{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:51:56Z","timestamp":1792601516143,"version":"4.5.0"},"reference-count":176,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81401512, 31970177"],"award-info":[{"award-number":["81401512, 31970177"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Fund Project of Hunan Provincial Department of Education","award":["18A234"],"award-info":[{"award-number":["18A234"]}]},{"name":"Clinical Research Project of the University of South China","award":["USCKF201902K01"],"award-info":[{"award-number":["USCKF201902K01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Mycoplasma pneumoniae is a major causative agent of community-acquired pneumonia which can lead to both acute upper and lower respiratory tract inflammation, and extrapulmonary syndromes. Refractory pneumonia caused by M. pneumonia can be life-threatening, especially in infants and the elderly. Here, based on a comprehensive review of the scientific literature related to the respective area, we summarize the virulence factors of M. pneumoniae and the major pathogenic mechanisms mediated by the pathogen: adhesion to host cells, direct cytotoxicity against host cells, inflammatory response-induced immune injury, and immune evasion. The increasing rate of macrolide-resistant strains and the harmful side effects of other sensitive antibiotics (e.g., respiratory quinolones and tetracyclines) in young children make it difficult to treat, and increase the health risk or re-infections. Hence, there is an urgent need for development of an effective vaccine to prevent M. pneumoniae infections in children. Various types of M. pneumoniae vaccines have been reported, including whole-cell vaccines (inactivated and live-attenuated vaccines), subunit vaccines (involving M. pneumoniae protein P1, protein P30, protein P116 and CARDS toxin) and DNA vaccines. This narrative review summarizes the key pathogenic mechanisms underlying M. pneumoniae infection and highlights the relevant vaccines that have been developed and their reported effectiveness.<\/jats:p>","DOI":"10.3390\/pathogens10020119","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T09:59:40Z","timestamp":1611568780000},"page":"119","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":167,"title":["Mycoplasma pneumoniae Infections: Pathogenesis and Vaccine Development"],"prefix":"10.3390","volume":"10","author":[{"given":"Zhulin","family":"Jiang","sequence":"first","affiliation":[{"name":"Institution of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang 421001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2575-6149","authenticated-orcid":false,"given":"Shuihong","family":"Li","sequence":"additional","affiliation":[{"name":"Institution of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang 421001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiming","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institution of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang 421001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runjie","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institution of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang 421001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2406-4773","authenticated-orcid":false,"given":"Polly H. M.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong 999077, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2478\/jtim-2018-0006","article-title":"Contemporary situation of community-acquired pneumonia in China: A systematic review","volume":"6","author":"Zhu","year":"2018","journal-title":"J. Transl. Int. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Meyer Sauteur, P.M., Jacobs, B.C., Spuesens, E.B.M., Jacobs, E., Nadal, D., Vink, C., and Rossum, A.M.C. (2014). Antibody responses to Mycoplasma pneumoniae: Role in pathogenesis and diagnosis of encephalitis?. 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