Infectious Mononucleosis at Children: Features of the Course of the Disease Depending on Types of Antiviral Therapy

The state of the interferon system in 38 children with acute infectious mononucleosis (IM) caused by the Epstein-Barr virus was analyzed. Interferon status was examined in accordance with F.I. Ershov method based on assessing related biological activity by measuring interferon level in the blood serum or produced by blood cells. The aim of the study was to gain scientifically justified data for use of interferon preparations or interferonogens in IM combination therapy. For this, interferon status in children with acute IM was compared with that one not only in control group (30 healthy children, aged 3-6 and 20 children, aged 7-14 years, examined earlier to create an intra-laboratory interferon normal range), but also in children with lacunar angina or acute respiratory viral infection, hospitalized in the same department of the clinic and comparable with the main group in severity of the condition. In addition, we assessed changes in IFN-status in IM patients receiving no interferon preparations, one month after the disease onset.The study showed that patients with moderate acute IM were featured with decreased potential of blood leukocytes to virus-induced IFNα and mitogen-induced IFNγ production observed with almost similar or some lower rate as in the control group of children hospitalized with angina or acute respiratory viral infection.Peripheral blood cells from moderate acute IM patients in the 3-6-year age group were found to produce virtually unaltered interferon level, whereas almost sole IFN-alpha production was affected in 7-14-year-old patients. Moreover, in 7-14-year old patients the level 1 and level 2 of IFNα deficiency was observed in 38% and 6% of cases, respectively. It is likely it was just this patient group requiring administration of any IFNα replacement therapy.As few as 12 children were re-examined after discharge from the clinic. Initially, prevalence and severity level of impaired interferon production in this subgroup did not differ from that one for total patient sample, whereas 1 month later a host potential to produce both IFNα and IFNγ even without therapy acting on interferon system was noted to be moderately augmented.

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Altered interferon defense in children with dynamically changed infectious mononucleosis

Кукушкина

Koteleva

Бляхер

et al. 2021

Russian Journal of Infection and Immunity

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Hormone therapy affecting interferon defense in children with infectious mononucleosis

Федорова

Koteleva

Kapustin

et al. 2021

Russian Journal of Infection and Immunity

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23 children diagnosed with acute infectious mononucleosis were hospitalized and examined after a short prednisolone treatment course. Related interferon status during infection was compared with that in 38 patients with acute infectious mononucleosis receiving no hormone therapy. Interferon status was investigated by Ershov method, allowing to estimate amount of interferon in the blood serum samples or patient blood cell culture by assessing interferon biological activity. Along with measuring IFNα or IFNγ biological activity, their level was quantified by using enzyme immunoassay. Immunological examination conducted on the next day after the end of hormone therapy revealed sharply decreased potential of patient blood cells to produce both IFNα and IFNγ. The multiplicity of IFNα and IFNγ titer reduction in various patients varied by 4–5 and 3–4-fold, respectively. The concentration of IFNα, determined by ELISA, decreased by 4–6-fold, whereas for IFNγ — by 1.5–2-fold. A follow-up examination 1 month after discharge from the clinic showed that mean IFNα titer in children aged 3–6 years and treated with prednisolone was significantly reduced compared to the baseline, whereas most patients receiving no hormone therapy had normal IFNα production. The change in the level of IFNα 1 month after hormone therapy in 7–14-year age group was similar. IFNγ production quickly recovered, and 1 month after discharge from the clinic, its concentration in culture supernatants from patients reached 10–15 ng/ml, exceeding normal values more than twice. The biological activity of IFNγ in these culture supernatants was significantly higher than those immediately after hormone therapy, whereas in 3–6-year-old group of patients it was also higher than baseline level. These results can serve as a laboratory justification for including recombinant IFNα-2b drugs in the therapy of such patients, presumably immediately after the end of hormone course. Overall, laboratory justified administration of interferon preparations seems to be necessary to determine optimal timepoint for applying such drugs to increase effectiveness for achieving a durable patient recovery.

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Infectious mononucleosis in children: clinical and laboratory criteria for assessing severity

Ikkes

Мартынова

2022

Det. infekc.

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Рurpose: to identify clinical and laboratory criteria that mark the severity of infectious mononucleosis in children, with the identification of risk factors for the development of severe forms and unfavorable course.Patients and methods. A comparative prospective clinical study involved 200 children aged 3 to 11 years with moderate (125 people) and severe (75 people) form of infectious mononucleosis. When comparing clinical and laboratory data in the compared groups, the Mann-Whitney test was used. For multiple comparisons, the Kruskal-Wally test was used. Significance of differences was determined at a significance level of 0.05 (p < 0.05).Results. A comparative analysis of the clinical and laboratory manifestations of infectious mononucleosis revealed statistically significant differences in the studied parameters depending on the severity of the disease. Severe forms of infectious mononucleosis were distinguished by the most pronounced clinical symptoms, as well as changes in hematological parameters and biochemical changes. The combined etiology of infectious mononucleosis also contributed to a more severe course of the disease.Сonclusion. Timely diagnosis and assessment of the severity of the manifest form of infectious mononucleosis determine the adequacy of the appointment of rational antiviral and pathogenetic therapy, preventing the development of adverse effects and complications.

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Infectious Mononucleosis at Children: Features of the Course of the Disease Depending on Types of Antiviral Therapy

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Altered interferon defense in children with dynamically changed infectious mononucleosis

Altered interferon defense in children with dynamically changed infectious mononucleosis

Hormone therapy affecting interferon defense in children with infectious mononucleosis

Infectious mononucleosis in children: clinical and laboratory criteria for assessing severity

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