Proteomics study of Mycoplasma pneumoniae pneumonia reveals the Fc fragment of the IgG-binding protein as a serum biomarker and implicates potential therapeutic targets

Abstract

Macrolide and corticosteroid resistance has been reported in patients with Mycoplasma pneumoniae (MP) pneumonia (MPP). MP clearance is difficult to achieve through antibiotic treatment in sensitive patients with severe MPP (SMPP). SMPP in children might progress to airway remodeling and even bronchiolitis/bronchitis obliterans. Therefore, identifying serum biomarkers that indicate MPP progression and exploring new targeted drugs for SMPP treatment require urgency. In this study, serum samples were collected from patients with general MPP (GMPP) and SMPP to conduct proteomics profiling. The Fc fragment of the IgG-binding protein (FCGBP) was identified as the most promising indicator of SMPP. Biological enrichment analysis indicated uncontrolled inflammation in SMPP. ELISA results proved that the FCGBP level in patients with SMPP was substantially higher than that in patients with GMPP. Furthermore, the FCGBP levels showed a decreasing trend in patients with GMPP but the opposite trend in patients with SMPP during disease progression. Connectivity map analyses identified 25 possible targeted drugs for SMPP treatment. Among them, a mechanistic target of rapamycin kinase (mTOR) inhibitor, which is a macrolide compound and a cell proliferation inhibitor, was the most promising candidate for targeting SMPP. To our knowledge, this study was the first proteomics-based characterization of patients with SMPP and GMPP.

Keywords

severe Mycoplasma pneumoniae pneumonia / children / proteomics / Fc fragment of the IgG-binding protein / mechanistic target of rapamycin kinase inhibitor

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Acknowledgements

We would like to thank all patients who donated serum samples. This study was supported by the CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2019-I2M-1-003), the National Natural Science Foundation of China (No. 81741060), and the Beijing Municipal Natural Science Foundation (No. 7182051).

Compliance with ethics guidelines

Jinrong Liu, Rongfang Shen, Lin Feng, Shujun Cheng, Jun Chen, Ting Xiao, and Shunying Zhao declare that there are no conflicts of interest. Written informed consent was obtained from the caregivers of all children before starting the study. This study was approved by the Ethics Committee of Beijing Children’s Hospital, Capital Medical University (No. 2017-23).

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11684-021-0840-y and is accessible for authorized users.

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