Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Using 16S rDNA Sequencing Technology to Preliminarily Analyze Intestinal Flora in Children with Mycoplasma pneumoniae Pneumonia

Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.

Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage:A single-center retrospective study

BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.

Preparation of Curcumin Chitosan Nanoparticles and Its Effect on Free Radical Injury in Mice with Mycoplasma Pneumoniae Pneumonia

Objective:Curcumin(Cur)and Chitosan(CS)were utilized as primary components for the production of curcumin chitosan nanoparticles.The impact of these nanoparticles on oxidative stress in mycoplasma pneumoniae-infected mice was assessed.Methods:The drug loading and entrapment efficiency of Cur-CS nanoparticles were determined for various feeding ratios,and the release profiles of Cur-CS nanoparticles in different release media were investigated using the dynamic membrane dialysis method.The mycoplasma pneumoniae pneumonia(MPP)mouse model was created through the infection of mice with mycoplasma pneumoniae.The mice were then allocated randomly into five groups:a blank control group,an MPP model group,a low Cur-CS dose group,a middle Cur-CS dose group,and a high Cur-CS dose group,each consisting of 7 mice.The study compared the levels of antioxidant enzymes and phospholipid peroxide content in the lung tissue of mice across various experimental groups.Results:The findings indicated that the drug loading of nanoparticles escalated from 2.10%to 11.74%as the feed ratio of Cur to CS increased from 1∶20 to 1∶2.5.Concurrently,as drug loading increased,the entrapment efficiency of nanoparticles decreased from 85.33%to 58.92%.The cumulative release rate of Cur was 95.3%after 24 h,whereas the cumulative release rate of Cur-CS nanoparticles was only 94.3%after 48 h.Analysis of the lung tissue samples indicated that the levels of SOD[(76.17±9.36)U/ml,(86.23±10.09)U/ml,(98.06±11.12)U/ml]and GSH-Px[(19.75±2.22)U/ml,(23.92±2.53)U/ml,(27.23±2.67)U/ml]were significantly higher than those in the MPP model group(P<0.05).Conclusion:This suggests that curcumin chitosan nanoparticles may be suitable for antioxidant treatment of mycoplasma pneumoniae in mice,and can dose-dependently inhibit the release of oxygen free radicals in the lung tissue of MPP mice.This finding may offer a new avenue for the development of therapeutic drug carriers for MPP.

Proteomics study of Mycoplasma pneumoniae pneumonia reveals the Fc fragment of the IgG-binding protein as a serum biomarker and implicates potential therapeutic targets

Macrolide and corticosteroid resistance has been reported in patients with Mycoplasma pneumoniae(MP)pneumonia(MPP).MP clearance is difficult to achieve through antibiotic treatment in sensitive patients with severe MPP(SMPP).SMPP in children might progress to airway remodeling and even bronchiolitis/bronchitis obliterans.Therefore,identifying serum biomarkers that indicate MPP progression and exploring new targeted drugs for SMPP treatment require urgency.In this study,serum samples were collected from patients with general MPP(GMPP)and SMPP to conduct proteomics profiling.The Fc fragment of the IgG-binding protein(FCGBP)was identified as the most promising indicator of SMPP.Biological enrichment analysis indicated uncontrolled inflammation in SMPP.ELISA results proved that the FCGBP level in patients with SMPP was substantially higher than that in patients with GMPP.Furthermore,the FCGBP levels showed a decreasing trend in patients with GMPP but the opposite trend in patients with SMPP during disease progression.Connectivity map analyses identified 25 possible targeted drugs for SMPP treatment.Among them,a mechanistic target of rapamycin kinase(mTOR)inhibitor,which is a macrolide compound and a cell proliferation inhibitor,was the most promising candidate for targeting SMPP.To our knowledge,this study was the first proteomics-based characterization of patients with SMPP and GMPP.

Establishment of a Predictive Diagnostic Model for Acute Mycoplasma Pneumoniae Infection in Elderly Patients with Community-acquired Pneumonia

We established a diagnostic model to predict acute Mycoplasma pneumoniae （M. pneumonia） infection in elderly Community-acquired pneumonia （CAP） patients. We divided 456 patients into acute and non-acute M. pneumoniae infection groups. Binary logistic regression and receiver operating characteristic （ROC） curves were used to establish a predictive model. The following independent factors were identified： age 〉 70 years; serum cTNT level 〉 0.0S ng/mL; lobar consolidation; mediastinal lymphadenopathy; and antibody titer in the acute phase 〉 1：40. The area under the ROC curve of the model was 0.923 and a score of 2 7 score predicted acute M. pneumoniae infection in elderly patients with CAP. The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M. pneumoniae infection.