不同气道损害肺炎支原体肺炎患儿PI3K-Akt信号通路变化及治疗转归  

Changes of PI3K-Akt signaling pathway and treatment outcomes in Mycoplasma pneumoniae pneumonia children with different airway damage

作　　者：张俊英[1] 赵晓莉 王鑫 单馨慧 朱丕雷 ZHANG Jun-ying;ZHAO Xiao-li;WANG Xin;SHAN Xin-hui;ZHU Pi-lei(Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser Hospital),Qingdao,Shandong 266033,China)

机构地区：[1]青岛市中医医院(青岛市海慈医院)儿科,山东青岛266033

出　　处：《中华医院感染学杂志》2022年第7期1106-1110,共5页Chinese Journal of Nosocomiology

基　　金：山东省科技计划基金资助项目(2019-3801)。

摘　　要：目的 评估不同气道损害肺炎支原体(MP)肺炎患儿磷脂酰肌醇3-激酶(PI3K)-蛋白激酶B(Akt)信号通路变化情况,并分析其治疗转归情况。方法 回顾性分析2018年2月-2020年12月青岛市中医医院108例MP肺炎患儿临床资料,根据支气管镜表现分为黏膜充血组、黏液性分泌物组、黏液栓阻塞组,比较三组基线资料及支气管肺泡灌洗液(BALF)PI3K、Akt、核因子κB(NF-κB)mRNA表达量、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)水平,并评估三组治疗转归情况。结果 黏膜充血组血清C-反应蛋白、乳酸脱氢酶水平及BALF PI3K、Akt、NF-κB mRNA相对表达量、IFN-γ、TNF-α、IL-4、IL-6水平均低于黏液性分泌物组、黏液栓阻塞组(P<0.05),黏液性分泌物组则低于黏液栓阻塞组(P<0.05)。所有患儿均达到临床痊愈,但黏膜充血组退热时间、咳嗽消失时间、肺部啰音消失时间、住院时间均短于黏液性分泌物组及黏液栓阻塞组(P<0.05),黏液性分泌物组则短于黏液栓阻塞组(P<0.05)。结论 MP肺炎可能通过激活PI3K-Akt信号通路,活化NF-κB,介导机体细胞免疫及体液免疫应答,形成气道损害,该信号通路相关蛋白可作为新的治疗靶点,为MP肺炎提供治疗新方向。OBJECTIVE To evaluate the changes of phosphatidylinositol 3-kinase(PI3 K)-protein kinase B(Akt) signaling pathway in Mycoplasma pneumoniae(MP) pneumonia children with different airway damages, and to analyze the outcomes of treatment. METHODS The clinical data of 108 children patients with MP pneumonia in Qingdao Hospital of Traditional Chinese Medicine were retrospectively analyzed between Feb 2018 and Dec 2020. According to the results of bronchoscopy, they were divided into the mucosal hyperemia group, mucous secretion group and mucous plug obstruction group. The baseline data, mRNA expression levels of PI3 K, Akt and nuclear factor κB(NF-κB) and levels of interferon γ(IFN-γ), tumor necrosis factor-α(TNF-α), interleukin 4(IL-4) and interleukin-6(IL-6) in bronchoalveolar lavage fluid(BALF) were compared among the three groups. The treatment outcomes in the three groups were evaluated. RESULTS The levels of serum C-reactive protein and lactate dehydrogenase as well as mRNA relative expression levels of PI3 K, Akt and NF-κB and levels of IFN-γ, TNF-α, IL-4 and IL-6 in BALF in the mucosal hyperemia group were significantly lower than those in the mucous secretion group and mucous plug obstruction group(P<0.05), and the indexes in the mucous secretion group were significantly lower than those in the mucous plug obstruction group(P<0.05). All children clinical recovered, but the fever abatement time, cough disappearance time, disappearance time of lung rales and hospital stay in the mucosal hyperemia group were significantly shorter than those in the mucous secretion group and mucous plug obstruction group(P<0.05);the above indexes in the mucous secretion group were significantly shorter than those in the mucus plug obstruction group(P<0.05). CONCLUSION MP pneumonia may stimulate cellular immunity and humoral immune response by regulating NF-κB to active PI3 K-Akt signaling pathway and lead to the damage of the airway. Proteins related to the signaling pathway may be used as the new therapeutic targets to

关 键 词：肺炎支原体肺炎 磷脂酰肌醇3-激酶-蛋白激酶B 核因子κB 支气管肺泡灌洗液 气道损害 转归 

分 类 号：R725.6[医药卫生—儿科]