Cytokine production and clinical and laboratory aspects of EBV-associated acute infectious mononucleosis in children

Objective. To analyze clinical and laboratory parameters, as well as the dynamics of cytokine production in children of different ages with acute infectious mononucleosis caused by Epstein-Barr virus (EBV mononucleosis). Patients and methods. We examined two groups of patients: group I included 20 children aged 1 to 7 years, whereas group II included 29 children aged 8 to 17 years. All study participants were tested in the acute phase of the disease and in early convalescence. We evaluated serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-α (IFN-α) using enzyme-linked immunosorbent assay (ELISA) (standard Vektor-Best kits, Russia). Data analysis was performed using Microsoft Excel 2019 for Windows and IBM SPSS statistics; we applied the methods of non-parametric statistics. Differences were considered significant at p < 0.05. Results. The majority of children had fever, intoxication, acute tonsillitis, and enlarged cervical lymph nodes. Laboratory makers, such as lymphocytosis, neutropenia, and thrombocytopenia were more pronounced in children from group II. In both groups, the level of cytokines in the acute period of the disease was higher than the discriminatory one. In early convalescence, patients from group I demonstrated more significant reduction in the cytokine level than patients from group II (р < 0.05). In children over 7 years of age, the levels of IL-10 and TNF-α positively correlated with the disease duration (p < 0.01 and p < 0.05, respectively) Conclusion. The level of cytokine production in acute EBV mononucleosis depends on patients’ age. Concentrations of IL-10 and TNF-α can serve as markers reflecting the severity of EBV mononucleosis and can be used for disease prognosis. Key words: EBV mononucleosis, children, cytokines, IL-6, IL-10, TNF-α, IFN-α