Changes in the miR-1323/IL-6 inflammatory axis in peripheral blood of children with refractory mycoplasma pneu-moniae pneumonia and its correlation with poor prognosis risk

Xiao Erming; Liu Haijie; Yu Meiyao; Bian Ling; Liu Xiaojing

doi:10.3969/j.issn.1671-6450.2025.09.015

Abstract：Objective To investigate changes in the microRNA-1323(miR-1323)/interleukin-6(IL-6)inflammatory axis in peripheral blood of children with refractory Mycoplasma pneumoniae pneumonia(RMPP)and its correlation with the risk of poor prognosis.Methods A total of 202 children with RMPP admitted to the Pediatric Department of Maternity and Child Healthcare Hospital in Langfang City,Hebei Province,from January 2021 to March 2024 were selected as study sub-jects.Based on treatment prognosis,children were categorized into a good prognosis group(n=160)and a poor prognosis group(n=42).According to disease severity,they were further divided into a mild subgroup(n=33),a moderate subgroup(n=91),and a severe subgroup(n=78).Real-time quantitative polymerase chain reaction(qPCR)was used to detect the rela-tive expression level of miR-1323,and enzyme-linked immunosorbent assay(ELISA)was used to measure serum IL-6 levels.Pearson correlation analysis was conducted to examine the correlation between miR-1323,IL-6 levels,and CRP and PCT lev-els in children with RMPP.Multivariate Logistic regression analysis was performed to explore the relationship between miR-1323,IL-6 levels,and poor prognosis.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predic-tive value of the miR-1323/IL-6 inflammatory axis for poor prognosis in children with RMPP.Results Levels of miR-1323 and IL-6 were higher in the poor prognosis group than in the good prognosis group(t/P=8.523/＜0.001,6.514/＜0.001).As dis-ease severity increased,miR-1323 and IL-6 levels gradually rose(F/P=41.205/＜0.001,44.976/＜0.001).Pearson correlation analysis showed that miR-1323 and IL-6 levels were positively correlated with CRP and PCT levels(miR-1323:r/P=0.734/＜0.001,0.824/＜0.001;IL-6:r/P=0.839/＜0.001,0.834/＜0.001).Multivariate logistic regression analysis revealed that high miR-1323 and IL-6 levels were independent risk factors for poor prognosis in children with RMPP[OR(95％CI)=1.661(1.305-2.115),1.579(1.231-2.026)].The AUCs for predicting poor prognosis using miR-1323 alone,IL-6 alone,and their combination were 0.793,0.779,and 0.895,respectively.The miR-1323/IL-6 inflammatory axis showed superior predictive per-formance compared to either factor alone(Z/P=1.997/0.043,2.367/0.031).Conclusion The peripheral blood miR-1323/IL-6 inflammatory axis is significantly upregulated in children with RMPP,independently associated with poor prognosis risk,and demonstrates reliable predictive value.