| Purpose:1 IFN-γ(Th1 type cytokine),IL-33 and IL-4(Th2 type cytokine)three cytokines and IFN-y in the peripheral blood of infants and young children with lower respiratory tract infection caused by Mycoplasma Pneumoniae(MP)/IL-33,IFN-γ/IL-4 ratio level;compare the changes of serum three cytokines and Th1/Th2 levels in the MP-infected wheezing group and MP-infected non-wheezing group;explore the three types of cells in the serum The role of the changes in the levels of factors and their Thl/Th2 ratio in the pathogenesis of lower respiratory tract infections in infants and young children caused by MP.MethodA total of 80 infants and young children with lower respiratory tract infection caused by MP who were admitted to the respiratory ward of Dalian Children’s Hospital from January 2019 to March 2020 were selected as the MP infection group,and their age,gender,clinical manifestations,and total serum levels were recorded.IgE value(IU/mL),eosinophil count(eosinophil,EOS)count(*10^9/L)and the characteristics of lung imaging,of which 49 children with wheezing symptoms were in the MP infection wheezing group,and none 31 children with wheezing symptoms were in the MP-infected non-wheezing group,and 30 infants and young children who participated in the health checkup at the same time period were selected as the healthy control group.Compare the total serum IgE values and EOS counts of the MP-infected wheezing group and MP-infected children;take 2ml of peripheral venous blood from the MP-infected group and healthy control group,and use ELISA to obtain IFN-y,IL-4,and IL-33 level,record the value(pg/mL),observe the respective changes in the levels of IFN-y,IL-4,and IL-33 in the three groups of serum,and calculate the ratios of IFN-γ/IL-33 and IFN-γ/IL-4 respectively,And compare between groups;analyze the correlation between the total IgE,peripheral blood EOS level and IL-4,IL-33,IFN-γ in the wheezing group.Result1.Among 80 children with lower respiratory tract infection caused by MP infection,children(12-36 months old)are the majority,accounting for 88.75%,and infancy(less than 12 months old)accounting for 11.25%.The clinical manifestations are mostly cough,fever,and wheezing,accounting for 100%,63.75%,and 61.25%respectively.In chest imaging,patchy shadows and lung texture enhancement were the majority,accounting for 58.75%and 41.25%respectively.2.There was no significant difference in the EOS count between the MP-infected wheezing group and the non-wheezing group(P>0.05).The EOS count and serum IL-4,IL-33,IFN-γ levels in the MP-infected wheezing group were compared Correlation analysis(P>0.05).3.The total serum IgE(IU/ml)of the MP-infected wheezing group and the MP-infected non-wheezing group were 123.5±69.65 and 61.48±38.34,respectively.The comparison between the two groups was statistically significant(P<0.05).The total of the MP-infected wheezing group IgE was higher than that in the MP-infected non-wheezing group.Correlation analysis between total IgE and serum IL-4,IL-33,IFN-y levels in MP infection wheezing group(P>0.05).4.Serum IL-4,IL-33,and IFN-γ in the MP infection group were 48.60±15.75,30.69±8.16,19.36±5.59(pg/mL),and the healthy control group were 34.40±15.10,14.83±8.16,respectively.26.90±9.33(pg/mL);comparing the levels of serum IL-4,IL-33,and IFN-y between the MP infection group and the healthy control group was statistically significant(P value<0.01),that is,IL-4 in the MP infection group,IL-33 level increased,IFN-y level decreased.5.Serum IL-4,IL-33,IFN-γ in the MP infection wheezing group were 49.41±11.04,22.43±9.90,19.80±5.00(pg/mL),and the MP infection non-wheezing group serum IL-4 and IL-33,IFN-γ were 48.11 ± 18.10,35.64± 18.40,18.67±6.42,respectively.The MP-infected wheezing group and MP-infected non-wheezing group were compared with the healthy control group,and they were statistically significant(P<0.05),that is,IL-4 and IL-33 increased,and IFN-y decreased in the MP-infected wheezing group and MP-infected non-wheezing group.6.Comparing the levels of IL-4 and IL-33 in the serum of the MP-infected wheezing group and the non-wheezing group was statistically significant(P<0.05),that is,the IL-4 and IL-33 levels of the MP-infected group were compared with the MP-infected non-wheezing group The increase was obvious;comparing the IFN-γ levels between the MP-infected wheezing group and the non-wheezing group,there was no statistically significant(P>0.05).7.Calculate the ratios of IFN-y/IL-4 and IFN-y/IL-33 in the MP infection group as 0.44±0.21,1.07±1.28,and the healthy control group IFN-γ/IL-4,IFN-y/IL-33 The ratios were 0.91 ±0.52,2.67±2.47,respectively.Comparison of the IFN-γ/IL-4 and IFN-y/IL-33 ratios of the groups respectively showed statistical significance(P<0.01),that is,children with MP infection Thl/Th2 immune imbalance,shift to Th2 direction;8.Calculate the ratios of IFN-γ/IL-4 and IFN-γ/IL-33 in the MP-infected wheezing group as 0.26±0.06 and l.44±1.52,respectively.The MP-infected non-wheezing group IFN-y/IL-4,IFN-y/IL-33 ratios were 0.42±0.15 and 0.49±0.24,respectively.Compared with the healthy control group,the difference was statistically significant(P<0.01),that is,children in the MP-infected wheezing group and non-wheezing group had Th1/Th2 immunity Unbalance,offset to Th2 direction;9.Compare the ratios of IFN-y/IL-4 and IFN-y/IL-33 between the MP-infected wheezing group and the MP-infected non-wheezing group.There is no statistical comparison between the MP-infected wheezing group and the non-wheezing group IFN-γ/IL-4 Scientific significance,P>0.05;The comparison of IFN-γ/IL-33 between MP-infected wheezing group and non-wheezing group was statistically significant(P<0.01).Conclusion1.In infants with lower respiratory tract infections caused by MP,the main clinical manifestations are cough,fever,and wheezing;chest imaging is dominated by patchy shadows and enhanced lung texture;the total IgE level of children with wheezing is higher than that of non-wheezing There was no difference in the counts of children and eosinophils.2.MP infection causes increased expression of IL-4,IL-33(Th2 cytokines),and decreased expression of IFN-y(Th1 cytokines);the expression of Th2 cytokines in infants with wheezing symptoms increases more significantly,The expression of TH1 decreased more significantly;IL-4,IL-33,and IFN-γ were involved in the pathogenesis of lower respiratory tract infections in infants and young children caused by MP.3.The levels of serum total IgE,eosinophil count and IL-4 and IL-33(Th2 cytokines)expression in infants with lower respiratory tract infections and infant wheezing group caused by MP increased.IFN-γ(Thl cells)Factor)expression reduction has no correlation.4.MP infection can cause Th1/Th2 immune imbalance in infants and young children,and Th2 immunity is dominant. |
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