The concentration of IL-6, TNF-α, s-ICAM-1, and EBV DNA load – predictive factors of hepatological complications in children with infectious mononucleosis. A pilot study

Abstract

Introduction:The aim of the study was to assess the relationship between the concentration of pro-inflammatory cytokines such as interleukin 6 (IL-6), tumour necrosis factor α (TNF-α), soluble intercellular adhesion molecule 1 (s-ICAM-1), and Epstein-Barr virus (EBV) DNA viraemia in children with infectious mononucleosis and hepatitis. Material and methods: The Epstein-Barr virus DNA load in the plasma of 36 immunocompetent patients aged 2.5-18 years with a symptomatic (sore throat, cervical lymph node enlargement, fatigue, and fever), antibody-confirmed EBV primary infection was assessed using a quantitative real-time polymerase chain reaction assay. The concentration of IL-6, s-ICAM-1, and TNF-α in serum was determined using enzyme-linked immunosorbent assay tests. Results: In a group of patients with infectious mononucleosis caused by EBV and viraemia > 3.5 log10 copies/ ml, shorter duration of symptoms, and higher serum levels of s-ICAM-1 and C-reactive protein (CRP) were confirmed. In group of children with EBV hepatitis and CRP > 5 mg/l, levels of s-ICAM-1, γ-glutamyl transpeptidase activity, count of total white blood cells and lymphocytes, and EBV DNA load were significantly higher than in patients with CRP < 5 mg/l. Among patients with EBV hepatitis the increase of s-ICAM-1 concentration correlated with the increase of IL-6 and TNF-α serum levels. Conclusions: The results suggest a higher risk of cholestatic complications in children with elevated CRP level. They indicate that EBV DNA viraemia in conjunction with an s-ICAM-1, IL-6, and TNF-α assessment may be helpful in selecting patients requiring hospitalization.

Are Selected Cytokines and Epstein–Barr Virus DNA Load Predictors of Hepatological Complications of Epstein–Barr Virus Infection in Children?

“…In immunocompetent patients, an EBV DNA viral load assessment is not currently recommended for the routine diagnosis of EBV infection. A pilot in-house study enrolling 36 children with serologically and molecularly confirmed EBV infection, as well as the current study enrolling 68 children, showed a statistically significant correlation between EBV DNA viral load and CRP level, TNF-α concentration, leukocyte count, and monocyte count [30]. A group of 54 children with hepatological complications in the course of EBV infection were analysed in detail, in which correlations among ALT activity, GGTP activity, the duration of symptoms, selected elements of the protein-cell system, and EBV DNA viral load levels were analysed.…”