{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:15:36Z","timestamp":1783664136561,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      To investigate the clinical characteristics and cytokine profiles of children with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP) and to establish a predictive nomogram for the early recognition of severe\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (SMPP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective study enrolled 445 children with MPP admitted to the Department of Pediatric Respiratory Medicine of Chengdu Women's and Children's Central Hospital between December 2022 and December 2023. Based on disease severity, patients were assigned to the mild MPP (MMPP,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009190) and SMPP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009255) groups. Clinical features and laboratory parameters were compared between the two groups.Binary Logistic regression analysis was used to identify the independent risk factors of SMPP, and a predictive nomogram was constructed based on these factors. The discrimination of the model was evaluated by the area under the receiver operating characteristic curve (AUC) and calibration curve. In addition, 42 children were randomly selected from each group using stratified random sampling, and serum cytokine levels were measured by enzyme-linked immunosorbent assay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 445 children, 255 cases (57.3%) developed SMPP. Multivariate regression analysis showed that wheezing (OR=4.016, 95% CI: 1.609\u201310.029), shortness of breath (OR=4.717, 95% CI: 1.290\u201316.008), D-dimer (OR=3.032, 95% CI: 1.926\u20134.773), CRP (OR=1.033, 95% CI: 1.018\u20131.048), fever (OR=3.432, 95% CI: 1.658\u20137.105), and age (OR=1.114, 95% CI: 1.015\u20131.223) were independent risk factors for SMPP (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The constructed nomogram prediction model had an AUC of 0.818 and the calibration curve indicated good predictive ability. In the cytokine sub-cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984), serum levels of HMGB-1, TFEB, MCP-1, MCP-2, MCP-3, MCP-4, and TNF-\u03b1 were significantly higher in the SMPP group than in the MMPP group (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A predictive nomogram incorporating wheezing, shortness of breath, fever, D-dimer, CRP, and age was established for early risk stratification of SMPP in hospitalized children. Multiple serum cytokines were significantly elevated in SMPP patients, and their potential clinical utility warrants further investigation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1862535","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:38:09Z","timestamp":1783661889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and cytokine profiles for early prediction of severe Mycoplasma pneumoniae pneumonia in children: a prospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiayi","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Ai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanmin","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Respiratory Medicine, Chengdu Women\u2019s and Children\u2019s Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1097\/INF.0000000000000171","article-title":"Mycoplasma pneumoniae infections in childhood","volume":"33","author":"Atkinson","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.4103\/ijmr.IJMR_1582_16","article-title":"Mycoplasma pneumoniae: a significant but underrated pathogen in paediatric community-acquired lower respiratory tract infections","volume":"147","author":"Kumar","year":"2018","journal-title":"Indian J Med Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"4979","DOI":"10.1016\/j.vaccine.2020.05.074","article-title":"Vaccination using inactivated Mycoplasma pneumoniae induces detrimental infiltration of neutrophils after subsequent infection in mice","volume":"38","author":"Tamiya","year":"2020","journal-title":"Vaccine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"101200","DOI":"10.1016\/j.lanmic.2025.101200","article-title":"Macrolide-resistant Mycoplasma pneumoniae resurgence in Chinese children in 2023: a longitudinal, cross-sectional, genomic epidemiology study","volume":"6","author":"Yan","year":"2025","journal-title":"Lancet Microbe"},{"key":"B5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3760\/cma.j.issn.1674-2397.2019.01.002","article-title":"Guideline for diagnosis and treatment of community-acquired pneumonia in Children (2019 version)","volume":"12","year":"2019","journal-title":"Chin J Clin Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.3760\/cma.j.issn.2095-428X.2015.17.006","article-title":"Expert consensus on diagnosis and treatment of mycoplasma pneumoniae pneumonia in children","volume":"30","year":"2015","journal-title":"Chin J Appl Clin Pediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0156465","DOI":"10.1371\/journal.pone.0156465","article-title":"The clinical characteristics and predictors of refractory Mycoplasma pneumoniae pneumonia in children","volume":"11","author":"Zhang","year":"2016","journal-title":"PLoS One"},{"key":"B8","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s13052-023-01545-1","article-title":"Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for Mycoplasma severity","volume":"49","author":"Li","year":"2023","journal-title":"Ital J Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1017\/s0950268803001365","article-title":"Community-based estimates of incidence and risk factors for childhood pneumonia in western Sydney","volume":"131","author":"MacIntyre","year":"2003","journal-title":"Epidemiol Infect"},{"key":"B10","doi-asserted-by":"publisher","first-page":"306","DOI":"10.3390\/jcm11020306","article-title":"Clinical characteristics of macrolide-refractory Mycoplasma pneumoniae pneumonia in Korean children: a multicenter retrospective study","volume":"11","author":"Choi","year":"2022","journal-title":"J Clin Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.21037\/tp-24-293","article-title":"Exploring high-risk factors for the prediction of severe mycoplasma pneumonia in children","volume":"13","author":"Liu","year":"2024","journal-title":"Transl Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e39665","DOI":"10.1097\/MD.0000000000039665","article-title":"Prospective cohort study on the clinical significance of interferon-\u03b3, D-dimer, LDH, and CRP tests in children with severe mycoplasma pneumonia","volume":"103","author":"Zhang","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"754","DOI":"10.3389\/fimmu.2018.00754","article-title":"Role of C-reactive protein at sites of inflammation and infection","volume":"9","author":"Sproston","year":"2018","journal-title":"Front Immunol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s12890-017-0566-4","article-title":"Adjunctive corticosteroid therapy for inpatients with Mycoplasma pneumoniae pneumonia","volume":"17","author":"Tashiro","year":"2017","journal-title":"BMC Pulm Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"8354892","DOI":"10.1155\/2018\/8354892","article-title":"Serum tumor necrosis factor-\u03b1 and interferon-\u03b3 levels in pediatric Mycoplasma pneumoniae pneumonia: a systematic review and meta-analysis","volume":"2018","author":"Wang","year":"2018","journal-title":"Can Respir J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1002\/ppul.23095","article-title":"Increased T cell activation in BALF from children with Mycoplasma pneumoniae pneumonia","volume":"50","author":"Guo","year":"2015","journal-title":"Pediatr Pulmonol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1002\/jgf2.15","article-title":"Mycoplasma pneumoniae infection: basics","volume":"18","author":"Saraya","year":"2017","journal-title":"J Gen Fam Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12931-019-1152-5","article-title":"Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: a case control study","volume":"20","author":"Choi","year":"2019","journal-title":"Respir Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e14417","DOI":"10.1371\/journal.pone.0014417","article-title":"Critical role of macrophages and their activation via MyD88-NF\u03baB signaling in lung innate immunity to Mycoplasma pneumoniae","volume":"5","author":"Lai","year":"2010","journal-title":"PLoS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"314","DOI":"10.2174\/157339630904131223110655","article-title":"What we have learned from animal models of Mycoplasma pneumoniae disease: virulence mechanisms and host responses","volume":"9","author":"Simecka","year":"2013","journal-title":"Curr Pediatr Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1016\/j.jmii.2020.03.030","article-title":"Altered chemokine profile in refractory Mycoplasma pneumoniae pneumonia infected children","volume":"54","author":"Lee","year":"2021","journal-title":"J Microbiol Immunol Infect"},{"key":"B22","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s13052-022-01254-1","article-title":"Investigation of the relationship between community-acquired respiratory distress syndrome toxin and the high-mobility group box protein 1-toll-like receptors-myeloid differentiation factor 88 signaling pathway in Mycoplasma pneumoniae pneumonia","volume":"48","author":"Fan","year":"2022","journal-title":"Ital J Pediatr"},{"key":"B23","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1186\/s12879-018-3346-8","article-title":"High expression of HMGB1 in children with refractory Mycoplasma pneumoniae pneumonia","volume":"18","author":"Ding","year":"2018","journal-title":"BMC Infect Dis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2719","DOI":"10.3390\/ijms22052719","article-title":"The role of tumor necrosis factor alpha (TNF-\u03b1) in autoimmune disease and current TNF-\u03b1 inhibitors in therapeutics","volume":"22","author":"Jang","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B25","first-page":"765","article-title":"Expression of CCL2 and its receptor in activation and migration of microglia and monocytes induced by photoreceptor apoptosis","volume":"23","author":"Feng","year":"2017","journal-title":"Mol Vis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1515\/bmc-2014-0022","article-title":"Epigenetic regulation of CC-chemokine ligand 2 in nonresolving inflammation","volume":"5","author":"Kiguchi","year":"2014","journal-title":"Biomol Concepts"},{"key":"B27","doi-asserted-by":"publisher","first-page":"824027","DOI":"10.3389\/fcimb.2022.824027","article-title":"Toll-Like receptor 2 modulates pulmonary inflammation and TNF-\u03b1 release mediated by Mycoplasma pneumoniae","volume":"12","author":"Chen","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"3357694","DOI":"10.1155\/2022\/3357694","article-title":"Toll-Like receptor 4 exacerbates Mycoplasma pneumoniaevia promoting transcription factor EB-mediated autophagy","volume":"2022","author":"Liu","year":"2022","journal-title":"Contrast Media Mol Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1038\/nature15514","article-title":"Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death","volume":"526","author":"Shi","year":"2015","journal-title":"Nature"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1862535\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:38:12Z","timestamp":1783661892000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1862535\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":29,"alternative-id":["10.3389\/fped.2026.1862535"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1862535","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"article-number":"1862535"}}