The correlation between cytokine concentrations and IgG/IgM antibodies to viruses of the Herpesviridae family in children with rheumatic heart disease

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are still urgent medical issues in developing countries and in some communities of high-income countries. The aim of our study was to evaluate plasma cytokine concentrations in children with RHD and their correlation with antibody concentrations to viruses of the Herpesviridae family. Sixty-two patients with RHD aged 8 to 17 years were included in the study. The concentrations of TNF-α, IL-4, IL-8, IL-10 and IFN-γ were evaluated; IgG and IgM antibodies to cytomegalovirus (CMV), herpes simplex virus (HSV) groups I-II and Epstein-Barr virus (EBV) in serum were determined by ELISA meth-od. A significant increase of cytokine concentrations (TNF-α, IL-8, IL-4 and IL-10) was recorded in RHD patients. Antibodies to intracel-lular Herpesviridae family viruses were detected in all children with RHD. Children with RHD were significantly more likely to have IgG HSV I-II antibodies, and IgG and IgM EBV antibodies compared to controls (p<0.05). The concentration of IgM antibody to CMV showed positive correlation with TNF-α; the concentration of IgG antibody to EBV showed negative correlation with TNF-α; and the concentration of IgG and IgM antibodies to EBV showed positive correlation with IL-10 levels. Considering positive correlation of IL-10 concentration with IgG and IgM antibody concentrations to EBV, and the significance of IL-10 in the progression of RHD, the possible predisposing role of EBV in the progression of RHD can be postulated, which needs further study.