Abstract: Objective The objective of this study was to explore the relationship between T helper cell type 1/T helper cell type 2 (Th1/Th2) cytokines and the therapeutic efficacy in children with human metapneumovirus pneumonia, and to assess their potential value as biomarkers for predicting therapeutic efficacy, thereby providing a theoretical basis for optimizing clinical treatment strategies. Method A total of 156 pediatric patients with human metapneumovirus pneumonia admitted to Hebei Children's Hospital from January 2022 to January 2024 were selected as the study subjects. Symptomatic supportive treatment was administered, and the patients were divided into an effective group(134 cases) and an ineffective group(22 cases) based on treatment efficacy. General information, pulmonary function indicators, Th1 cytokines [interferon-γ (IFN-γ), interleukin-2 (IL-2)], and Th2 cytokines (IL-4, IL-6) of the two groups were compared. Pearson correlation analysis was used to examine the correlation between Th1/Th2 cytokines and pulmonary function indicators. Logistic regression analysis was conducted to investigate the impact of Th1/Th2 cytokines on the efficacy of treatment for human metapneumovirus pneumonia. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the predictive value of Th1/Th2 cytokines for treatment efficacy. Result Compared with the effective group, the ineffective group had lower respiratory ratio (spiratory time/expiratory time, TI/TE), tidal volume (VT), IFN-γ, and IL-2 levels, and higher respiratory rate (RR), IL-4, IL-6 levels, and moderate disease severity (P<0.05). IFN-γ and IL-2 were positively correlated with TI/TE and VT, whereas negatively correlated with RR; IL-4 and IL-6 were negatively correlated with TI/TE and VT, and positively correlated with RR (P<0.05). After adjusting for confounding factors, IFN-γ, IL-2, IL-4, and IL-6 were associated with the efficacy of treatment in children with human metapneumovirus pneumonia (P<0.05). The combined prediction of IFN-γ, IL-2, IL-4, and IL-6 for the efficacy of treatment in children with human metapneumovirus pneumonia was superior to that of individual indicators (AUC: 0.927, 0.805, 0.791, 0.789, 0.777). Conclusion IFN-γ, IL-2, IL-4, and IL-6 are influencing factors for the therapeutic efficacy in children with human metapneumovirus pneumonia, and are closely associated with lung function indicators. They can be used jointly to predict the therapeutic efficacy efficacy and help guide clinical diagnosis and treatment.

Key words: Human metapneumovirus, Pneumonia, Th1/Th2 cytokines, Treatment efficacy