MP-DNA载量与气道黏液高分泌关系的研究进展

Research Progress on the Relationship between MP-DNA Load and Hypermucus Secretion in the Airway

摘要: 肺炎支原体性肺炎(MPP)是由肺炎支原体(MP)感染引起的非典型肺炎。MP感染可能直接损伤呼吸道纤毛柱状上皮细胞，或导致免疫损伤，从而影响纤毛和黏液的清除功能。这可能导致炎症渗出和管腔狭窄，同时增加呼吸道黏液分泌，导致黏液积聚和黏液栓的形成，进而导致气道阻塞，影响气道的通气和气体交换。伴有气道黏液高分泌(AMH)的儿童通常预后不良，这严重影响了他们的生活质量。目前关于肺炎支原体性肺炎(MPP)伴气道黏液高分泌(AMH)发病机制的研究相对较少。AMH的机制尚未完全阐明，但近年研究表明可能与MP感染后引发的炎症反应、免疫反应等以及随后的纤毛运动障碍、下呼吸道微生物群有关。研究发现，MP-DNA的载量可作为评估MP感染的新标准，在MP感染后，MP-DNA会在上呼吸道持续存在一段时间。目前气道黏液高分泌已成为MPP的研究热点及治疗目标，探讨MP-DNA载量与气道黏液高分泌的关系及发病机制，可以为气道黏液高分泌所致的难治性MPP感染的治疗及降低MPP的发生率有一定帮助。本文综述了MP-DNA载量与气道黏液高分泌关系的最新研究进展，旨在为临床医生在MPP伴发气道粘液高分泌的早期诊断和临床治疗提供一定的理论支持。

Abstract: Mycoplasma pneumoniae pneumonia (MPP) is an atypical pneumonia caused by infection with Mycoplasma pneumoniae (MP). MP infection may directly damage respiratory ciliated columnar epithelial cells or cause immune impairment, thereby affecting ciliary and mucus clearance functions. This can lead to inflammatory exudation and luminal narrowing while increasing respiratory mucus secretion, resulting in mucus accumulation and mucus plug formation. Consequently, airway obstruction occurs, impairing airway ventilation and gas exchange. Children with airway mucus hypersecretion (AMH) typically have a poor prognosis, significantly impairing their quality of life. Research on the pathogenesis of Mycoplasma pneumoniae pneumonia (MPP) with AMH remains relatively scarce. The mechanisms underlying AMH are not fully elucidated, but recent studies suggest potential associations with inflammatory and immune responses triggered by MP infection, subsequent ciliary dysfunction, and lower respiratory tract microbiota. Research indicates that MP-DNA load serves as a novel criterion for assessing MP infection, persisting in the upper respiratory tract for an extended period post-infection. Currently, AMH has emerged as a research focus and therapeutic target for MPP. Investigating the relationship between MP-DNA load and AMH, along with its underlying mechanisms, may contribute to treating refractory MPP caused by AMH and reducing MPP incidence. This review summarizes recent research advances on the relationship between MP-DNA load and excessive airway mucus secretion, aiming to provide theoretical support for clinicians in the early diagnosis and clinical management of MPP complicated by excessive airway mucus secretion.