Mechanism of pulmonary alveolar lavage combined with local budesonide spray therapy on SMPP based on NLRP3 inflammasome signaling pathway
Objective To investigate the clinical efficacy of bronchoalveolar lavage combined with budesonide in the treatment of severe mycoplasma pneumonia(SMPP),and to analyze the possible mechanism.Methods A total of 96 children with SMPP admitted to our hospital from January 2019 to January 2022 were selected as research objects.They were divided into study group(n=48)and control group(n=48)by an odd-even number grouping method.The control group was treated with bronchoalveolar lavage,and the study group was treated with budesonide spray on the basis of the control group.The clinical efficacy and improvement time of clinical symptoms were compared between the two groups after 7 days of treatment.The levels of lung function indexes,including the predicted forced expiratory volume in the first second(FEV1%Pred),peak expiratory flow(PEF),and the ratio of FEV1 to forced vital capacity(FEV1/FVC)and lymphocyte subsets(CD19+)before and after the treatment were analyzed.Nod-like receptor heat protein domain associated protein 3(NLRP3)inflammasome signaling pathway related factors,such as interleukin-1β(IL-1β)and interleukin-18(IL-18),and related proteins including NLRP3,apoptosis-related spot-like protein(ASC),aspartic proteolytic enzyme containing cysteine(Caspase-1)before and after treatment were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,and the improvement time of clinical symptoms was shorter than that of the control group(P<0.05).After treatment,FEV1%Pred,FEV1/FVC and PEF in the study group were significantly higher than those in the control group(P<0.05).After treatment,the absolute count and proportion of CD19+ in the study group were lower than the control group(P<0.05).After treatment,the levels of IL-1β,IL-18 and the mRNA expressions of NLRP3,ASC and Caspase-1 in the study group were significantly lower than those in the control group(P<0.05).Conclusion The combination of bronchoalveolar lavage and local budesonide spray has a definite therapeutic effect on children with SMPP,which can improve lung function,immune function and pathological status,and reduce inflammatory response.The possible mechanism may be related to the inhibition of NLRP3 inflammasome signaling pathway.
severe mycoplasma pneumonia(SMPP)Nod-like receptor heat protein domain associated protein 3(NLRP3)bronchoalveolar lavagebudesonidecurative effectlung functioninflammation
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维普
