Correlations of serum ferroptosis level with inflammatory response and oxidative stress in children with severe Mycoplasma pneumonia and their significance
Objective To study correlations of serum level of ferroptosis with inflammatory response and oxidative stress in children with severe Mycoplasma pneumonia(MPP)and their significance.Methods 74 children with mild MPP and 136 children with severe MPP who admitted to our Department of Pediatrics from June 2019 to June 2022 were selected as the mild MPP group and the severe MPP group respectively,and 80 healthy children were selected as the control group.Serum samples were taken and the serum levels of ferroptosis markers as transferrin receptor 1(TfR1),Acyl-CoA synthase long chain family member 4(ACSL4)and glutathione peroxidase 4(GPX4),inflammatory response markers as C-reactive protein(CRP)and interleukin-6(IL-6),oxidative stress markers as malondialdehyde(MDA),and lipid peroxide(LPO)were detected,and the differences in serum levels of these indexes among the three groups were compared.The correlations of ferroptosis markers with inflammatory response markers and oxidative stress markers were analyzed.The short-term prognosis of the children with severe MPP was evaluated,and the values of serum ferroptosis markers in diagnosing and predicting prognosis of severe MPP were analyzed.Results The serum levels of TfR1,ACSL4,CRP,IL-6,MDA,and LPO of the children in the severe MPP group were higher than those in the mild MPP group and the control group,while the serum level of GPX4 was lower than that in the mild MPP group and the control group(F=321.061,233.544,839.887,761.429,897.668,585.581 and 196.558 respectively,all P＜0.05).In the severe MPP group,the serum levels of TfR1 and ACSL4 were positively correlated with the serum levels of CRP,IL-6,MDA and LPO(r=0.311-0.441,all P＜0.05),while the serum level of GPX4 was negatively correlated with the serum levels of CRP,IL-6,MDA and LPO(r=-0.413--0.309,all P＜0.05).In the severe MPP group,the serum levels of TfR1 and ACSL4 of the children with poor prognoses were higher than those of the children with good prognoses,while the serum level of GPX4 was lower than that of the children with good prognoses(t=5.025,4.535 and 5.440 respectively,all P＜0.05).The combination of serum levels of TfRl,ACSL4 and GPX4 had the highest diagnostic value and predictive value for prognosis of severe MPP(for diagnostic value:AUC=0.973,the sensitivity was 95.59% and the speciality was 100% ;for predictive value:AUC=0.952,the sensitivity was 86.96% and the speciality was 88.46% ).Conclusion Activation of ferroptosis in children with severe MPP relates with increased inflammation and oxidative stress.Serum ferroptosis markers are indicators for diagnosing severe MPP and predicting the prognosis.
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