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Abstract
Mycoplasma pneumoniae is a major causative agent of community-acquired pneumonia which can lead to both acute upper and lower respiratory tract inflammation, and extrapulmonary syndromes. Refractory pneumonia caused by M. pneumonia can be life-threatening, especially in infants and the elderly. Here, based on a comprehensive review of the scientific literature related to the respective area, we summarize the virulence factors of M. pneumoniae and the major pathogenic mechanisms mediated by the pathogen: adhesion to host cells, direct cytotoxicity against host cells, inflammatory response-induced immune injury, and immune evasion. The increasing rate of macrolide-resistant strains and the harmful side effects of other sensitive antibiotics (e.g., respiratory quinolones and tetracyclines) in young children make it difficult to treat, and increase the health risk or re-infections. Hence, there is an urgent need for development of an effective vaccine to prevent M. pneumoniae infections in children. Various types of M. pneumoniae vaccines have been reported, including whole-cell vaccines (inactivated and live-attenuated vaccines), subunit vaccines (involving M. pneumoniae protein P1, protein P30, protein P116 and CARDS toxin) and DNA vaccines. This narrative review summarizes the key pathogenic mechanisms underlying M. pneumoniae infection and highlights the relevant vaccines that have been developed and their reported effectiveness.
Highlights
Community-acquired pneumonia (CAP) is associated with high morbidity and mortality, and the disease is a major threat to public health worldwide [1]
P1 plays an important role in the pathogenesis of M. pneumoniae infection by mediating the attachment of the pathogen to host cells [123], and the p1 gene is used as target to detect M. pneumoniae by qRT-polymerase chain reaction (PCR), as well as to perform genotyping [124,125]
These results provide insights into vaccine development for effective protection against M. pneumoniae infection in humans
Summary
Community-acquired pneumonia (CAP) is associated with high morbidity and mortality, and the disease is a major threat to public health worldwide [1]. M. pneumoniae causes both upper and lower respiratory tract infections, and in most cases the clinical symptoms are non-specific [7]. CAP is the most significant disease caused by M. pneumoniae, the pathogen is known to cause upper respiratory tract infections. M. pneumoniae infection is generally self-limiting and does not require antibiotic treatment, patients of all age groups can develop severe, life-threatening or extrapulmonary diseases [24]. Antibiotics such as tetracycline and fluoroquinolone have been reported to be effective in eliminating M. pneumoniae infections [25] but tetracyclines cause discoloration of bones and teeth in young children.
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