Correlation between Serum IL-10，CTL and EB Virus Associated Infectious Mononucleosis Complicated with Liver Damage in Children

Weili LI; Danhua RU; Dan XIE; Jing ZHANG; Ya CHANG; Zhaoxin YANG

Article Contents

Article Navigation > Journal of Kunming Medical University > 2025 > Accepted Manuscript

Weili LI, Danhua RU, Dan XIE, Jing ZHANG, Ya CHANG, Zhaoxin YANG. Correlation between Serum IL-10，CTL and EB Virus Associated Infectious Mononucleosis Complicated with Liver Damage in Children[J]. Journal of Kunming Medical University.

Citation:

PDF( 814 KB)

Correlation between Serum IL-10，CTL and EB Virus Associated Infectious Mononucleosis Complicated with Liver Damage in Children

1.
Department of Pediatrics，Hainan Hospital of Shanghai Children’s Medical Center，Shanghai Jiao Tong University School of Medicine，Sanya Hainan 572000
2.
Department of Infectious Diseases，Children's Hospital of Wujiang District，Wujiang Suzhou 215200
3.
Department of Pediatrics，Handan First Hospital，Handan Hebei 056004，China

Abstract

Abstract

Objective To investigate the correlation between serum interleukin-10 （IL-10）, cytotoxic T lymphocytes （CTL） and Epstein Barr virus （EBV）-associated infectious mononucleosis （IM） complicated with liver damage in children. Methods A prospective study was conducted on 215 children with EBV-associated IM admitted to Hainan Hospital of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Children's Hospital of Wujiang District, Suzhou and Handan First Hospital from September 2021 to May 2025. Participants were divided into complicated group （with hepatic impairment） and non-complicated group （without hepatic impairment） based on the presence or absence of concurrent hepatic impairment. Additionally, 215 healthy children during the same period were selected as the control group. Clinical data, serum IL-10 and CTL levels were compared among groups. Restricted cubic spline （RCS） analysis was used to assess the correlation between serum IL-10, CTL, and hepatic impairment in children with EBV-associated IM. Logistic regression analysis was performed to identify relevant factors affecting hepatic impairment in children with EBV-associated IM. Receiver operating characteristic （ROC） curves were used to evaluate the predictive value of serum IL-10, CTL, and their combination for hepatic impairment in children with EBV-associated IM. Results Pre-treatment serum IL-10 and CTL levels in children with EBV-associated IM were higher than those in the control group （P < 0.05）. EBV DNA in the complicated group was higher than in the non-complicated group （P < 0.05）. Pre-treatment and 3-day post-treatment IL-10 and CTL levels in the complicated group were significantly higher than in the non-complicated group, with statistical significance （P < 0.05）. RCS model analysis revealed optimal fitting when the number of knots was 3, with significant likelihood ratio test （P < 0.05）. Serum IL-10 demonstrated a "U"-shaped dose-response relationship with hepatic impairment in children with EBV-associated IM （P < 0.05）, with a high-risk threshold of 14.90 pg/mL. CTL showed a non-linear relationship with hepatic impairment, characterized by gradual stability followed by elevation （P < 0.05）, with a high-risk threshold of 46.10%. Logistic regression analysis showed that after adjusting for EBV DNA, IL-10>14.90 pg/mL and CTL>46.10% remained independent risk factors for hepatic impairment in children with EBV-associated IM （P < 0.05）. ROC curve analysis showed that the AUC value of IL-10+CTL （0.850, 95%CI: 0.795-0.895） was significantly higher than the individual AUC values of either marker （P < 0.05）. Pre-treatment and 3-day post-treatment IL-10 and CTL levels in children with moderate hepatic impairment were significantly higher than in those with mild impairment, with statistical significance （P < 0.05）. Conclusion Serum IL-10 and CTL are correlated with hepatic impairment in children with EBV-associated IM, with high-risk thresholds of 14.90 pg/mL and 46.10%, respectively. Combined detection of both markers enhances the predictive value for concurrent hepatic impairment and provides clinical guidance.
- Interleukin-10,
- Cytotoxic T lymphocytes,
- Epstein Barr virus associated infectious mononucleosis in children,
- Liver damage,
- Correlation

FullText(HTML)

References(26)

References

[1]	Borghol A H, Bitar E R, Hanna A, et al. The role of Epstein-Barr virus in autoimmune and autoinflammatory diseases[J]. Crit Rev Microbiol, 2025, 51(2): 296-316. doi: 10.1080/1040841X.2024.2344114
[2]	Li Y, Tang J, Ma Y, et al. Clinical significance and pathogenesis of GBP5 in infectious mononucleosis associated liver injury[J]. Ital J Pediatr, 2025, 51(1): 72. doi: 10.1186/s13052-025-01907-x
[3]	Liu Y, Wu Y, Liu D, et al. Infectious mononucleosis disguised as acute tonsillitis: Pay attention to liver function[J]. Asian J Surg, 2024: S1015-S9584(24)01481-7.
[4]	Zhang Y, Xie J, Zheng Y, et al. Infectious mononucleosis complicated by transitory Epstein-Barr virus infection of T and natural killer cells[J]. J Hematop, 2024, 17(3): 129-137. doi: 10.1007/s12308-024-00595-6
[5]	邵辉, 李杰, 马树民, 等. 甲状腺癌EB病毒感染与XRCC1、STING1、IL-10基因多态性及病理类型的关联[J]. 中华医院感染学杂志, 2024, 34(14): 2158-2162.
[6]	靳丹丹, 周卫芳. 儿童EBV传染性单核细胞增多症细胞因子IL-6、γ-IFN、IL-10的改变[J]. 右江医学, 2024, 52(7): 607-612.
[7]	Fang C H, Cheng Y F, Lin S R, et al. Establishment of a protocol for rapidly expanding Epstein-Barr-virus-specific cytotoxic T cells with enhanced cytotoxicity[J]. BMC Cancer, 2024, 24(1): 980. doi: 10.1186/s12885-024-12707-7
[8]	Aslan N, Watkin L B, Gil A, et al. Severity of acute infectious mononucleosis correlates with cross-reactive influenza CD8 T-cell receptor repertoires[J]. mBio, 2017, 8(6): e01841-e01847.
[9]	中华医学会儿科学分会感染学组, 全国儿童EB病毒感染协作组. 儿童主要非肿瘤性EB病毒感染相关疾病的诊断和治疗原则建议[J]. 中华儿科杂志, 2016, 54(8): 563-568.
[10]	中华医学会肝病学分会, 中华医学会消化病学分会. 常用肝脏生物化学试验的临床意义及评价共识[J]. 中华消化杂志, 2010, 18(5): 387-393.
[11]	Zhan Y, Fu Y, Dai H, et al. Characteristics and clinical significance of gut microbiota in patients with Epstein-Barr virus-associated liver dysfunction[J]. Microbiol Immunol, 2025, 69(4): 203-211. doi: 10.1111/1348-0421.13200
[12]	岳贇, 马丽, 王卫国. 学龄前儿童传染性单核细胞增多症合并肝功能异常的临床特征及影响因素[J]. 肝脏, 2024, 29(7): 852-856. doi: 10.14000/j.cnki.issn.1008-1704.2024.07.030
[13]	Moyano A, Ferressini Gerpe N M, De Matteo E, et al. M1 macrophage polarization prevails in Epstein-Barr virus-infected children in an immunoregulatory environment[J]. J Virol, 2022, 96(1): e01434-21.
[14]	周胜, 马晓慧, 孟晓飞. 血清白细胞介素10、腺苷脱氨酶与传染性单核细胞增多症患儿心肌损害的关系分析[J]. 中国卫生检验杂志, 2023, 33(14): 1718-1721.
[15]	刘瑞坪, 陈彦妤, 王俊颖, 等. EB病毒vIL-10基因的表达与功能研究[J]. 中国病原生物学杂志, 2025, 20(2): 131-135, 140. doi: 10.13350/j.cjpb.250201
[16]	Zhang Y, Huang C, Zhang H, et al. Characteristics of immunological events in Epstein-Barr virus infection in children with infectious mononucleosis[J]. Front Pediatr, 2023, 11: 1060053. doi: 10.3389/fped.2023.1060053
[17]	Cai L, Xing Y, Xia Y, et al. Comparative study of biomarkers for the early identification of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in infectious mononucleosis[J]. BMC Infect Dis, 2023, 23(1): 728. doi: 10.1186/s12879-023-08654-6
[18]	Zhu J, Cao N, Wu F, et al. Predicting 30-day mortality in hemophagocytic lymphohistiocytosis: Clinical features, biochemical parameters, and machine learning insights[J]. Ann Hematol, 2025, 104(4): 2239-2264. doi: 10.1007/s00277-025-06249-6
[19]	Weng Y, Wang L, Wang Y, et al. Spatial organization of macrophages in CTL-rich hepatocellular carcinoma influences CTL antitumor activity[J]. Cancer Immunol Res, 2025, 13(3): 310-322. doi: 10.1158/2326-6066.CIR-24-0589
[20]	Zhou Y, Wang D, Zhou L, et al. Cell softness renders cytotoxic T lymphocytes and T leukemic cells resistant to perforin-mediated killing[J]. Nat Commun, 2024, 15(1): 1405. doi: 10.1038/s41467-024-45750-w
[21]	Chiang S C C, Covill L E, Tesi B, et al. Efficacy of T-cell assays for the diagnosis of primary defects in cytotoxic lymphocyte exocytosis[J]. Blood, 2024, 144(8): 873-887. doi: 10.1182/blood.2024024499
[22]	秦爱华, 白桦, 孙秀丽, 等. IM患儿EBV DNA载量与外周血CTL细胞、TLRs表达和临床转归的关系[J]. 中华医院感染学杂志, 2023, 33(15): 2372-2376.
[23]	Liu L, Yang X, Li M, et al. EBV-DNA load: A predictor of immune and hepatic dysfunction in pediatric infectious mononucleosis[J]. Diagn Microbiol Infect Dis, 2025, 113(1): 116897. doi: 10.1016/j.diagmicrobio.2025.116897
[24]	Gutiérrez-Guerrero A, Espinosa-Padilla SE, Lugo-Reyes SO. Si algo puede fallar: las células citotóxicas en la contención del virus Epstein-Barr [Anything that can go wrong: cytotoxic cells and their control of Epstein-Barr virus[J]. Rev Alerg Mex, 2024, 71(1): 29-39. Spanish. DOI: 10.29262/ram.v71i1.1276.
[25]	Latour S. Human immune responses to Epstein-Barr virus highlighted by immunodeficiencies[J]. Annu Rev Immunol, 2025, 43(1): 723-749. doi: 10.1146/annurev-immunol-082323-035455
[26]	Rex D A B, Keshava Prasad T S, Kandasamy R K. Revisiting regulated cell death responses in viral infections[J]. Int J Mol Sci, 2022, 23(13): 7023. doi: 10.3390/ijms23137023

Relative Articles(20)

Relative Articles

[1]	Anmin WANG, Zhongfa LIU, Chunhui YANG, Guangsi ZOU, Chengmin SHI, Yujian ZENG. Concordance and Correlation Analysis of Mismatch Repair and Microsatellite Status in 412 Cases of Colorectal Cancer in Yunnan Province. Journal of Kunming Medical University,
[2]	Rongmei LIN, Bangyan LIU, Yangjun CHEN, Yan YANG, Yuan JIN, Yongrui YANG, Nihong LU. Correlation of Multiple Clinical Indicators with Benign and Malignant Pulmonary Nodules. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250712
[3]	Kaige ZHANG, Ruonan LI, Jialin CHEN, Deping FENG, Yu LIU. Correlation and Diagnostic Performance of Inflammatory Cytokines in Relation to Bone Mineral Density and β-CTX in Postmenopausal Women with Type 2 Diabetes Mellitus. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250909
[4]	Yueting YAO, Shuai LI, Yang CAO, Mu LIN, Zhengguang LUO, Xiaobo CHEN, Qianli MA. Correlation between Epidermal Growth Factor Gene Polymorphisms and Non-small Cell Lung Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250910
[5]	Zhixin NIU, Lihua TANG, Lei SHI, Chao HONG, Yufeng YAO, Zhiling YAN. Correlation of MAPK1 and NRAS Gene Polymorphisms with Cervical Intraepithelial Neoplasia in Yunnan Han Population. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240502
[6]	Jianheng AO, Lei MIAO, Huiying WANG, Tianyun ZHANG, Tao WANG, Yonghang TANG, Liping HU, Shengjie NIE. Correlation between DNA Detection Rate and Sweat Pore Density of Palm Touch Biological Samples. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230601
[7]	Xiaohua LU, Hongxin YUAN. The Analysis of the Correlation between BTLA，CTLA-4 Gene Polymorphisms and the Efficacy and Prognosis of TACE Combined Targeted Therapy for Liver Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230927
[8]	Yan LIANG, Lei WANG, Ming LEI, Benchao CHEN, Ping SUN, Shuai LI, Li LIU, Qianrong WANG, Manlin LIAO, Qianli MA. Correlation between KRAS Gene Polymorphism and Non-small Cell Lung Cancer in Yunnan Han Population. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230210
[9]	Shulan SHI, Lijuan QIU, Liyue KUI, Min SU, Bailing ZHOU, Rongjie LI, Jianming SUN. Diagnostic Value of Interleukin-6，Interleukin-10，High-sensitivity C-reactive Protein and Procalcitonin in Children with Acute Lymphoblastic Leukemia Complicated by Infection. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230115
[10]	Rong LIU, Yang SUN, Fameng LUO, Dezhi TAO, Haiyan ZHANG. Correlation between the Acceptance of Illness and Quality of Life in Patients with Inflammatory Bowel Disease. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20220507
[11]	Yanfen MA, Jian HU, Depei CAI, Yongfeng QIAO, Xiaoqin WANG. Correlation between Serum Gamma-glutamyl Transferase Level and Blood Lipid Indexes in 3137 Checkup Population. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20221001
[12]	Xin WU, Yun LI, Pin-fei ZOU, Mei-ling LI, Yong-bin PU. The Detection Rate of Musculoskeletal Ultrasound in Patients with Rheumatic Knee Arthritis and Its Correlation with Knee Function. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210814
[13]	Ying HUANG, Xiang LI, Shan JIANG, Bing LIU, Yan-ling ZHANG, Yang LI, Hua HE, Yan WU, Yun LUO, Jun XU. Correlation Analysis of Chest Imaging and Laboratory Indicators in Patients with 2019-nCoV Infection. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20211232
[14]	Juan-juan WANG, Yu-qing CHEN, Qian DENG, Jian GAO. The Correlation between Myocardial Enzymes and the Severity of Ketoacidosis in Children with Type 1 Diabetes. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210129
[15]	Jia YANG, Ya-xian LI, Ying-ying WANG, Lin XIAO, Chuan-yin LI, Fang TAN, Qian-li MA, Shu-yuan LIU. Association of the miR-149,miR-219 and miR-let-7 Polymorphisms with the Occurrence and Development of Non-small Cell Lung Cancer in a Chinese Han Population in Yunnan Province. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20211037
[16]	Zhao Heng , Xu Bin , Zhao Guang Zhou , Li Rong Jie , Zhou Bai Ling , Liu Ye , Shi Shu Lan . . Journal of Kunming Medical University,
[17]	Mei Xue . . Journal of Kunming Medical University,
[18]	Zheng Hong Mei . . Journal of Kunming Medical University,
[19]	Zhao Jin You . . Journal of Kunming Medical University,
[20]	Zhang Hong . . Journal of Kunming Medical University,