Abstract
BackgroundThis study aimed to assess the host immune signatures associated with EBV infection and its clinical value in indicating the severity of children with acute infectious mononucleosis (IM).MethodsTwenty-eight pediatric patients with IM aged 3–8 years were enrolled. The immune phenotypes and cytokine secretion capability of T cells were detected.ResultsThe percentages and absolute numbers of CD3+ and CD8+ T cells were significantly increased in IM patients compared with HCs. The percentages of Naïve CD4+ and CD8+ T cells were decreased but with increased percentages of memory CD4+ and CD8+ T subsets. Our results showed the upregulation of active marker HLA-DR, TCR-αβ, and inhibitory receptors PD-1, TIGIT in CD8+ T cells from IM patients, which suggested that effective cytotoxic T cells were highly against EBV infection. However, EBV exposure impaired the cytokine (IFN-γ, IL-2, and TNF-α) secretion capability of CD4+ and CD8+ T cells after stimulation with PMA/ionomycin in vitro. Multivariate analysis revealed that the percentage of HLA-DR+ CD8+ T cells was an independent prognostic marker for IM. The percentage of HLA-DR+ CD8+ T cells was significantly correlated with high viral load and abnormal liver function results.ConclusionRobust expansion and upregulation of HLA-DR in CD8+ T cells, accompanied with impaired cytokine secretion, were typical characteristics of children with acute IM. The percentage of HLA-DR+ CD8+ T cells might be used as a prominent marker not only for the early diagnosis but also for indicating the severity of IM.
Highlights
Infectious mononucleosis (IM) is an acute infectious disease in children caused mainly by Epstein-Barr virus (EBV) infection [1]
Our study provided a comprehensive evaluation of mononuclear cells in peripheral blood, which is critically important for further elucidating the pathogenesis mechanisms during EBV infection
The present study recruited 28 children diagnosed with IM, including 19 (67.9%) males and 9 (32.1%) females, median age of 6.0 (25th–75th quartiles, range 3.9–7.75 years)
Summary
Infectious mononucleosis (IM) is an acute infectious disease in children caused mainly by Epstein-Barr virus (EBV) infection [1]. Epidemiological studies showed that the positive rate of EBV is estimated to be more than 90% worldwide [2]. The typical clinical manifestations of children with IM include fever, sore throat, lymph node enlargement, hepatosplenomegaly, skin rash, eyelid edema [3, 4]. IM presents as a self-revolving illness, some patients may develop serious complications, such as spleen rupture, malignancies, and EBV-related hemophagocytic syndrome (HPS) [5,6,7]. Accurate early diagnosis, timely treatment, and effective monitoring are important for children with acute IM. This study aimed to assess the host immune signatures associated with EBV infection and its clinical value in indicating the severity of children with acute infectious mononucleosis (IM)
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