Correlation between Treg/Th17 immune imbalance and EBV-DNA positivity after treatment in children with infectious mononucleosis

doi:10.19871/j.cnki.xfcrbzz.2024.03.010

Abstract

Abstract: Objective To explore the relationship between Treg/Th17 immune imbalance and EBV-DNA positivity in children with infectious mononucleosis, and to provide important markers for treatment and prognosis evaluation of such children. Method 88 children with infectious mononucleosis who were treated in our hospital from January 2021 to June 2023 were studied. Children received standardized treatment based on acyclovir or ganciclovir and continued follow-up. According to whether the EBV-DNA load was positive or not at 14 days after treatment, they were divided into EBV-DNA negative group (n=70) and EBV-DNA positive group (n=18). The general clinical data, treatment-related characteristics, T cell subsets, inflammatory cytokines, immunoglobulin before treatment of the two groups were compared. Spearman correlation analysis and multiple Logistic regression analysis were used to evaluate the correlation between different indicators and EBV-DNA positive in children with infectious mononucleosis after 14 days of treatment, and screen for risk factors. Result The average hospitalization time, average temperature recovery time and lymph node enlargement recovery time in EBV-DNA positive group were significantly higher than those in EBV-DNA negative group (P<0.05). The average CD4⁺T cell ratio, CD4⁺/CD8⁺ ratio, Treg cell ratio, Treg/Th17 ratio and serum IL-4 level in the EBV-DNA positive group were significantly lower than those in the EBV-DNA negative group, while the average Th17 cell proportion and serum IFN-γ level in the EBV-DNA negative group were significantly higher (P<0.05). Spearman correlation analysis and multivariate Logistic regression analysis showed that lower proportion of CD4⁺T cells, lower proportion of Treg cells, higher proportion of Th17 cells and lower Treg/Th17 ratio were risk factors for EBV-DNA positive after 14 days of standardized treatment in children with infectious mononucleosis (P<0.05). Conclusion The proportion of T cell subsets, the severity of Treg/Th17 immune imbalance, Th1/Th2 cytokine levels and immunoglobulin levels in children with infectious mononucleosis before treatment were significantly correlated with EBV-DNA positive after 14 days of treatment. Close monitoring and promoting the recovery of immune-inflammatory balance in children with infectious mononucleosis has important clinical significance for improving the prognosis of infectious mononucleosis treatment.

Key words: Infectious mononucleosis, Treg/Th17, Epstein-Barr virus, Children

CLC Number:

R512.7

Zhou Guijuan, Jia Yuee, Sun Youjia, Li Haixia, Fang Xue. Correlation between Treg/Th17 immune imbalance and EBV-DNA positivity after treatment in children with infectious mononucleosis[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(3): 45-50.

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