Analysis of gut microbiota and fecal immune factors in children with Mycoplasma pneumoniae pneumonia
10.3760/cma.j.cn112309-20240428-00151
- VernacularTitle:肺炎支原体肺炎患儿肠道菌群和粪便免疫因子分析
- Author:
Jinjin HU
1
;
Xiaoying ZHANG
Author Information
1. 上海交通大学医学院附属第九人民医院儿科，上海 200011
- Keywords:
Mycoplasma pneumoniae pneumonia;
Intestinal microbiota;
Immune factors;
Blautia;
Bifidobacterium
- From:
Chinese Journal of Microbiology and Immunology
2024;44(10):838-852
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences in gut microbiota and immune factors in fecal lysate of children with different clinical subtypes of Mycoplasma pneumoniae pneumonia (MPP). Methods:Children aged 3-14 years with MPP who visited Shanghai Ninth People′s Hospital from March 2023 to February 2024 were selected and divided into general group (GMPP group) and severe group (SMPP group) based on the severity of the condition. They were also divided into non-refractory group (NRMPP group) and refractory group (RMPP group) based on treatment response. 16S rRNA sequencing was used to analyze the characteristics of gut microbiota, and MSD electrochemiluminescence method was used to determine the levels of immune factors in fecal lysate. Differences in the clinical characteristics, gut microbiota, and fecal immune factors were analyzed. Spearman correlation analysis was performed. Receiver operating characteristic(ROC) curve was used to analyze the evaluation and predictive value of gut microbiota in clinical classification of MPP.Results:Among the 64 children with MPP, there were 34 cases in the GMPP group and 30 cases in the SMPP group. There were statistically significant differences between the two groups in terms of fever duration, presence or absence of hypoxemia, C-reactive protein(CRP), D-Dimer, and chest CT scores ( t=-4.94, P<0.001; χ2=5.33, P=0.021; z=-2.93, P=0.003; z=-3.93, P<0.001; z=-4.10, P<0.001). Among the 64 children with MPP, there were 50 cases in the NRMPP group and 14 cases in the RMPP group. There were statistically significant differences in age, fever duration, and chest CT scores between the two groups ( t=-3.21, P=0.002; t=-5.28, P<0.001; z=-2.95, P=0.003). There was no statistically significant difference in the alpha diversity analysis of gut microbiota between GMPP group and SMPP group( P>0.05). There was a statistically significant difference in beta diversity analysis between the two groups of gut microbiota ( R2=0.06, P=0.001). Species difference analysis showed that the relative abundance of Bifidobacterium in the SMPP group was significantly lower than that in the GMPP group, while the relative abundance of Blautia and Ruminococcus gnavus was significantly higher than that in the GMPP group, with statistical significance ( z=5.21, P<0.001, Q=0.039; z=1.56, P<0.001, Q=0.039; z=2.08, P=0.007, Q=0.700). There was no statistically significant difference in the alpha diversity analysis of gut microbiota between NRMPP and RMPP group( P>0.05). There was a statistically significant difference in beta diversity analysis between the two groups of gut microbiota ( R2=0.05, P=0.001). Analysis of species differences showed that the relative abundance of Bifidobacterium and Subdoligranulum in the RMPP group was significantly lower than that in the NRMPP group, while the relative abundance of Blautia and Ruminococcus gnavus was significantly higher than that in the NRMPP group, with statistical significance( z=3.44, P=0.012, Q=0.638; z=3.64, P=0.040, Q=0.638; z=5.80, P=0.001, Q=0.338; z=5.46, P=0.015, Q=0.638). The level of fecal immune factors IL-10 and IL-1β were statistically significant between GMPP group and SMPP group( z=-1.96, P=0.050; z=-2.46, P=0.014). The level of fecal immune factors IFN-γ, IL-10, IL-1β, IL-8, and TNF-α were statistically significant between NRMPP group and RMPP group ( z=-2.20, P=0.028; z=-2.17, P=0.030; z=-2.00, P=0.046; z=-2.14, P=0.032; z=-2.22, P=0.027). Sperman correlation analysis showed that Bifidobacterium was negatively correlated with fever duration and chest CT score ( r=-0.35, P=0.005; r=-0.30, P=0.017); Blautia was positively correlated with D-Dimer, fever duration, and chest CT score ( r=0.33, P=0.008; r=0.37, P=0.003; r=0.40, P=0.001); Ruminococcus gnavus and TNF-α, IL-10, IL-4, and IL-6 were negatively correlated ( r=-0.34, P=0.001; r=-0.29, P=0.021; r=-0.28, P=0.024; r=-0.28, P=0.027). ROC curve analysis showed that the area under curve(AUC) of Bifidobacterium abundance for assessing the severity of MPP was 0.767 (95% CI: 0.649-0.885, P<0.001). The AUC of Blautia abundance for assessing the severity of MPP was 0.774 (95% CI: 0.658-0.889, P<0.001), and the AUC for predicting treatment response to MPP was 0.787 (95% CI: 0.655-0.919, P=0.001). Conclusions:The levels of fecal immune factors vary among children with different clinical subtypes of MPP. The relative abundance analysis of Bifidobacterium and Blautia in the gut microbiota of children with MPP may have certain clinical value for evaluating the severity of MPP, adopting adjuvant therapy, and predicting treatment response.
