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Chen B, Han N, Gao LY, Zhou TD, Zhang H, He P, Zhou Q. Comparison of immune responses in children with infectious mononucleosis caused by Epstein-Barr virus at different infection stages. Int J Lab Hematol 2023; 45:890-898. [PMID: 37501513 DOI: 10.1111/ijlh.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Infectious mononucleosis (IM) is a common infectious disease in children mainly caused by Epstein-Barr virus (EBV) infection, followed by abnormal immune response, and resulting in serious complications. However, there are few clinical analyses of immune responses in children with IM at different stages. METHODS This study combined EBV serological test and EBV DNA test to diagnose the infection status of children with IM, and the infection status was divided into primary acute IM infection (AIM), primary late IM infection (LIM) and reactivation IM infection (RIM). RESULTS The results revealed that the absolute numbers of leukocytes and CD8+ T lymphocytes in primary IM infection were significantly higher than those in reactivation infection, while the frequencies of CD4+ T lymphocytes and B cells were significantly lower than those in reactivation infection. In addition, the activities of ALT, AST, α-HBDH and LDH in liver function indicators in primary infection were significantly increased compared with reactivation infection. Similarly, the EBV DNA levels of the primary infection were significantly higher than that of the reactivation infection. CONCLUSION There are differences in immune response at different stages of infection, which can provide guidance for effective treatment in children with IM infection.
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Affiliation(s)
- Bing Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Ning Han
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Ling-Yu Gao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ting-Dong Zhou
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Hao Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Pei He
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Qiang Zhou
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
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Cai L, Xing Y, Xia Y, Zhang Z, Luo Z, Tang Y, Chen Y, Xu X. Comparative study of biomarkers for the early identification of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis. BMC Infect Dis 2023; 23:728. [PMID: 37880605 PMCID: PMC10601177 DOI: 10.1186/s12879-023-08654-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND AND AIM Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and infectious mononucleosis (EBV-IM) share mimic symptoms in the early stages of childhood development. We aimed to examine the clinical features and laboratory indices of these two diseases in children and uncover unique indicators to assist pediatricians in identifying these diseases early. METHODS We collected clinical data from 791 pediatric patients diagnosed with EBV-IM or EBV-HLH, compared the clinical traits and laboratory biomarkers presented in the two groups, and constructed predictive models based on them. RESULTS Patients with EBV-IM had greater ratios of cervical lymphadenopathy, eyelid edema, and tonsillitis, whereas individuals with EBV-HLH were more likely to have hepatomegaly and splenomegaly. When using the criteria of interleukin (IL)-10 > 89.6 pg/mL, interferon (IFN)-γ > 45.6 pg/mL, ferritin > 429 μg/L, D-dimer > 3.15 mg/L and triglycerides > 2.1 mmol/L, the sensitivity was 87.9%, 90.7%, 98.1%, 91.1% and 81.5% to predict EBV-HLH, while the specificity was 98.4%, 96.3%, 96.5%, 94.1% and 80.6%, respectively. A logistic regression model based on four parameters (IL-10, ferritin, D-dimer, and triglycerides) was established to distinguish EBV-HLH patients from EBV-IM patients, with a sensitivity of 98.0% and a specificity of 98.2%. CONCLUSIONS IL-10, IFN-γ, ferritin and D-dimer levels are significantly different between EBV-HLH and EBV-IM. Predictive models based on clinical signs and laboratory findings provide simple tools to distinguish the two situations.
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Affiliation(s)
- Lisha Cai
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, Guizhou Children's Hospital, No. 149 Dalian Rd, Huichuan District, Zunyi, Guizhou, 563000, PR China
| | - Yuan Xing
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, Guizhou Children's Hospital, No. 149 Dalian Rd, Huichuan District, Zunyi, Guizhou, 563000, PR China
| | - Yahong Xia
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
| | - Zihan Zhang
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
| | - Zebin Luo
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
| | - Yongmin Tang
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China
| | - Yan Chen
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, Guizhou Children's Hospital, No. 149 Dalian Rd, Huichuan District, Zunyi, Guizhou, 563000, PR China.
| | - Xiaojun Xu
- Division of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, No. 57 Zhugan Lane, Yan-an Street, Hangzhou, 310003, PR China.
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He Z, Liu JJ, Shu GF, Ma SL, Wu GQ. Diagnostic Utility of CD64 and CD38 Biomarkers for the Differential Diagnosis of Infections. Genet Test Mol Biomarkers 2022; 26:133-139. [PMID: 35230865 DOI: 10.1089/gtmb.2021.0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Identification of infection type in patients with fever is particularly important in the emergency departments (EDs) of hospitals. This study aimed to evaluate the performance of two biomarkers, namely the modified neutrophil CD64 (nCD64) index and CD38 present on T cells, using flow cytometry. Methods: A total of 305 potentially infected patients with fever were admitted to the ED of Zhongda Hospital (Nanjing, China) between March 2021 and August 2021. This study grouped 180, 30, and 65 patients as having bacterial (local, Gram-positive, and Gram-negative infections), viral, or no infections, respectively, based on their diagnostic outcomes and clinical records. Results: The expression level of traditional/modified nCD64 was significantly increased in the bacterial infection group, especially in case of patients infected with Gram-negative bacteria, and the main infectious strains were Staphylococcus and Escherichia coli. Similarly, CD3+CD38+ cell percentages were elevated in patients with viral infections, which were mostly caused by Epstein-Barr virus and cytomegalovirus. CD38 expression is age dependent, and high percentages of CD3+CD38+ cells were observed in children with viral infections. For the prediction of bacterial infections, the area under the curve (AUC) of modified nCD64 (AUC: 0.800) was significantly higher than that of C-reactive protein and heparin-binding protein but slightly lower than that of traditional nCD64 (AUC: 0.831). The AUC, specificity, and sensitivity values for the prediction of viral infections using CD3+CD38+ cells percentages in children were 0.899 (0.785-1.000), 96.2%, and 85.9%, respectively. Conclusion: nCD64 levels and CD3+CD38+ cell percentage are potential biomarkers that facilitate identification of patients with bacterial and viral infections.
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Affiliation(s)
- Zhi He
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Jing-Jing Liu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guo-Fang Shu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Shao-Lei Ma
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guo-Qiu Wu
- Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China
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Zhou J, Jin F, Wu F. Clinical significance of changes in serum inflammatory factors in patients with chronic obstructive pulmonary disease and pulmonary infection. J Int Med Res 2021; 49:3000605211013275. [PMID: 34018839 PMCID: PMC8150426 DOI: 10.1177/03000605211013275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/06/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is often accompanied by pulmonary infection, inflammatory responses, decreased immunity, and decreased lung function. The relationships among the pulmonary inflammation index (PII), lung function, and immunity in COPD patients with pulmonary infection remain unclear. METHODS This retrospective observational study enrolled 234 participants (patients with COPD and pulmonary infection, patients with COPD without pulmonary infection, and healthy individuals) from January 2017 to December 2019. RESULTS Levels of interleukin (IL)-6 were lower and levels of IL-8 were higher in patients with COPD and pulmonary infection. Levels of white blood cells (WBCs), C-reactive protein (CRP), IL-6, IL-8, tumor necrosis factor (TNF)-α and CD8+ cells were higher, while levels of CD3+ and CD4+ cells, the CD4+/CD8+ ratio, forced expiratory volume in 1 s (FEV1), FEV1 % predicted (FEV1%pred), and FEV1/forced vital capacity (FVC) (FEV1%FVC) were lower in patients with COPD and pulmonary infection. Levels of WBCs, CRP, IL-6, IL-8, and TNF-α were negatively associated with FEV1, FEV1%pred and FEV1%FVC. CONCLUSIONS Patients with COPD and pulmonary infection have high PIIs, decreased immunity, and poor lung function. PII is closely related to lung function and may represent a useful biomarker for the assessment of patients with COPD and pulmonary infection.
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Affiliation(s)
- Jun Zhou
- Department of Respiratory Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Feng Jin
- Department of Respiratory Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Feng Wu
- Department of Respiratory Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
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