Frontiers in pediatrics · 2025
Immunological profile and its clinical implications in pediatric infectious mononucleosis.
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Wang Jie, Zhao Xinfeng, Ye Cuiying, Xu Xudong
Аннотация
OBJECTIVE: To analyze the differences in peripheral blood immune function between children with infectious mononucleosis (IM) who developed liver injury (LI) and those non-liver injury (NLI), and to investigate the regulatory role of immune markers in IM infection.
METHODS: A total of 50 hospitalized children diagnosed with IM at Hangzhou Children's Hospital between November 2023 and August 2024 were enrolled as the Epstein-Barr Virus (EBV) infection group, including 19 without LI and 31 with LI. Additionally, 30 age-matched healthy children undergoing routine physical examinations during the same period were included as the control group. Flow cytometry was used to detect 12 cytokines, granzyme B (GzmB), perforin (PRF), regulatory T cells (Tregs), programmed cell death protein 1 (PD-1), and other immune markers in peripheral blood. CD100 levels were measured by ELISA.
RESULTS: The expression levels of IL-5, IFN-α, IL-2, IL-6, IL-10, IFN-γ, and IL-8 were significantly elevated in the EBV infection group compared to the control group (P < 0.01). Expression of GzmB and PRF in CD3+ and CD8+ T lymphocytes was significantly higher in the EBV group than in controls (P < 0.05). PD-1 and CD100 were also elevated in the EBV group (P < 0.01). Conversely, the expression of Tregs, CD28 in CD3+ and CD8+ T lymphocytes was significantly lower in the EBV group than in the control group (P < 0.01). Further comparison between the LI and non-liver injury (NLI) subgroups revealed that GzmB levels in CD3+ and CD8+ T lymphocytes were significantly higher in the LI group, while CD28 expression in CD3+ and CD8+ T lymphocytes was lower in the LI group compared to the NLI group (P < 0.05). Correlation analysis showed that PRF, PD-1 expression in CD3+ and CD8+ T lymphocytes, and IL-10 levels were positively correlated with EBV-DNA load (P < 0.05). GzmB in CD3+ and CD8+ T lymphocytes and IFN-γ levels were positively correlated with body temperature (P < 0.05). CD28 expression in CD3+ and CD8+ T lymphocytes was negatively correlated with ALT levels (P < 0.05).
CONCLUSION: EBV infection-induced IM is associated with abnormal expression of various immune markers in peripheral blood.The high expression of GzmB and low expression of CD28 are associated with LI in IM.
METHODS: A total of 50 hospitalized children diagnosed with IM at Hangzhou Children's Hospital between November 2023 and August 2024 were enrolled as the Epstein-Barr Virus (EBV) infection group, including 19 without LI and 31 with LI. Additionally, 30 age-matched healthy children undergoing routine physical examinations during the same period were included as the control group. Flow cytometry was used to detect 12 cytokines, granzyme B (GzmB), perforin (PRF), regulatory T cells (Tregs), programmed cell death protein 1 (PD-1), and other immune markers in peripheral blood. CD100 levels were measured by ELISA.
RESULTS: The expression levels of IL-5, IFN-α, IL-2, IL-6, IL-10, IFN-γ, and IL-8 were significantly elevated in the EBV infection group compared to the control group (P < 0.01). Expression of GzmB and PRF in CD3+ and CD8+ T lymphocytes was significantly higher in the EBV group than in controls (P < 0.05). PD-1 and CD100 were also elevated in the EBV group (P < 0.01). Conversely, the expression of Tregs, CD28 in CD3+ and CD8+ T lymphocytes was significantly lower in the EBV group than in the control group (P < 0.01). Further comparison between the LI and non-liver injury (NLI) subgroups revealed that GzmB levels in CD3+ and CD8+ T lymphocytes were significantly higher in the LI group, while CD28 expression in CD3+ and CD8+ T lymphocytes was lower in the LI group compared to the NLI group (P < 0.05). Correlation analysis showed that PRF, PD-1 expression in CD3+ and CD8+ T lymphocytes, and IL-10 levels were positively correlated with EBV-DNA load (P < 0.05). GzmB in CD3+ and CD8+ T lymphocytes and IFN-γ levels were positively correlated with body temperature (P < 0.05). CD28 expression in CD3+ and CD8+ T lymphocytes was negatively correlated with ALT levels (P < 0.05).
CONCLUSION: EBV infection-induced IM is associated with abnormal expression of various immune markers in peripheral blood.The high expression of GzmB and low expression of CD28 are associated with LI in IM.