Exploration on the diagnostic value of S100 calcium-binding protein A8/A9 in hypercoagulation state of children with Mycoplasma pneumoniae pneumonia and its mechanism in exacerbating endothelial cell dysfunction
Objective To explore the diagnostic value of S100 calcium-binding protein A8/A9(S100A8/A9) in hypercoagulation state of children with Mycoplasma pneumoniae pneumonia( MPP) and its effect on endothelial cell function.Methods A total of 87 MPP pediatric patients admitted to the First Affiliated Hospital of Hunan Normal University (People's Hospital of Hunan Province) from September 2023 to February 2024 were included as the MPP group,and other 30 healthy children were selected as the control group.The MPP group was further divided into non-hypercoagulation group(n=45) and hypercoagulation group(n=42) according to the detection results of blood coagulation indicators[D-dimer(D-D),thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),antithrombin-Ⅲ(AT-Ⅲ)].The differences in the levels of neutrophil-to-lymphocyte ratio( NLR),C-reactive protein( CRP),procalcitonin( PCT),interleukin-6(IL-6),interferon-gamma(IFN-γ) and S100A8/A9 were compared among all the groups,and the role of S100A8/A9 in evaluating MPP hypercoagulation state was analyzed.Human umbilical vein endothelial cells(HUVECs) were stimulated with 100 ng/mL of recombinant human S100A8/A9 for 24 hours to observe its effects on CD31,tissue factor(TF),and vascular endothelial(VE)-cadherin expressions.Results The levels of CRP,PCT,IL-6 and IFN-γ in the MPP group were significantly higher than those in the control group(P＜0.05),and NLR in the MPP group was significantly lower than that in the control group(P＜0.05).The levels of CRP,PCT and IFN-γ in the hypercoagulation group were significantly higher than those in the non-hypercoagulation group(P＜0.05).The S100A8/A9 level in the MPP group was significantly higher than that in the control group,and the S100A8/A9 level in the hypercoagulation group was significantly higher than that in the non-hypercoagulation group(P＜0.05).The results of receiver operating characteristic(ROC) curve analysis showed that the area under the curve of S100A8/A9 was 0.860,with the sensitivity of 71.4％ and the specificity of 93.9％ in diagnosing hypercoagulation state in the MPP pediatric patients.The results of cell experiment showed that after S100A8/A9 intervention,the expression levels of CD31 and VE-cadherin in HUVECs were significantly decreased,and the expression level of TF in HUVECs in was significantly increased(P＜0.05).Conclusion S100A8/A9 is closely associated with hypercoagulation state of MPP pediatric patients.S100A8/A9 can disrupt the integrity of endothelial cell structure and drive thrombogenesis.
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