Serum Tumor Necrosis Factor-α and Interferon-γ Levels in Pediatric Mycoplasma pneumoniae Pneumonia: A Systematic Review and Meta-Analysis

Abstract EN

Background.

Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children.

The objective of this study was to explore potential changes in levels of serum tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) associated with pediatric MPP.

Methods.

This protocol has been registered (PROSPERO 2017: CRD42017077979).

A literature search was performed in October 2017 using PubMed, Embase, the Cochrane Library, and other Chinese medical databases to identify studies.

The meta-analysis was performed using Review Manager 5.3 software.

Random-effect models were used to estimate mean differences (MDs) and 95% confidence intervals (CIs) of cytokine levels.

Results.

Twelve studies were included in the meta-analysis, encompassing 2,422 children with MPP and 454 healthy control children.

Serum TNF-α levels were significantly higher in children with MPP compared with healthy children (MD = 22.5, 95% CI = 13.78–31.22, P<0.00001), and there was significant heterogeneity across studies (I2 = 100%, P<0.00001).

Subgroup analyses showed no evidence for a difference in serum TNF-α levels between children with refractory and nonrefractory MPP.

Serum IFN-γ levels did not significantly differ in children with MPP compared with healthy children (MD = 4.83, 95% CI = −3.27–12.93, P=0.24).

Conclusions.

Our meta-analysis showed that serum TNF-α and IFN-γ levels were significantly elevated and unchanged, respectively, in pediatric MPP.

Because infection by different pathogens has variable effects on serum TNF-α and IFN-γ levels, the finding could be helpful in developing novel diagnostic methods.