Predictive Value of Plasma SB7-H3 and YKL-40 in Pediatric Refractory Mycoplasma Pneumoniae Pneumonia

Overview

Journal Open Med (Wars)

Date 2025 Jan 17

PMID 39822987

Authors

QiuMin Zhao

ShiYan Ji

Haiping Jiang

Dongming Lu

LiFen Qian

Jingwen Zhang

Yue Cui

Wei Lin

HaoYing Ge

Meng Gu

Affiliations

Soon will be listed here.

Abstract

Objective: This study investigated the clinical significance of plasma sB7-H3 and YKL-40 levels in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).

Methods: A total of 182 RMPP patients (103 general Mycoplasma pneumoniae patients and 79 RMPP patients) were included. sB7-H3, YKL-40, and other inflammatory factors were measured. Independent factors associated with the early diagnosis of RMPP were determined. The value of each independent risk factor in predicting RMPP was evaluated.

Results: The RMPP group reported significantly longer hospital stays and total fever durations. Levels of C-reactive protein, D-dimer, IL-13, IL-6/-10, sB7-H3, and YKL-40 were higher in the RMPP group. sB7-H3 was positively correlated with IL-13, IL-6, and IL-4, whereas YKL-40 was positively correlated with all of the above indicators (IL-5 was also included). sB7-H3 and YKL-40 were independent risk factors for RMPP. The critical values for sB7-H3 and YKL-40 were 3.525 and 313.3 ng/mL, respectively. sB7-H3 and YKL-40 had areas under the curve of 0.734 and 0.859, respectively. YKL-40 had high sensitivity and specificity of 88.61 and 87.38%, respectively. Both indicators had predictive value, YKL-40 had the highest predictive ability for RMPP.

Conclusion: Detection of sB7-H3 and YKL-40 levels in the plasma may be useful in diagnosing RMPP early in the disease process.

References

Unal Cetin E, Kamis F, Cetin A, Beyazit Y, Kekilli M . Serum chitotriosidase and YKL-40 in acute pancreatitis: Reliability as prognostic marker for disease severity and correlation with inflammatory markers. Turk J Med Sci. 2021; 51(6):3038-3046. PMC: 10734882. DOI: 10.3906/sag-2106-59. View

Nakano H, Free M, Whitehead G, Maruoka S, Wilson R, Nakano K . Pulmonary CD103(+) dendritic cells prime Th2 responses to inhaled allergens. Mucosal Immunol. 2011; 5(1):53-65. PMC: 3697034. DOI: 10.1038/mi.2011.47. View

Ji J, Song L, Hong F, Zhang W, Zhu M, Yang X . Highly Expressed lncRNA GAS5 in the Serum of Children with Pneumonia and Its Effect on LAMPs-Induced Apoptosis and Inflammation. Contrast Media Mol Imaging. 2022; 2022:7872107. PMC: 9381243. DOI: 10.1155/2022/7872107. View

Xue Y, Wang M, Han H . Interaction between alveolar macrophages and epithelial cells during infection. Front Cell Infect Microbiol. 2023; 13:1052020. PMC: 10126420. DOI: 10.3389/fcimb.2023.1052020. View

Shimizu T, Kida Y, Kuwano K . Cytoadherence-dependent induction of inflammatory responses by Mycoplasma pneumoniae. Immunology. 2011; 133(1):51-61. PMC: 3088967. DOI: 10.1111/j.1365-2567.2011.03408.x. View

Kim Y, Choi S, Choi J, Jeon S, Oh S, Lee B . IL-12-STAT4-IFN-gamma axis is a key downstream pathway in the development of IL-13-mediated asthma phenotypes in a Th2 type asthma model. Exp Mol Med. 2010; 42(8):533-46. PMC: 2928926. DOI: 10.3858/emm.2010.42.8.054. View

Gao L, Yin J, Hu Y, Liu X, Feng X, He J . The epidemiology of paediatric Mycoplasma pneumoniae pneumonia in North China: 2006 to 2016. Epidemiol Infect. 2019; 147:e192. PMC: 6518602. DOI: 10.1017/S0950268819000839. View

Yang X, Sheng G . YKL-40 levels are associated with disease severity and prognosis of viral pneumonia, but not available in bacterial pneumonia in children. BMC Pediatr. 2018; 18(1):381. PMC: 6280336. DOI: 10.1186/s12887-018-1345-y. View

Xu Y, Yu L, Hao C, Wang Y, Zhu C, Ji W . Plasma soluble B7-H3 levels for severity evaluation in pediatric patients with Mycoplasma pneumoniae pneumonia. Int Immunopharmacol. 2019; 73:163-171. DOI: 10.1016/j.intimp.2019.05.014. View

10.

Lu A, Wang C, Zhang X, Wang L, Qian L . Lactate Dehydrogenase as a Biomarker for Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children. Respir Care. 2015; 60(10):1469-75. DOI: 10.4187/respcare.03920. View

11.

Nielsen A, Plomgaard P, Krabbe K, Johansen J, Pedersen B . IL-6, but not TNF-α, increases plasma YKL-40 in human subjects. Cytokine. 2011; 55(1):152-5. DOI: 10.1016/j.cyto.2011.03.014. View

12.

Shimizu T, Kimura Y, Kida Y, Kuwano K, Tachibana M, Hashino M . Cytadherence of Mycoplasma pneumoniae induces inflammatory responses through autophagy and toll-like receptor 4. Infect Immun. 2014; 82(7):3076-86. PMC: 4097642. DOI: 10.1128/IAI.01961-14. View

13.

Peng L, Zhang H, Hao Y, Xu F, Yang J, Zhang R . Reprogramming macrophage orientation by microRNA 146b targeting transcription factor IRF5. EBioMedicine. 2016; 14:83-96. PMC: 5161420. DOI: 10.1016/j.ebiom.2016.10.041. View

14.

Nada D, Julien C, Rompre P, Akoume M, Gorman K, Samuels M . Association of Circulating YKL-40 Levels and CHI3L1 Variants with the Risk of Spinal Deformity Progression in Adolescent Idiopathic Scoliosis. Sci Rep. 2019; 9(1):5712. PMC: 6450973. DOI: 10.1038/s41598-019-41191-4. View

15.

Li Y, Yang W, Wu X, Gou X . Effect of bronchofiberscopic lavage with budesonide suspension on refractory mycoplasma pneumoniae pneumonia. Pak J Med Sci. 2022; 38(4Part-II):922-927. PMC: 9121973. DOI: 10.12669/pjms.38.4.4835. View

16.

Lorenz G, Schmalenberg M, Kemmner S, Haller B, Steubl D, Pham D . Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 40-kDa glycoprotein associated with inflammation. Kidney Int. 2017; 93(1):221-230. DOI: 10.1016/j.kint.2017.07.010. View

17.

Huang W, Xu X, Zhao W, Cheng Q . Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors. J Immunol Res. 2022; 2022:9227838. PMC: 9251082. DOI: 10.1155/2022/9227838. View

18.

Fang C, Mao Y, Jiang M, Yin W . Pediatric Critical Illness Score, Clinical Characteristics and Comprehensive Treatment of Children with Severe Mycoplasma Pneumoniae Pneumonia. Front Surg. 2022; 9:897550. PMC: 9174934. DOI: 10.3389/fsurg.2022.897550. View

19.

Huang F, Fan H, Yang D, Zhang J, Shi T, Zhang D . Ribosomal RNA‑depleted RNA sequencing reveals the pathogenesis of refractory pneumonia in children. Mol Med Rep. 2021; 24(5). PMC: 8436218. DOI: 10.3892/mmr.2021.12401. View

20.

Gu W, Li G, Zhang W, Zhang X, He Y, Huang L . MiR-29b regulates Th2 cell differentiation in asthma by targeting inducible B7-H3 and STAT3. Clin Transl Allergy. 2022; 12(1):e12114. PMC: 8764737. DOI: 10.1002/clt2.12114. View