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Observational Study
. 2025 Aug 5;51(1):247.
doi: 10.1186/s13052-025-02105-5.

Serum expression of ESM-1 and Syndecan-1 and its relationship with disease severity in children with Mycoplasma pneumoniae pneumonia

Yanjuan Yu #  1 , Yanyan Su #  1 , Xiuhong Jin  1 , Xiangfeng Zhang  1 , Yeran Yang  2 , Yuelin Shen  3
Affiliations
Observational Study

Serum expression of ESM-1 and Syndecan-1 and its relationship with disease severity in children with Mycoplasma pneumoniae pneumonia

Yanjuan Yu et al. Ital J Pediatr. .

Abstract

Background: This study aim to investigate the role of endothelial damage in the pathogenesis of Mycoplasma pneumoniae pneumonia (MPP) by comparing serum levels of endothelial cell-specific molecule 1 (ESM-1) and Syndecan-1 in patients with varying degrees of MPP severity. Additionally, we aim to explore the relationship between the production of ESM-1 and Syndecan-1 and the severity of MPP, inflammation, as well as hypercoagulative state in children.

Methods: A prospective, observational study that included clinical manifestations, laboratory tests, and serum ESM-1 and Syndecan-1 assays. The correlation between ESM-1 and Syndecan-1 levels with inflammatory markers and coagulation markers was analyzed. Multivariate logistic regression analysis was conducted to identify significant risk factors for Severe Mycoplasma pneumoniae pneumonia (SMPP).

Results: A total of 179 children with MPP and 40 healthy volunteers were enrolled. Serum ESM-1 and Syndecan-1 levels were significantly elevated in children with MPP compared to the healthy children (all P < 0.05). A multivariate analysis revealed that ESM-1, Syndecan-1, D-dimer and LDH were the significant predictors of SMPP, with odds ratios of 1.034, 1.002, 5.042 and 1.014, respectively. The optimal cutoff values of ESM-1, Syndecan-1, D-dimer and LDH for predicting SMPP were 79.67 ng/mL, 3219.35 pg/mL, 0.67 µg/mL and 365.00 U/L, respectively.

Conclusions: ESM-1, Syndecan-1, D-dimer, and LDH can serve as independent predictors for SMPP. The interaction between endothelial damage, excessive inflammatory response, and hypercoagulable state collectively contributes to the development and progression of SMPP.

Keywords: ESM-1; Endothelial damage; Independent predictors; Severe Mycoplasma pneumoniae pneumonia; Syndecan-1.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the Ethics Committee of Children’s Hospital Affiliated to Zhengzhou University (Approval no. 2024-K-065). In addition, informed consent was obtained from the patients for the publication of all clinical data included in the main manuscript. Consent for publication: Written informed consent for publication was obtained from all participants. Conflict of interest: The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Box-and-whisker plot for comparison of the biomarkers of endothelial damage in SMPP, MMPP and healthy control. (A) Serum ESM1 levels in different groups. (B) Serum Syndecan-1 levels in different groups. ***: P<0.001;****P:<0.0001
Fig. 2
Fig. 2
ROC curve for predictive values of the independent correlation factors of SMPP
See this image and copyright information in PMC

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