Th17-related cytokines are involved in the response to step-wise treatment of Mycoplasma pneumoniae pneumonia in children

Purpose: Treatment responses to Mycoplasma pneumoniae (MP) pneumonia in children exhibit considerable variability.It is essential to identify predictive indicators and elucidate mechanisms associated with treatment responses.This study aimed to characterize the clinical, radiological, laboratory, and cytokine profiles associated with treatment responses in pediatric MP pneumonia.Methods: A retrospective analysis was performed in 85 children hospitalized with MP pneumonia between May 2019 and March 2020.Patients were categorized into the good response group (n=74) or the poor response group (n=11) based on clinical responses to step-wise treatment.Clinical characteristics, radiological findings, laboratory parameters, and serum levels of 27 cytokines obtained at admission were compared between the groups.Results: Compared to the good response group, the poor response group exhibited significantly longer fever duration (11.36±5.33 days vs. 5.77±3.95days, P=0.006), more frequent lobar consolidation (63.6% vs. 20.3%,P=0.043), and higher lactate dehydrogenase levels (1,146±505 IU/L vs. 731±231 IU/L, P=0.008) and MP-specific immunoglobulin M index (6.49±3.01 vs. 3.85±3.28,P=0.014).Among the cytokines assessed, IL-21, IL-22, and IL-31 levels were significantly elevated in the good response group.IL-17A levels were also higher in this group, albeit not statistically significant.Conclusion: Early identification of clinical, laboratory, and radiologic markers may facilitate early prediction of treatment response in pediatric MP pneumonia.Elevated IL-21, IL-22, and IL-31 levels in the good response group suggest a potential role for Th17-related cytokine activity in favorable treatment outcomes, warranting further investigation in larger cohorts.(Allergy