Abstract:Objective To investigate the association of YKL-40 in bronchoalveolar lavage fluid (BALF) with airway damage in children with Mycoplasma pneumoniae pneumonia (MPP). Methods A total of 60 children with MPP who were admitted to the hospital were enrolled as the MPP group, and 12 children with bronchial foreign bodies were enrolled as the control group. According to the imaging findings, the MPP group was further divided into 3 subgroups:pulmonary patchy shadow (n=34), pulmonary consolidation (n=19) and pulmonary ground-glass opacity (n=7). According to the bronchoscopic findings, the MPP group was further divided into 3 subgroups:mucosal congestion/edema (n=38), mucous secretion (n=18) and plastic bronchitis (n=4). The clinical manifestations and laboratory characteristics of the children with MPP were analyzed, the expression of YKL-40 in BALF was measured. Results The MPP group had significantly higher levels of serum lactate dehydrogenase and BALF YKL-40 than the control group (P < 0.05). The pulmonary consolidation subgroup had significantly higher levels of serum C-reactive protein and lactate dehydrogenase than the pulmonary patchy shadow subgroup (P < 0.05), and the pulmonary consolidation and pulmonary ground-glass opacity subgroups had a significantly higher level of BALF YKL-40 than the pulmonary patchy shadow subgroup (P < 0.05). The plastic bronchitis subgroup had a significantly higher level of BALF YKL-40 than the mucous secretion and mucosal congestion/edema subgroups (P < 0.05). The mucous secretion and plastic bronchitis subgroups had a significantly higher proportion of children with shortness of breath than the mucosal congestion/edema subgroup (P < 0.05). The plastic bronchitis subgroup had significantly higher serum levels of C-reactive protein and lactate dehydrogenase than the mucosal congestion/edema subgroup (P < 0.05). Conclusions The level of BALF YKL-40 is associated with airway damage and disease severity in children with MPP.
HUANG Li-Lin,LI Rong-Han,LI Jing et al. Association of YKL-40 in bronchoalveolar lavage fluid with airway damage in children with Mycoplasma pneumoniae pneumonia[J]. CJCP, 2019, 21(12): 1188-1192.
Youn YS, Lee KY. Mycoplasma pneumoniae pneumonia in children[J]. Korean J Pediatr, 2012, 55(2):42-47.
[2]
Marion CR, Wang J, Sharma L, et al. Chitinase 3-like 1(Chil1) regulates survival and macrophage-mediated interleukin-1β and tumor necrosis factor alpha during pseudomonas aeruginosa pneumonia[J]. Infect Immun, 2016, 84(7):2094-2104.
[3]
James A, Stenberg Hammar K, Reinius L, et al. A longitudinal assessment of circulating YKL-40 levels in preschool children with wheeze[J]. Pediatr Allergy Immunol, 2017, 28(1):79-85.
[4]
Duru S, Yüce G, Ulasli SS, et al. The relationship between serum YKL-40 levels and severity of asthma[J]. Iran J Allergy Asthma Immunol, 2013, 12(3):247-253.
[5]
Lai T, Wu D, Chen M, et al. YKL-40 expression in chronic obstructive pulmonary disease:relation to acute exacerbations and airway remodeling[J]. Respir Res, 2016, 17:31.
Huang L, Chen H, Peng S. Spontaneous pneumomediastinum, emphysema, and pulmonary bullae associated with refractory Mycoplasma pneumoniae pneumonia in a child[J]. Pediatr Pulmonol, 2017, 52(10):E77-E80.
[11]
Kang MJ, Yoon CM, Nam M, et al. Role of Chitinase 3-like-1 in interleukin-18-induced pulmonary type 1, type 2, and type 17 inflammation; alveolar destruction; and airway fibrosis in the murine lung[J]. Am J Respir Cell Mol Biol, 2015, 53(6):863-871.
[12]
Spoorenberg SM, Vestjens SM, Rijkers GT, et al. YKL-40, CCL18 and SP-D predict mortality in patients hospitalized with community-acquired pneumonia[J]. Respirology, 2017, 22(3):542-550.
[13]
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[J]. BMC Pediatr, 2018, 18(1):381.