Study on the Correlation Between the Expression of NF-Ƙb in the Alveolar Lavage Fluid of Children with Severe Mycoplasma Pneumoniae Pneumonia, Its Clinical Characteristics, and Cellular Immunity

Figures & data

Table 1 The Level of NF-Ƙb in SMPP Group and FB Group

	SMPP	FB	Z value	P value
BALF NF-ƙB (ng/mL)	13.68 (10.53, 19.12)	2.19 (1.39, 4.69)	−5.392	<0.001
Intracellular NF-ƙB. (ng/mL)	24.50 (19.15, 36.80)	1.58 (1.23, 2.66)	−5.392	<0.001
Total NF-ƙB (ng/mL)	39.56 (30.04, 56.90)	4.40 (3.32, 6.79)	−5.392	<0.001

Abbreviations: NF-ƙB, Nuclear factor-ƙB; SMPP Severe Mycoplasma Pneumoniae Pneumonia; FB, foreign bodies; BALF, bronchoalveolar lavage fluid.

Figure 1 NF of FB group and SMPP group- ƙ Correlation of B (****p < 0.0001).

Table 2 Basic Clinical Characteristics of Children with Severe Mycoplasma Pneumoniae Pneumonia

Clinical features	n or M(P25, P75) or (X±S)
Total number of people (example)	41
Boy (example)	25
Age (years)	7.1±2.6
Days of hospitalization	13.15±5.86
Fever days before admission	8.0 (6.0, 12.0)
Total number of fever days	11.0 (7.0, 13.5)
Heat peak (°C)	39.4±0.7
BALF mycoplasma load (copies/mL)	1.73E+07 (1.57E+06, 1.63E+08)
IL-6 (pg/mL)	27.5 (11.45, 52.06)
LDH (U/L)	407.0 (267.5, 911.5)
WBC (×10^9/L)	7.10 (5.45, 11.05)
LY (×10^9/L)	1.55 (0.88, 2.71)
PLT (×10^9/L)	289.0 (207.5, 408.5)
CRP (mg/L)	25.4 (3.57, 56.79)
BALF NF-ƙB (ng/mL)	13.68 (10.53, 19.12)
Intracellular NF-ƙB (ng/mL)	24.50 (19.15, 36.80)
Total NF-ƙB (ng/mL)	39.56 (30.04, 56.90)

Abbreviations: LDH, Lactate dehydrogenase; WBC, white blood cell; LY, lymphocyte; PLT, platelet; CRP, c-reactive protein; BALF, bronchoalveolar lavage fluid.

Table 3 Correlation Analysis Between BALF MP-DNA and Clinical Characteristics

		Age	Number of Days in Hospital	Heat Peak	Duration of Fever	IL-6	CRP	LDH
BALF MP-DNA	r	−0.128	0.474	0.040	0.282	0.453	0.324	0.289
	P value	0.427	0.002	0.806	0.074	0.003	0.039	0.067

Abbreviation: MP-DNA, mycoplasma-DNA;

Table 4 Analysis of Correlation Between IL-6 and Clinical Characteristics

		Age	Number of Days in Hospital	Heat Peak	Duration of Fever	MP-DNA	CRP	LDH
IL-6	r	0.298	0.401	0.291	0.041	0.453	0.605	0.411
	P value	0.059	0.009	0.065	0.80	0.003	0.000	0.008

Abbreviations: MP-DNA, mycoplasma-DNA; LDH, Lactate dehydrogenase; CRP, c-reactive protein.

Figure 2 Correlation between clinical features (*p <0.05, red indicates positive correlation, blue indicates negative correlation).

Table 5 Correlation Analysis of NF-Ƙb in BALF, NF-Ƙb in Cells, Total NF-Ƙb and Clinical Features

	BALF NF-ƙB		Intracellular NF-ƙB		Total NF-ƙB
	r	P value	r	P value	r	P value
Age	−0.033	0.839	−0.145	0.364	−0.117	0.466
Heat peak	0.341	0.029	0.467	0.002	0.461	0.002
Days of hospitalization	0.365	0.019	0.445	0.004	0.453	0.003
Duration of fever.	0.398	0.010	0.297	0.060	0.375	0.016
BALF MP-DNA	0.510	0.001	0.377	0.015	0.502	0.001
BALF NF-ƙB	1		0.644	0.000	0.846	0.000
Intracellular NF-ƙB	0.644	0.000	1		0.942	0.000
Total NF-ƙB	0.846	0.000	0.942	0.000	1
IL-6	0.433	0.005	0.347	0.026	0.430	0.005
LDH	0.271	0.086	0.261	0.100	0.280	0.077
WBC	−0.062	0.700	−0.042	0.793	−0.075	0.641
LY	−0.112	0.487	−0.189	0.235	−0.177	0.269
PLT	−0.267	0.092	−0.308	0.050	−0.312	0.047
CRP	0.087	0.591	0.256	0.107	0.220	0.168
CD3^+CD4^+ (n=17)	−0.145	0.580	−0.483	0.050	−0.390	0.122
CD3^+CD8^+ (n=17)	−0.321	0.209	0.081	0.758	−0.034	0.896
^CD3+CD4+/CD3+CD8+	0.123	0.639	−0.395	0.117	−0.238	0.358

Abbreviations: LDH, Lactate dehydrogenase; WBC, white blood cell; LY, lymphocyte; PLT, platelet; CRP, c-reactive protein; BALF, bronchoalveolar lavage fluid; MP-DNA, mycoplasma-DNA.

Table 6 NF-Ƙb Levels in Phlegm Suppository Group and No Phlegm Suppository Group

	BALF NF-ƙB (ng/mL)	Intracellular NF-ƙB (ng/mL)	Total NF-ƙB (ng/mL)
With phlegm suppository group	16.60±5.92	31.57±11.20	48.16±15.63
No sputum suppository group.	13.24±3.83	24.64±8.54	37.89±11.29
T value	−2.115	−2.197	−2.378
P value	0.041	0.034	0.022

Abbreviations: NF-ƙB, Nuclear factor-ƙB; BALF, bronchoalveolar lavage fluid.

Table 7 Correlation Analysis Between BALF NF-Ƙb and Complications

	BALF NF-ƙB (ng/mL)	Z value	P value
Extrapulmonary Complications	14.24(10.96, 19.69)	−1.087	0.277
No Extrapulmonary Complications	13.56(8.90, 17.09)
Atelectasis	14.63(9.91, 20.47)	−0.111	0.912
No atelectasis	13.68(10.63, 19.20)
Pleural effusion	15.13(10.87, 21.98)	−1.122	0.262
No pleural effusion	13.27(10.19, 15.43)
Pericardial effusion	18.55(11.55, 24.19)	−1.678	0.093
No pericardial effusion	13.58(10.21, 17.49)
With Phlegm suppository	14.28(10.53, 21.26)	−0.704	0.482
No Phlegm suppository	12.50(10.43, 18.40)

Figure 3 Correlation between BALF NF-ƙB and complications (*p< 0.05).

Table 8 Correlation Analysis Between Intracellular NF-Ƙb and Complications

	Intracellular NF-ƙB (ng/mL)	Z value	P value
Extrapulmonary Complications	33.17(21.93, 28.21)	−2.677	0.007
No Extrapulmonary Complications	19.31(17.02, 20.17)
Atelectasis	32.58(19.81, 46.90)	−1.328	0.184
No atelectasis	24.10(18.33, 36.74)
Pleural effusion	36.74(18.46, 40.39)	−2.282	0.022
No pleural effusion	22.57(19.10.26.30)
Pericardial effusion	38.72(36.28, 43.52)	−3.158	0.002
No pericardial effusion	23.85(17.97, 34.99)
With Phlegm suppository	29.30(18.89, 37.49)	−0.636	0.525
No Phlegm suppository	23.85(18.98, 36.80)

Figure 4 Correlation between intracellular NF-ƙB and complications. (NS p > 0.05, *p < 0.05, **p < 0.01, ***p < 0.001).

Table 9 Correlation Analysis of Total NF-Ƙb and Complications

	Total NF-ƙB (ng/mL)	Z value	P value
Extrapulmonary Complications	46.38(34.42, 58.27)	−2.205	0.027
No Extrapulmonary Complications	28.91(27.89, 36.75)
Atelectasis	44.64(34.10, 66.51)	−1.033	0.302
No atelectasis	39.56(28.69, 56.72)
Pleural effusion	50.92(33.51, 60.71)	−2.060	0.039
No pleural effusion	35.02(28.75, 41.66)
Pericardial effusion	57.87(52.13, 62.13)	−3.059	0.002
No pericardial effusion	35.15(28.64, 48.95)
With Phlegm suppository	43.46(31.54, 60.32)	−1.001	0.317
No Phlegm suppository	35.15(28.59, 56.65)

Figure 5 Correlation between total NF-ƙB and complications (NS>0.05,*p <0.05, **p <0.01).

Figure 6 Chest CT changes. (A) Multilobar consolidation (high-density shadow, 3-year-old boy); (B) Consolidation of the right and left upper and lower lobes (5-year-old boy). (C) consolidation of the right upper lobe (high-density shadow, 4-year-old Boy); (D) Consolidation of the right middle lobe (hyperdense opacity, 6-year-old boy) (E) consolidation of the right lower lobe (high-density shadow, 9-year-old boy); (F) Consolidation of the left upper lobe (hyperdense opacity, 7-year-old boy). (G) Left lower lobe consolidation (high density, 5-year-old girl); (H) Atelectasis of the right upper lobe (wedge-shaped soft tissue shadow in a 9-year-old girl).

Table 10 Mucosa Changes Under Bronchoscopy

Mucosal Changes	Pale	Hyperemia	Pale + Wrinkled	Hyperemia + Wrinkled	Hyperemia + Pale	Pale + Bleeding	Hyperemia +Bleeding	Hyperemia + Pale + Wrinkled	Hyperemia + Pale + Bleeding	Hyperemia + Bleeding + Wrinkled
n	4	8	3	7	1	3	7	2	3	3
%	9.8	19.5	7.3	17.1	2.4	7.3	17.1	4.9	7.3	7.3

Figure 7 Mucosal changes under fiberoptic bronchoscopy. (A) 7-year-old girl with mucosal congestion and bleeding; (B) 4-year-old boy with pale mucosa; (C) 3-year-old girl with mucosal folds; (D) 11-year-old girl with mucosal bleeding points and folds; (E) 9-year-old boy with mucosal hemorrhage; (F) 5-year-old Mucous membrane erosion in a girl; (G) Sputum suppository in a 5-year-old boy; (H) Bronchial tube shape in a 4-year-old boy.

Table 11 Univariate Logistic Regression Analysis of Extrapulmonary Complications

Variable	B value	Standard Error of b value	Wald Chi-Square value	P value	OR value
Age	−0.189	0.136	1.954	0.162	0.827
Sex	0.156	0.700	0.050	0.824	1.169
Heat peak	0.623	0.521	1.431	0.232	1.865
WBC	0.043	0.085	0.254	0.614	1.044
LY	0.244	0.307	0.633	0.426	1.277
PLT	−0.001	0.003	0.082	0.775	0.999
CRP	0.009	0.010	0.695	0.404	1.009
LDH	0.003	0.002	3.160	0.075	1.003
IL-6	0.018	0.015	1.541	0.215	1.019
BALF MP-DNA	0.000	0.000	0.794	0.373	1.000
BALF NF-ƙB	0.079	0.072	1.212	0.271	1.083
Intracellular NF-ƙB	0.139	0.053	6.761	0.009	1.149
Total NF-ƙB	0.078	0.033	5.485	0.019	1.081

Abbreviations: LDH, Lactate dehydrogenase; WBC, white blood cell; LY, lymphocyte; PLT, platelet; CRP, c-reactive protein; BALF, bronchoalveolar lavage fluid; MP-DNA, mycoplasma-DNA; NF-ƙB, Nuclear factor-ƙB.

Table 12 Multivariate Logistic Regression Analysis of Extrapulmonary Complications

Variable	b value	Standard Error of b value	Wald Chi-Square value	P value	OR value	95% CI
Age	−0.202	0.191	1.121	0.290	0.817	0.562 1.188
LDH	0.004	0.002	3.774	0.052	1.004	1.000 1.009
Intracellular NF-ƙB	0.794	0.356	4.975	0.026	2.211	1.101 4.442
Total NF-ƙB	−0.412	0.206	3.995	0.046	0.662	0.442 0.992

Abbreviations: LDH, Lactate dehydrogenase; NF-ƙB, Nuclear factor-ƙB.