Analysis on associations of IL-17A,ICAM-1 and MUC5AC levels in bronchoalveolar lavage fluid and serum with MPP complicating AMP and clinical prognosis in pediatric patients
LI Fang
ZOU Deng
LEI Chaolan
PENG Xinxin
LEI Yuan
Abstract：Objective To explore the associations of interleukin-17A(IL-17A),intercellular adhesion molecule-1(ICAM-1)and mucin 5AC(MUC5AC)levels in bronchoalveolar lavage fluid(BALF)and serum with Mycoplasma pneumoniae pneumonia(MPP)complicating airway mucus plugs(AMP)and clinical prognosis in pediatric patients.Methods A total of 249 pediatric patients with MPP who were admitted to the Fourth Hospital of Changsha from October 2020 to October 2024 were recruited in a 1∶2 matching design.The pediatric patients were divided into AMP group(83 patients)and non-AMP group(166 patients)according to the occurrence of AMP.BALF and serum specimens were collected before treatment.The levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum were detected by using enzyme-linked immunosorbent assay(ELISA)and were compared between the two groups.The pediatric patients were followed up and their prognosis was observed 28 days after admission for treatment.The factors influencing prognosis of the MPP pediatric patients complicated with AMP were analyzed by using logistic regression.The efficacy of IL-17A,ICAM-1 and MUC5AC levels in BALF and serum in diagnosing the MPP pediatric patients complicated with AMP and the efficacy in predicting the prognosis of the MPP pediatric patients complicated with AMP were analyzed by using receiver operating characteristic(ROC)curve.Results The levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum in the AMP group were higher than those in the non-AMP group,with statistically significant differences between the two groups(P＜0.05).The results of ROC curve analysis showed that the levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum could effectively diagnose the MPP pediatric patients complicated with AMP(P＜0.05),and the diagnostic efficacy of the combination of the three indicators was superior to that of a single indicator(P＜0.05),and the combined diagnostic efficacy of the three indicators in BALF was comparable to that of the three indicators in serum,and the difference was not statistically significant(Z=1.303,P=0.193).The poor prognosis rate of the MPP pediatric patients complicated with AMP was 36.14%(30/83).The results of multivariate logistic regression analysis showed that higher levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum were independent risk factors for poor prognosis in the MPP pediatric patients complicated with AMP(P＜0.05).The results of ROC curve analysis showed that the levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum could effectively predict the poor prognosis of the MPP pediatric patients complicated with AMP(P＜0.05),and the diagnostic efficacy of the combination of the three indicators was superior to that of a single indicator(P＜0.05).The combined diagnostic efficacy of the three indicators in BALF was comparable to that of the three indicators in serum,and the difference was not statistically significant(Z=1.426,P=0.141).Conclusion Elevated levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum are associated with the complicating AMP and poor clinical prognosis in MPP pediatric patients.The combined detection of the three indicators is helpful for clinicians to identify the high-risk pediatric patients and perform active interventions and treatments,improving the prognosis of the pediatric patients.
Keywords：Mycoplasma pneumoniae pneumonia(MPP)Interleukin-17A(IL-17A)Intercellular adhesion molecule-1(ICAM-1)Mucin 5AC(MUC5AC)Airway mucus plugs(AMP)Clinical prognosis
Publication Date：2025-12-30
Online Publishing Date：2026-01-16(First online date of this platform, not the publication date of the document)
Pages：7( 1378-1384 )