients and control (MD =83.96 pg/mL, 95% CI: 76.62, 91.29 pg/mL, P=0.01). In severe and mild MPP, the IL-17 levels were significantly increased (MD =19.08 pg/mL, 95% CI: 11.51, 26.65 pg/mL, P=0.01) and heterogeneity was appeared (I2=99.39%; P=0.01). For the risks of bias, two studies had a "high risk" in comparability domain, and the 7 studies were classified as "low risk" and "unclear risk".

Conclusions: Our meta-analysis revealed that serum IL-17 levels are significantly elevated in pediatric with general and severe MPP. IL-17 might be a potential biomarker or therapeutic target for pneumonia caused by M. pneumoniae.

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来源期刊
Translational pediatrics
Translational pediatrics Medicine-Pediatrics, Perinatology and Child Health
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