Role of serum MyD88 and TRAF-6 combined determination in diagnosis and prognosis of severe acute respiratory tract infection in children

doi:10.3969/j.issn.1673-8640.2024.03.005

Abstract

Abstract:

Objective To investigate the roles of serum myeloid differentiation primary response protein 88（MyD88）and tumor necrosis factor receptor-associated factor 6（TRAF-6）combined determination in the diagnosis and prognosis of severe acute respiratory tract infection in children. Method Totally，80 children with acute respiratory tract infection（acute respiratory tract infection group）in Nanyang Central Hospital from January 2020 to June 2022 were enrolled. According to the results of etiological diagnosis，they were classified into non-bacterial infection group（42 cases）and bacterial infection group（38 cases）. According to the severity of patients' condition，they were classified into mild group（28 cases），moderate group（20 cases）and severe group（32 cases）. According to the prognosis of children，they were classified into good prognosis group（58 cases）and poor prognosis group（22 cases）. Totally，80 healthy children were enrolled as controls. Multivariate Logistic regression analysis was used to evaluate the prognostic factors of acute respiratory tract infection in children. Receiver operating characteristic（ROC）curve was used to analyze the diagnostic roles of serum MyD88 and TRAF-6 levels for severe acute respiratory tract infection in children. Results Serum levels of MyD88 and TRAF-6 in acute respiratory tract infection group were higher than those in control group（P<0.001）. Serum levels of MyD88 and TRAF-6 in bacterial infection group were higher than those in non-bacterial infection group（P<0.001）. Serum levels of MyD88 and TRAF-6 in mild，moderate and severe groups were increased in turn（P<0.001）. The areas under curves（AUC）of serum MyD88 and TRAF-6 single and combined determinations for the diagnosis of severe acute respiratory tract infection were 0.762，0.734 and 0.876，respectively. The proportion of bacterial infection，infection site in lower respiratory tract，the proportion of severe disease and the levels of white blood cell（WBC）count，C-reactive protein（CRP），MyD88 and TRAF-6 in poor prognosis group were higher than those in good prognosis group（P<0.05）. The severity of disease，elevated CRP，MyD88 and TRAF-6 were all risk factors for poor prognosis of children with acute respiratory tract infection [odds ratios（OR）were 1.693，1.864，3.218 and 2.869，95% confidence intervals（CI）were 1.142-2.510，1.228-2.830，1.561-6.633 and 1.511-5.446，P<0.05]. The AUC of serum MyD88，TRAF-6 and CRP for the prognosis of children with acute respiratory tract infection were 0.848，0.900，0.817 and 0.951，respectively. Conclusions Serum levels of MyD88 and TRAF-6 in children with acute respiratory tract infection are elevated，and the combined determination has good evaluation value in the diagnosis and prognosis of severe acute respiratory tract infection in children.

Key words: Myeloid differentiation primary response protein 88, Tumor necrosis factor receptor-associated factor 6, C-reactive protein, Acute respiratory tract infection, Children

CLC Number:

R446.1

YANG Jing, LIU Huapeng, LIU Ni. Role of serum MyD88 and TRAF-6 combined determination in diagnosis and prognosis of severe acute respiratory tract infection in children[J]. Laboratory Medicine, 2024, 39(3): 237-242.

Figures/Tables 9

References 22

[1]	LI Z J, ZHANG H Y, REN L L, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021, 12(1):5026. DOI
[2]	李东秀, 黄健. 血清sICAM-1和hs-CRP水平在儿童急性病毒性下呼吸道感染病情监测中的意义[J]. 检验医学, 2022, 37(3):226-229. DOI
[3]	LI Y, MIN L, ZHANG X. Usefulness of procalcitonin(PCT),C-reactive protein(CRP),and white blood cell(WBC)levels in the differential diagnosis of acute bacterial,viral,and mycoplasmal respiratory tract infections in children[J]. BMC Pulm Med, 2021, 21(1):386. DOI
[4]	HADDADIN Z, BEVERIDGE S, FERNANDEZ K, et al. Respiratory syncytial virus disease severity in young children[J]. Clin Infect Dis, 2021, 73(11):e4384-e4391. DOI URL
[5]	ALCOCEBA M, GARCÍA-ÁLVAREZ M, MEDINA A, et al. MYD88 mutations:transforming the landscape of IgM monoclonal gammopathies[J]. Int J Mol Sci, 2022, 23(10):5570. DOI URL
[6]	YUAN Q, GU J, ZHANG J, et al. MyD88 in myofibroblasts enhances colitis-associated tumorigenesis via promoting macrophage M2 polarization[J]. Cell Rep, 2021, 34(5):108724. DOI URL
[7]	陈英, 王艺磊, 邹鹏飞. 大黄鱼TRAF6的克隆及表达分析[J]. 生物技术通报, 2022, 38(8):233-243. DOI
[8]	GARCIA-MAURIÑO C, MOORE-CLINGENPEEL M, THOMAS J, et al. Viral load dynamics and clinical disease severity in infants with respiratory syncytial virus infection[J]. J Infect Dis, 2019, 219(8):1207-1215. DOI URL
[9]	彭蕾, 王豪杰, 王扎根. 脾氨肽冻干粉对反复呼吸道感染患儿疗效的Meta分析[J]. 中国免疫学杂志, 2020, 36(15):1877-1883.
[10]	王卫平, 孙锟, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2018.
[11]	BHURTEL R, POKHREL R P, KALAKHETI B. Acute respiratory infections among under-five children admitted in a tertiary hospital of Nepal:a descriptive cross-sectional study[J]. JNMA J Nepal Med Assoc, 2022, 60(245):17-21.
[12]	HASAN M M, SAHA K K, YUNUS R M, et al. Prevalence of acute respiratory infections among children in India:regional inequalities and risk factors[J]. Matern Child Health J, 2022, 26(7):1594-1602. DOI
[13]	COSTA L F, DA SILVEIRA H L, QUEIRÓZ D A O, et al. Respiratory virus infections in hospitalized and non-hospitalized children:determinants of severe course of the disease[J]. J Infect Dev Ctries, 2022, 16(1):196-205. DOI URL
[14]	YU X, LI W, DENG Q, et al. MYD88 L265P elicits mutation-specific ubiquitination to drive NF-κB activation and lymphomagenesis[J]. Blood, 2021, 137(12):1615-1627. DOI PMID
[15]	胡玉懿, 陈朴, 郭玮, 等. 髓样分化因子88多态性的研究进展[J]. 检验医学, 2020, 35(4):380-386. DOI
[16]	杨勇, 杨绥宇, 陈宗波, 等. MyD88和TICAM1基因多态性及其交互作用与儿童社区获得性肺炎的关联研究[J]. 中国当代儿科杂志, 2023, 25(8):791-799.
[17]	ZHU Y, HAN Q, WANG L, et al. Jinhua Qinggan granules attenuates acute lung injury by promotion of neutrophil apoptosis and inhibition of TLR4/MyD88/NF-κB pathway[J]. J Ethnopharmacol, 2023, 301:115763. DOI URL
[18]	赵采芹, 王燕碧, 张福平, 等. 鸡TRAF6和TIFA基因克隆及其组织表达特征分析[J]. 南方农业学报, 2022, 53(2):546-556.
[19]	XIAO L, ZHONG M, HUANG Y, et al. Puerarin alleviates osteoporosis in the ovariectomy induced mice by suppressing osteoclastogenesis via inhibition of TRAF6/ ROS-dependent MAPK/ NF-κB signaling pathways[J]. Aging(Albany NY), 2020, 12(21):21706-21729.
[20]	HUANG Z, LIU X, WU X, et al. MiR-146a alleviates lung injury caused by RSV infection in young rats by targeting TRAF-6 and regulating JNK/ERKMAPK signaling pathways[J]. Sci Rep, 2022, 12(1):3481. DOI PMID
[21]	郭晨旭, 焦桂清, 常彩芳, 等. TRAF6基因多态性与肝硬化自发性细菌性腹膜炎易感性的关联[J]. 中华医院感染学杂志, 2022, 32(9):1307-1310.
[22]	WANG Q, ZHOU X, ZHAO Y, et al. Polyphyllin I ameliorates collagen-induced arthritis by suppressing the iInflammation response in macrophages through the NF-κB pathway[J]. Front Immunol, 2018, 9:2091. DOI URL

组别	例数	MyD88/（ng·mL^-1）	TRAF-6/（ng·mL^-1）
急性呼吸道感染组	80	12.09±4.28	6.59±3.09
正常对照组	80	2.87±1.14	3.63±1.58
t值		18.619	7.629
P值		<0.001	<0.001

组别	例数	MyD88/（ng·mL^-1）	TRAF-6/（ng·mL^-1）
急性呼吸道感染组	80	12.09±4.28	6.59±3.09
正常对照组	80	2.87±1.14	3.63±1.58
t值		18.619	7.629
P值		<0.001	<0.001

组别	例数	MyD88/（ng·mL^-1）	TRAF-6/（ng·mL^-1）
非细菌感染组	42	10.05±3.96	4.72±2.53
细菌感染组	38	14.34±4.87	8.66±3.47
t值		4.340	5.841
P值		<0.001	<0.001

组别	例数	MyD88/（ng·mL^-1）	TRAF-6/（ng·mL^-1）
非细菌感染组	42	10.05±3.96	4.72±2.53
细菌感染组	38	14.34±4.87	8.66±3.47
t值		4.340	5.841
P值		<0.001	<0.001

组别	例数	MyD88/（ng·mL^-1）	TRAF-6/（ng·mL^-1）
轻度组	28	8.46±2.12	4.21±1.96
中度组	20	12.85±3.31^*	6.58±2.37^*
重度组	32	14.79±4.03^*#	8.69±2.82^*#
F值		28.369	25.252
P值		<0.001	<0.001