Translational pediatrics最新文献

{"title":"Lateral external fixation plus K-wire for pediatric supracondylar humeral fracture with medial comminution: a retrospective study of 53 cases in a tertiary medical center.","authors":"Xiaocheng He, Kaitai Zou, Shuo Wang, Jin Li, Pan Hong","doi":"10.21037/tp-2025-365","DOIUrl":"10.21037/tp-2025-365","url":null,"abstract":"<p><strong>Background: </strong>Medial comminuted supracondylar humeral fracture (SCHF) is a common elbow injury in children, and there is no consensus on treatment yet. While crossed pinning offers biomechanical advantages for medial comminution, it carries inherent risks of iatrogenic ulnar nerve injury. This study aims to describe the surgical technique of lateral external fixation (LEF) combined with K-wire (KW) as an alternative technique and evaluate the clinical and radiological outcomes of this method.</p><p><strong>Methods: </strong>We retrospectively analyzed 53 children (mean age 7.1 years; 28 males, 25 females) with Gartland type II (n=9) and III (n=44) SCHFs with medial comminution, treated between January 2019 and January 2022. All fractures were fixed with LEF and KW. Functional outcomes were assessed using Flynn's criteria, with radiological parameters (carrying-angle loss, shaft condylar angle, Baumann's angle) measured at a minimum 12-month follow-up (range, 12-26 months).</p><p><strong>Results: </strong>At last follow-up, radiographic evaluation demonstrated a mean shaft condylar angle of 37.1°±4.4°, Baumann's angle of 75.6°±3.6°, and carrying angle loss of 3.4°±2.0°. Range-of-motion loss averaged 3.5°±2.4°. According to Flynn's criteria, 87% (46/53) achieved excellent and 13% (7/53) good outcomes. Subgroup analysis revealed significantly greater carrying-angle deviation (P<0.01) and motion loss (P=0.05) in Gartland III versus II fractures. Complications included two superficial pin-site infections (3.8%) resolved with oral antibiotics; no instances of iatrogenic nerve injury, vascular compromise, or malunion occurred.</p><p><strong>Conclusions: </strong>For pediatric SCHF with medial comminution, external fixator (EF) plus KW is a feasible alternative without the risk of iatrogenic ulnar nerve injury.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1952-1960"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of NF-κB2 mutations on Tfh cell differentiation and their critical role in immune function.","authors":"Yao Chen, Weitao Zhou, Leying Li, Tong Chen, Qi Wu, Qifan Li, Yufeng Zhou, Liling Qian","doi":"10.21037/tp-2025-122","DOIUrl":"10.21037/tp-2025-122","url":null,"abstract":"<p><strong>Background: </strong>The non-canonical NF-κB2 pathway is crucial for immune regulation, and pathogenic mutations in NF-κB2 are linked to common variable immunodeficiency (CVID), recurrent infections, and autoimmune diseases. T follicular helper (Tfh) cells play a key role in B cell differentiation and antibody production, but the effects of NF-κB2 mutations on Tfh cell differentiation remain unclear. This study investigates the clinical and functional consequences of two NF-κB2 mutations: c.1714G>A (p.A572T) and c.2540dupT (p.R848Efs*38).</p><p><strong>Methods: </strong>We analyzed clinical features, immunophenotypes, and endocrine profiles of three patients carrying NF-κB2 mutations. Transcriptome sequencing of peripheral blood mononuclear cells (PBMCs) from Patient 3 (P3) and five healthy donors was performed to examine gene expression changes. Flow cytometry quantified Tfh cell populations, and real-time quantitative polymerase chain reaction (RT-qPCR) validated the expression of genes involved in Tfh differentiation. The impact of NF-κB2 mutations on p100 processing and nuclear translocation was assessed via western blot and immunofluorescence in HEK293T cells.</p><p><strong>Results: </strong>Patient 1 (P1) exhibited mild clinical features, primarily asthma, while Patient 3 (P3) presented with severe immunodeficiency, recurrent pulmonary infections, and hormonal deficiencies. Transcriptome sequencing revealed significant downregulation of T cell differentiation pathways in P3, particularly Tfh-related genes such as <i>ASCL2</i>, <i>IRF4</i>, and <i>BHLHE40</i>. Flow cytometry confirmed a marked reduction in circulating Tfh cells in P3. Western blot and immunofluorescence analyses demonstrated that the R848Efs*38 mutation impaired the conversion of p100 into p52 and disrupted nuclear translocation.</p><p><strong>Conclusions: </strong>This study identifies novel mechanisms by which NF-κB2 mutations impair immune function. The R848Efs*38 mutation disrupts Tfh cell differentiation by interfering with p100 processing and reducing key Tfh-related transcription factors. These findings enhance our understanding of NF-κB2-related immunodeficiencies and their molecular underpinnings, contributing to the broader knowledge of immune regulation and potential therapeutic targets.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1908-1920"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of fecal short-chain fatty acids in neonatal necrotizing enterocolitis.","authors":"Ying Li, Jinxin Zhang, Miao Duan","doi":"10.21037/tp-2025-201","DOIUrl":"10.21037/tp-2025-201","url":null,"abstract":"<p><strong>Background: </strong>The metabolites of microbiota may contribute to the pathogenesis of neonatal necrotizing enterocolitis (NEC). The aim of this study was to explore the role of fecal short-chain fatty acids (SCFAs) in the development and progression of NEC.</p><p><strong>Methods: </strong>This study was a retrospective case-control study. The included infants with NEC and non-NEC infants who were hospitalized during the same period were classified into the NEC and control groups, respectively. The concentrations of SCFAs were measured by chromatography-mass spectrometry analysis. The clinical data and concentrations of SCFAs were compared between the NEC and control groups. The association between clinical data, concentrations of SCFAs, and levels of C-reactive protein (CRP) and procalcitonin (PCT) was assessed by Spearman correlation analysis and multivariate linear regression analysis. The predictive values of factors with statistical significance were assessed by receiver operator characteristic curve.</p><p><strong>Results: </strong>Twenty-one infants with NEC and 27 non-NEC infants were included in our study. Propionic acid and butyric acid were positively correlated with the incidence of NEC, while isobutyric acid, valeric acid, isocaproic acid, and caproic acid were negatively correlated with the incidence of NEC. Propionic acid concentrations were positively correlated with levels of CRP and PCT. Birth weight, gestational age, isobutyric acid, isocaproic acid, caproic acid, and valeric acid concentrations were negatively correlated with the levels of PCT. Increased propionate acid concentration and decreased butyric acid concentration were risk factors for increased PCT. The decreased level of valeric acid was an independent risk factor for the occurrence of NEC.</p><p><strong>Conclusions: </strong>Certain SCFAs were associated with the development and progression of NEC.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1816-1826"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive basic and clinical studies are needed to improve the treatment and outcome of patients with Kearns-Sayre syndrome.","authors":"Josef Finsterer","doi":"10.21037/tp-2025-425","DOIUrl":"10.21037/tp-2025-425","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"2075-2077"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring human adenovirus loads in bronchoalveolar lavage fluid in non-immunocompromised children with human adenovirus pneumonia.","authors":"Senqiang Zeng, Bingtai Lu, Diyuan Yang, Chen Chen, Xuehua Xu, Yaping Xie, Huifeng Fan, Gen Lu","doi":"10.21037/tp-2025-99","DOIUrl":"10.21037/tp-2025-99","url":null,"abstract":"<p><strong>Background: </strong>Human adenoviruses (HAdVs) are prevalent pathogens responsible for respiratory infections. In this study, we examined the relationship between adenovirus viral loads in bronchoalveolar lavage fluid (BALF) and the severity of adenovirus pneumonia in children.</p><p><strong>Methods: </strong>The medical records of patients admitted to Guangzhou Women and Children's Medical Center with confirmed adenovirus pneumonia were analyzed in a prospective manner. We evaluated the potential link between the severity of the disease and the viral load, which was measured using real-time polymerase chain reaction (PCR) on the BALF of pediatric patients. Furthermore, the study investigated the connection between viral loads in BALF and the progression of the illness.</p><p><strong>Results: </strong>In hospitalized pediatric patients with adenovirus pneumonia, the viral loads found in BALF were positively associated with the severity of the disease during the acute phase (P<0.05). In addition, lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels were positively associated with viral loads in BALF, whereas albumin (ALB) levels showed a negative relationship (P<0.05). In addition, In addition, The receiver operating characteristic (ROC) analysis indicated that viral loads in BALF displayed great potential for predicting severe adenovirus pneumonia, with a cut-off value of >187,500 copies/mL, which achieved a sensitivity of approximately 77.27% and a specificity of 80.65%.Moreover, viral loads in BALF from patients at the acute stage of the disease were positively correlated with fever duration and length of stay (LOS) at the hospital, and viral loads declined quickly during the recovery stage (P<0.05).</p><p><strong>Conclusions: </strong>Our findings indicated a significant correlation between viral loads in BALF from patients with adenovirus pneumonia and the severity of the disease. We suggested that viral loads can serve as potential biomarkers for identifying severe cases and predicting the progression of illness.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1836-1844"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of best evidence for enhanced recovery after surgery for perioperative management of pediatric cleft lip and palate surgery: a narrative review.","authors":"Chenxin Zhang, Junyi Guo, Sijia Chen, Yuying Zhou, Lingxuan Zhu","doi":"10.21037/tp-2025-318","DOIUrl":"10.21037/tp-2025-318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Children with cleft lip and palate face more complex stressful situations in the perioperative period due to their underdeveloped systems and relatively weaker resistance to various injurious stimuli. The concept of enhanced recovery after surgery (ERAS) offers a novel perspective on the perioperative management of pediatric patients with cleft lip and palate. This narrative review aimed to search, evaluate, and summarize the best evidence for ERAS in children with cleft lip and palate, and provide reference for clinical perioperative nursing practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched the databases of The British Medical Journal (BMJ), UpToDate, The Cochrane Library, Guidelines International Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), Joanna Briggs Institute (JBI), Medlive, American Cleft Palate-Craniofacial Association (ACPA), Enhanced Recovery After Surgery Society, Chinese Stomatological Association (CSA), PubMed, Web of Science, Embase, Scopus, SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal (VIP). The search covered the period from the database's inception to December 2024. This study included children undergoing congenital cleft lip and palate surgery who received perioperative ERAS interventions with evidence derived from guidelines, evidence summary, expert consensus, systematic reviews, or randomized controlled trials (RCTs), while excluding non-English/Chinese literature, incomplete methodological details or low-quality appraisal ratings, and studies with unavailable data. Quality was assessed using Clinical Guidelines Research and Evaluation System for guidelines, Critical Appraisal for Summaries of Evidence for evidence summaries, the JBI Critical Appraisal Tool for Systematic Reviews, the JBI Critical Appraisal Checklists for expert consensus, and the Cochrane Risk of Bias Tool for randomized trials. Evidence synthesis was performed using the JBI Evidence Pre-grading System (2014) to classify evidence levels (1-5), followed by recommendation grading (grade A/B).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key content and findings: &lt;/strong&gt;A total of 14 articles were included, including four guidelines, one technical report, two expert consensus articles, three systematic reviews, and four RCTs (covering 342 patients). The publication or update dates of these studies spanned 2019-2024, with their sources predominantly originating from the United States and China, and they covered the entire perioperative period. Through a comprehensive analysis of these studies, 17 themes and 34 recommendations were identified in total. These recommendations cover preoperative preparation (health education, nutrition, fasting), intraoperative care (anesthesia, temperature), postoperative management (pain, feeding, wound care), and discharge follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study synthesizes 34 key evidence-based recommendati","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"2009-2022"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of chorionicity on birth weight discordance in twins.","authors":"Qiuying Li, Hui Zhang, Qian Chen, Bijun Shi, Xiaohua Tan, Qiliang Cui","doi":"10.21037/tp-2025-5","DOIUrl":"10.21037/tp-2025-5","url":null,"abstract":"<p><strong>Background: </strong>Advanced maternal age (AMA, ≥35 years) is increasing, linked to delayed childbearing and infertility, with medically assisted reproductive (MAR) technology boosting twin pregnancy rates. Birth weight discordance in twins [BWDT, birth weight discordance (∆BW) >20%] raises neonatal morbidity. Chorionicity matters: monochorionic diamniotic (MCDA) twins face higher risks from placental anastomoses, while dichorionic diamniotic (DCDA) twins have better outcomes. This study explores their association with BWDT. The aim of this study was to characterize the association of chorionicity status in twin pregnancies and BWDT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on twin infants born between January 2011 and December 2020 at The Third Affiliated Hospital, Guangzhou Medical University, with complete birth data. The relationship between DCDA twins and the occurrence of BWDT was examined via the multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 3,231 pairs of twins were included, including 498 pairs in the MCDA twins group and 2,733 pairs in the DCDA twins group. In the DCDA twins group, the proportion of advanced puerperae (≥35 years old) and first conception was significantly higher than that in the MCDA twins group (P<0.05). An unconditioned logistic regression model was used to control for confounding factors, and the results indicated DCDA twins are at a lower risk for BWDT.</p><p><strong>Conclusions: </strong>DCDA twins are less likely to have BWDT.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1787-1796"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthritis associated with Kawasaki disease after initial combination therapy with cyclosporine: a case report.","authors":"Kaori Yoshida, Yoshitaka Watanabe, Maria Yoshimi, Nobuhiro Kawai, Minako Matsumoto, Hirokazu Ikeda","doi":"10.21037/tp-2025-176","DOIUrl":"10.21037/tp-2025-176","url":null,"abstract":"<p><strong>Background: </strong>Since the 2020 revision of the Kawasaki disease (KD) treatment guidelines, there have been few reports of reactive arthritis secondary to treatment-resistant KD. This study reports a case of KD that required initial treatment with cyclosporine A (CyA) followed by additional infliximab (IFX) and secondary to reactive arthritis.</p><p><strong>Case description: </strong>A 5-year-old boy met diagnostic criteria for KD on day 5 of fever and had an intravenous immunoglobulin (IVIG) refractory predictive score of 8 (≥5) was administered ulinastatin, IFX, and three IVIG doses in combination with CyA. His fever resolved on day 9. Subsequently, acetylsalicylic acid was changed to flurbiprofen and then to dipyridamole due to suspicion of a drug rash. Fever and pain appeared in ankle joints and right hip joint on day 18 of illness. Prednisolone (PSL) was started on day 23 of illness for reactive arthritis associated with KD, which improved the joint pain. No recurrence of joint symptoms or coronary artery lesions was observed after tapering off of PSL.</p><p><strong>Conclusions: </strong>Based on the evaluation at the start of treatment, although CyA is initially administered in potential IVIG-resistant patients, attention must be paid to secondary reactive arthritis if the patient becomes resistant to treatment and requires IFX treatment.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"2042-2046"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less may be enough: a transplant-free future for low-risk relapsed Hodgkin lymphoma.","authors":"Christopher J Forlenza, Sharon M Castellino","doi":"10.21037/tp-2025-346","DOIUrl":"10.21037/tp-2025-346","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1741-1745"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of CCL26 and CCR3 levels for prognosis assessment in children with <i>Mycoplasma pneumoniae</i> pneumonia treated with azithromycin.","authors":"Lingyan Ma, Shenghua Ge, Dongqing Song","doi":"10.21037/tp-2025-296","DOIUrl":"10.21037/tp-2025-296","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma pneumoniae</i> pneumonia (MPP), a prevalent form of community-acquired pneumonia (CAP) in schoolchildren, frequently results in persistent fever or complications in 15-25% of cases despite azithromycin treatment. This highlights the urgent need for novel biomarkers to identify high-risk cases. This study aims to investigate the predictive value of serum C-C motif chemokine ligand 26 (CCL26) and C-C chemokine receptor 3 (CCR3) levels for treatment prognosis in children with MPP receiving azithromycin therapy.</p><p><strong>Methods: </strong>Clinical data of 205 pediatric MPP patients treated in our hospital from February 2023 to February 2025 were collected. Serum levels of CCL26, CCR3, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and D-dimer (DD) were measured by enzyme-linked immunosorbent assay (ELISA), while <i>Mycoplasma pneumoniae</i> (MP) antibody titers were determined using passive agglutination. Pearson correlation analysis evaluated relationships between CCL26 and CCR3 and inflammatory cytokines (IL-6, TNF-α). Logistic regression identified risk factors for poor prognosis, with receiver operating characteristic (ROC) curve analysis assessing the predictive value of CCL26 and CCR3.</p><p><strong>Results: </strong>Compared with healthy controls, MPP patients showed elevated serum CCL26, CCR3 and inflammatory cytokines (TNF-α, IL-6) both pre- and post-treatment (all P<0.05). These markers significantly decreased after therapy (all P<0.05). Pretreatment CCL26 and CCR3 levels positively correlated with inflammatory cytokines (P<0.05). Poor prognosis cases exhibited higher levels of CCL26, CCR3, TNF-α, IL-6, C-reactive protein (CRP), DD, MP antibody titers (≥1:160), fever duration (≥5 d), and peak temperature (≥38.5 °C) (P<0.05). Multivariate analysis identified MP antibody titer ≥1:160, elevated CCL26, CCR3, TNF-α, and IL-6 levels, fever ≥5 days, and temperature ≥38.5 °C as independent risk factors. The area under the curve (AUC) for CCL26 and CCR3 in predicting poor prognosis was 0.709 and 0.751, respectively, increasing to 0.798 when combined.</p><p><strong>Conclusions: </strong>Serum CCL26 and CCR3 levels decrease following azithromycin treatment and demonstrate significant associations with inflammatory markers and clinical outcomes, serving as reliable predictors for poor prognosis in MPP patients.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 8","pages":"1806-1815"},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}