Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5346
Revised: May 24, 2024
Accepted: June 11, 2024
Published online: August 16, 2024
Processing time: 67 Days and 6.5 Hours
Mycoplasma pneumoniae (MP) frequently causes respiratory infections in children, whereas Epstein-Barr virus (EBV) typically presents subclinical manifestations in immunocompetent pediatric populations. The incidence of MP and EBV co-infections is often overlooked clinically, with the contributory role of EBV in pulmonary infections alongside MP remaining unclear.
To evaluate the serum concentrations of interleukin-2 (IL-2) and interleukin-12 (IL-12) in pediatric patients with MP pneumonia co-infected with EBV and assess their prognostic implications.
We retrospectively analyzed clinical data from patients diagnosed with MP and EBV co-infection, isolated MP infection, and a control group of healthy children, spanning from January 1, 2018 to December 31, 2021. Serum IL-2 and IL-12 levels were quantified using enzyme-linked immunosorbent assay. Logistic regression was employed to identify factors influencing poor prognosis, while receiver operating characteristic (ROC) curves evaluated the prognostic utility of serum IL-2 and IL-12 levels in co-infected patients.
The co-infection group exhibited elevated serum IL-2 and C-reactive protein (CRP) levels compared to both the MP-only and control groups, with a reverse trend observed for IL-12 (P < 0.05). In the poor prognosis cohort, elevated CRP and IL-2 levels, alongside prolonged fever duration, contrasted with reduced IL-12 levels (P < 0.05). Logistic regression identified elevated IL-2 as an independent risk factor and high IL-12 as a protective factor for adverse outcomes (P < 0.05). ROC analysis indicated that the area under the curves for IL-2, IL-12, and their combination in predicting poor prognosis were 0.815, 0.895, and 0.915, respectively.
Elevated serum IL-2 and diminished IL-12 levels in pediatric patients with MP and EBV co-infection correlate with poorer prognosis, with combined IL-2 and IL-12 levels offering enhanced predictive accuracy.
Core Tip: This study presents a novel exploration of the interaction between immune response markers and co-infection outcomes in pediatric respiratory infections, focusing on Mycoplasma pneumoniae and Epstein-Barr virus. Our research addresses a critical gap in understanding the immunological dynamics in co-infected pediatric patients, offering insights into the prognostic values of interleukins interleukin-2 and interleukin-12. Through a comprehensive analysis of clinical data and a robust methodological approach, we provide evidence that serum levels of these cytokines are significantly associated with disease prognosis in co-infected individuals. The findings suggest a nuanced role of the immune system in managing co-infections, with potential implications for therapeutic strategies.