1. Introduction
The clinical presentation of mycoplasma pneumoniae (MP) pneumonia
(MPP) includes pulmonary symptoms like bronchiolitis and pneumonia even
necrotizing pneumonia, thrombosis, and the extra-pulmonary symptoms such
as encephalitis, and hemolytic anemia. Persistent MP infection, airway
obstruction and airway remodeling have been concerned in human airway
epithelium, BALB/c mice, and SMPP children1-3. MPP
patients may develop into severe life-threatening pneumonia (severe MPP,
SMPP) with features of respiratory failure and acute respiratory
distress syndrome, and sequelae such as atelectasis and bronchiectasis
due to bronchiolitis/bronchitis obliterans (BO) resulting from airway
remodeling 2,4-7.
Due to the side effects of tetracyclines and quinolones, macrolides are
used as first‐line antibiotics for the treatment of MPP in young
children. However, high presence of macrolide resistance has been
reported and MP clearance is difficult even by sensitive antibiotics in
refractory MPP (RMPP) and SMPP 2 . Evidence
showed the incidence of SMPP has increased in recent years, particularly
in East Asia, posing serious threat to children’s health.
Corticosteroid could effectively
initiate the rapid improvement of clinical symptoms and chest
radiographic findings, however its resistant has been reported in some
RMPP patients with more severe presentations and more serious
radiological finding 8 . In the near ten
years, RMPP and SMPP are very common in North China particularly in our
hospital, which have much higher sequelae rate mainly
BO2,4-6 . Thus, there is an urgent need to
discover serum biomarkers and target drugs for monitoring the progress
and prevent airway remodeling of SMPP.
Numerous studies have been performed to explore biomarkers in order to
detect RMPP or SMPP early. Several have been discovered for the severity
evaluation of RMPP
or SMPP in children, such as cytokines. However, variations and these
biomarkers cannot predict severity or sequelae completely, limiting
their clinical applications. In recent years, proteomics has emerged as
a powerful method to investigate novel diagnostic and therapeutic
targets. The consistency of peptide identification and protein sequence
coverage in complex biological samples has been improved substantially
with rapid advances in mass spectrometry technology. The label-free
proteomic technology has been considered as a superior choice due to its
high proteome coverage and labeling efficiency, particularly to obtain
information not accessible using two-dimensional electrophoresis, and is
employed widely in quantitative proteomics.
In the present study, initially we applied label-free proteomic analysis
in general MPP (GMPP) and SMPP children, tried to find out
differentially expressed proteins. Fc Fragment of IgG Binding Protein
(FCGBP) was the identified protein with the highest expression
difference and Enzyme-linked immunosorbent assay (ELISA) was then
performed to verify the expression levels in GMPP and SMPP patients,
respectively. In order to identify potential useful drugs that can be
applied to the treatment of SMPP patients and deepen the understanding
of the mechanism of SMPP, we adopt the Connectivity Map tool to identify
potential useful drugs. To our knowledge, this is the first such study
in the progress of MP infection related disease.