ORIGINAL PAPER
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
1
Department of Paediatrics, Infectious Diseases and Hepatology, Voivodeship Infectious Observation Hospital, Bydgoszcz, Poland
2
Department of Infectious Diseases and Hepatology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
3
Department of Immunology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, Poland
4
Department of Laboratory Diagnostics, Tadeusz Browicz Provincial Hospital for Infectious Diseases and Observation, Bydgoszcz, Poland
Submission date: 2022-08-17
Final revision date: 2022-10-23
Acceptance date: 2022-11-12
Publication date: 2023-03-24
Corresponding author
Justyna Moppert
Dr. Justyna Moppert, Department of Paediatrics, Infectious Diseases, and Hepatology, Voivodeship Infectious Observation Hospital, Bydgoszcz, Poland
Dr. Justyna Moppert, Department of Paediatrics, Infectious Diseases, and Hepatology, Voivodeship Infectious Observation Hospital, Bydgoszcz, Poland
Pediatr Pol 2023;98(1):43-51
KEYWORDS
TOPICS
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.
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.
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