Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5346-5353
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5346
Evaluating the role of interleukin-2 and interleukin-12 in pediatric patients with concurrent Mycoplasma pneumoniae and Epstein-Barr virus infections
Yan-Ping Hao
Yan-Ping Hao, Department of Pediatrics, Maternal and Child Health Hospital, Shaoxing 312400, Zhejiang Province, China
Author contributions: Hao YP independently completed the following tasks: conceptualization, data curation, formal analysis, methodology development, resource acquisition, software implementation, and original draft writing; The final writing and editing were conducted by Hao YP.
Institutional review board statement: This study was approved by the Ethics committee of Maternal and Child Health Hospital.
Informed consent statement: Written informed consent for publication was obtained from all patients and their families included in this retrospective analysis.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Ping Hao, MBBS, Doctor, Department of Pediatrics, Maternal and Child Health Hospital, No. 261 Shanhu Road, Shengzhou, Shaoxing 312400, Zhejiang Province, China. yanpingh0021@163.com
Received: April 29, 2024
Revised: May 24, 2024
Accepted: June 11, 2024
Published online: August 16, 2024
Processing time: 67 Days and 6.5 Hours
Abstract
BACKGROUND

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.

AIM

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Interleukin-2; Interleukin-12; Mycoplasma pneumonia; Epstein-Barr virus; Coinfection

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.