ArticleMolecular medicine (Cambridge, Mass.)2019
High co-expression of TNF-α and CARDS toxin is a good predictor for refractory Mycoplasma pneumoniae pneumonia.
Article in Molecular medicine (Cambridge, Mass.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Prevalence, risk factors, and early prediction of refractory pneumonia caused by Mycoplasma pneumoniae in children: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Risk factors for complications of Mycoplasma pneumoniae pneumonia in hospitalized children in China: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors.Journal of immunology research · 2022Pooled it
- Research progress and trends of Mycoplasma pneumoniae pneumonia in children: a bibliometric and visualization analysis (1990s to post-COVID-19 era).Pediatric research · 2026Article
- Dysregulated myeloid-T cell immunity in refractory Mycoplasma pneumoniae pneumonia: high inflammation meets T cell suppression.BMC microbiology · 2026Article
- Network analysis of Mycoplasma pneumoniae pneumonia and Epstein-Barr virus co-infection.BMC infectious diseases · 2026Article
- Article
- A multi-epitope vaccine targetingFrontiers in immunology · 2026Article
- Association analysis of Mycoplasma pneumoniae 23S rRNA gene mutation with refractory Mycoplasma pneumoniae pneumonia in children.PloS one · 2026Article
- Prediction models for refractoryFrontiers in pediatrics · 2026Article
- Combining circ_0054633 and clinical features to predict refractory Mycoplasma pneumoniae pneumonia in children.Scientific reports · 2025Article
- Predictive value of an early comprehensive assessment model for refractory mycoplasma pneumoniae pneumonia and internal validation.BMC infectious diseases · 2025Article
- Predicting and interpreting key features of refractory Mycoplasma pneumoniae pneumonia using multiple machine learning methods.Scientific reports · 2025Article
- D-dimer serves as predictor of plastic bronchitis or necrotizing pneumonia in children withFrontiers in pediatrics · 2025Article
- Rapid detection ofFrontiers in cellular and infection microbiology · 2025Article
- [Protective effect ofNan fang yi ke da xue xue bao = Journal of Southern Medical University · 2024Article
- Prevalence of Atypical Bacteria in Patients from Different Paediatric Age Groups Diagnosed with a Respiratory Disease.Microorganisms · 2024Article
- Predicting the severity of mycoplasma pneumoniae pneumonia in pediatric and adult patients: a multicenter study.Scientific reports · 2024Article
- Research of recombinant influenza A virus as a vector for Mycoplasma pneumoniae P1a and P30a.Immunity, inflammation and disease · 2024Article
- Exploring the pathogenetic mechanisms ofExperimental and therapeutic medicine · 2024Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly distinction between refractory M. pneumoniae pneumonia (RMPP) and non-RMPP (NRMPP) is still difficult. The community-acquired respiratory distress syndrome (CARDS) toxin can induce inflammatory and histopathological phenotypes associated with M. pneumoniae infection. This study aimed to investigate the clinical significance of CARDS toxin and pro-inflammatory cytokines in children with RMPP and to explore whether CARDS toxin can induce TNF-α expression.
methodsLevels of CARDS toxin and cytokines in BALF from control and children with MPP were determined by real-time PCR and ELISA, respectively. A receiver-operating characteristic (ROC) analysis was performed to assess the diagnostic values of CARDS toxin, TNF-α, and IL-6 in RMPP. The recombinant CARDS toxin was constructed and prepared at different concentrations for stimulation of RAW264.7 cells. After co-culture with CARDS toxin, cytokines were detected by ELISA and the mRNA levels were measured by real-time PCR. Effects of CARDS toxin and TNF-α on inflammatory cell infiltration and mucus secretion in mouse lungs were also evaluated.
resultsLevels of CARDS toxin, TNF-α and IL-6 in bronchoalveolar lavage fluid (BALF) were significantly higher in RMPP cases compared with NRMPP cases. Furthermore, TNF-α had better diagnostic ability for differentiation of RMPP with AUC of 0.824 and Youden index of 0.692 compared with CARDS toxin and IL-6. Moreover, CARDS toxin was positively correlated with TNF-α level in MPP cases. In vitro assay revealed that CARDS toxin induced RAW264.7 macrophages to secrete TNF-α. Further in vivo assay showed that TNF-α deletion partially abrogated the CARDS toxin-mediated induction of inflammatory cell infiltration and mucus secretion in mouse lungs.
conclusionsThe high co-expression of TNF-α and CARDS toxin in BALF is a good diagnostic biomarker for differentiating children with RMPP and NRMPP.
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