Conclusions: IL-10 and IFN- could be used as the good predictors of RMPP in school-aged children. (MP) is one of the major pathogens causing community-acquired pneumonia (CAP) in children1,2. gamma (IFN-) in RMPP group were significantly higher than those in GMPP group (P? ?0.01). In ROC curve analysis, IL-10 and IFN- were useful for differentiating individuals with RMPP from those with GMPP. Logistic regression analysis showed the IL-10??3.65?pg/ml and IFN-??29.05?pg/ml were significant predictors regarding to RMPP. Additionally, a positive correlation between serum IL-10 and IFN- concentrations was observed. Conclusions: IL-10 and IFN- could be used as the good predictors of RMPP in school-aged children. (MP) is one of the major pathogens causing community-acquired pneumonia (CAP) in children1,2. MP was recognized in 30% of pediatric CAP, and in over 50% among children aged 5 years or older3. Although pneumonia (MPP) is usually considered as a self-limited disease, sometimes it may cause refractory pneumonia (RMPP) showing medical and radiological deterioration despite of macrolide antibiotic therapy for 7 days or longer4,5, and develop into a severe life-threatening pneumonia6,7. GSK598809 Even though underlying mechanisms are still uncertain, the macrolide-resistant MP illness and excessive immunological swelling are most commonly proposed8,9. In China, macrolide-resistant MP is very common and the prevalence varies from 83% to 95%10,11. In our earlier study, the prevalence of macrolide-resistance in MPP individuals reached to 87.7%, and there were no significant difference Rabbit Polyclonal to CLM-1 of resistance rate of MP between the general MPP (GMPP) group and the RMPP group10. So excessive immune response against pathogens, such as vigorous manifestation of cytokines and highly activated cell-mediated immune response may play a more important part in RMPP than macrolide resistance in China. Recent clinical researches shown that corticosteroids have been used with adequate therapeutic effect for children with RMPP5,11,12, which is definitely suggestive of an overreaction of sponsor immune systems. However, further studies are needed to elucidate the associations between excessive immune response, especially the cytokines and the progression of RMPP. In the present study, the medical characteristics of school-aged children diagnosed as RMPP were compared with school-aged children diagnosed as GMPP, including the cytokines in serum, GSK598809 and the predictive ideals of RMPP were explored. Results Clinical characteristics of RMPP and GMPP A total of 180 children were recruited into this study, 115 individuals were in the GMPP group, and the remaining 65 individuals were in the RMPP group. These individuals relevant demographic, medical, laboratory and radiological data GSK598809 are offered in Table 1. In short, there were no significant variations between the two groups with respect to age, gender distribution, duration of sign before admission and size GSK598809 before macrolide therapy. However, the median period of fever and the median length of stay were significant longer in the RMPP group than those in the GMPP group (P? ?0.01). And the incidence of extra-pulmonary complications was 27.7% in RMPP group and 8.7% in GMPP group, with a significant difference (P? ?0.01). Table 1 Assessment of medical and laboratory variables between GMPP and RMPP. pneumonia in school-aged children. em Sci. Rep /em . 6, 37037; doi: 10.1038/srep37037 (2016). Publishers notice: Springer GSK598809 Nature remains neutral with regard to jurisdictional statements in published maps and institutional affiliations. Supplementary Material Supplementary Info:Click here to view.(414K, pdf) Acknowledgments This work was partially supported by grants from National Natural Science Basis (81401301, 81501374), the Zhejiang Province Organic Technology Fundation of China (LY17H100004), and the Zhejiang Medicine & Health Study Fund (No. 2016 KYA132). Footnotes Author Contributions Y.Y.Z. and Z.M.C. published the main manuscript text. Y.L.Z. and S.F.M. collected day. M.X.H. and G.J.D. analyzed the data. All authors examined the manuscript..