Serum Tumor Necrosis Factor-α and Interferon-γ Levels in Pediatric Mycoplasma pneumoniae Pneumonia: A Systematic Review and Meta-Analysis

Background. Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children. ,e objective of this study was to explore potential changes in levels of serum tumor necrosis factor-α (TNF-α) and interferon-c (IFN-c) associated with pediatric MPP. Methods. ,is protocol has been registered (PROSPERO 2017: CRD42017077979). A literature search was performed in October 2017 using PubMed, Embase, the Cochrane Library, and other Chinese medical databases to identify studies. ,e meta-analysis was performed using Review Manager 5.3 software. Randomeffect models were used to estimate mean differences (MDs) and 95% confidence intervals (CIs) of cytokine levels. Results. Twelve studies were included in the meta-analysis, encompassing 2,422 children with MPP and 454 healthy control children. Serum TNFα levels were significantly higher in children with MPP compared with healthy children (MD = 22.5, 95% CI = 13.78–31.22, P < 0.00001), and there was significant heterogeneity across studies (I 2 = 100%, P < 0.00001). Subgroup analyses showed no evidence for a difference in serum TNF-α levels between children with refractory and nonrefractory MPP. Serum IFN-c levels did not significantly differ in children with MPP compared with healthy children (MD = 4.83, 95% CI = −3.27–12.93, P = 0.24). Conclusions. Our meta-analysis showed that serum TNF-α and IFN-c levels were significantly elevated and unchanged, respectively, in pediatric MPP. Because infection by different pathogens has variable effects on serum TNF-α and IFN-c levels, the finding could be helpful in developing novel diagnostic methods.