Neutrophil-to-lymphocyte ratio mediates pulmonary consolidation through oxidative stress in children with Mycoplasma pneumoniae pneumonia
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background This study investigated oxidative stress in bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and explored the association between the neutrophil-to-lymphocyte ratio (NLR) and pulmonary consolidation through oxidative stress pathways.Methods This retrospective case-control study enrolled 81 children with acute-phase MPP, categorized into consolidation (n = 41) and non-consolidation (n = 40) groups. BALF oxidative stress biomarkers (malondialdehyde [MDA], superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], and advanced oxidation protein products [AOPP]) and inflammatory markers were measured. Mediation analysis examined the NLR–MDA–consolidation pathway, and a Gaussian graphical model mapped the biomarker network.Results BALF MDA [2.58(1.53,3.07) vs. 1.76(1.22,2.11) nmol/mL, p = 0.005] and AOPP [2835.63(2127.52,3340.34) vs. 2270.57(1543.56,2918.73) pg/mL, p = 0.026] were significantly higher in the consolidation group, while GSH-Px [98.33(80.70,135.22) vs. 126.75(99.11,152.39) U/mL, p = 0.009] was lower; SOD showed a non-significant decrease (p = 0.130). Mediation analysis suggested a potential indirect pathway from NLR to consolidation through MDA (indirect effect = 0.229, 95% CI: −0.023 to 0.480, p = 0.075; mediation proportion = 48.0%), though not reaching conventional significance. Network density increased by 72.5% in the consolidation group, with CRP and IL-6 as hub nodes in the non-consolidation group.NLR and BALF oxidative stress biomarkers, but not M. pneumoniae load, were associated with extra-pulmonary organ involvement.Conclusions Children with MPP-associated consolidation exhibited oxidative-antioxidant imbalance in BALF. NLR may contribute to consolidation through lipid peroxidation These findings from a single-center retrospective study warrant validation in larger prospective multicenter cohorts.
Source: Annals of Medicine
Language: English
Subfield: Microbiology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,557
OpenAlex ID: W7154020946