Correlation and predictive value of serum TLR4, IL-25 and IL-33 in children with Mycoplasma pneumoniae pneumonia

Objective To analyze the correlation and predictive value of serum Toll-like receptor 4 (TLR4), interleukin-25 (IL-25) and interleukin-33 (IL-33) in children with Mycoplasma pneumoniae pneumonia (MPP). Methods A retrospective study was conducted on 150 cases of children with MPP admitted to the Second Affiliated Hospital of Soochow University from June 2022 to June 2023. Based on the severity of MPP, the children were divided into refractory Mycoplasma pneumoniae pneumonia (RMPP) group and mild Mycoplasma pneumoniae pneumonia (MMPP) group. According to the prognosis of children, they were divided into poor prognosis group and good prognosis group. Serum TLR4, IL-25 and IL-33 were detected in all children at admission, and the baseline data were statistically analyzed. Binary logistic regression was used to analyze the relationship between serum TLR4, IL-25, IL-33 and the severity and prognosis of children with MPP. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum TLR4, IL-25 and IL-33 levels on the severity of MPP in children. Results The proportion of children with lesion range ≥ 2 lobes and large patchy shadow in RMPP group and poor prognosis group was higher than that in MMPP group and good prognosis group. The relative expression level of TLR4, IL-25 and IL-33 in RMPP group and poor prognosis group was higher than those in MMPP group and good prognosis group (P＜0.05). Binary logistic regression analysis showed that the lesion type as large patchy shadows and high expression of serum TLR4, IL-25, and IL-33 were risk factors for MPP children having MMPP and poor prognosis (OR>1, P＜0.05). ROC curves showed that the AUC of relative expression of serum TLR4, the levels of IL-25, IL-33, and their combined detection for predicting RMPP in children with MPP were all>0.70, indicating a certain predictive value, which combined detection was the highest. Conclusions The levels of serum TLR4, IL-25 and IL-33 are closely related to the severity and prognosis of children with MPP, and their levels can effectively predict the development of MPP in children.