传染性单核细胞增多症病儿 EB病毒 DNA载量与 B淋巴细胞中免疫抑制因子表达的关系

徐莉垚; 戚静静; 武凌智; 田雪

文章摘要

徐莉垚,戚静静,武凌智,等.传染性单核细胞增多症病儿 EB病毒 DNA载量与 B淋巴细胞中免疫抑制因子表达的关系[J].安徽医药,2025,29(4):754-758.

传染性单核细胞增多症病儿 EB病毒 DNA载量与 B淋巴细胞中免疫抑制因子表达的关系

Relationship between EBV DNA load and expression of immunosuppressive factors in B lymphocytes in children with infectious mononucleosis

DOI：10.3969/j.issn.1009-6469.2025.04.024

中文关键词: 传染性单核细胞增多症 EB病毒 DNA 程序性死亡受体 1 程序性死亡受体 -1配体细胞毒性 T淋巴细胞相关抗原 4 T细胞免疫球蛋白和 ITIM结构域蛋白儿童

英文关键词: Infectious monocyte EB virus DNA Programmed death receptor 1 Programmed death receptor-1 ligand Cytotox. ic T lymphocyte associated antigen 4 T cell immunoglobulin and ITIM domain protein Child

基金项目:黑龙江省双鸭山市应用技术研发项目( 2021YFSF06)

作者	单位
徐莉垚	双鸭山市人民医院儿科，黑龙江双鸭山 155100
戚静静	双鸭山市人民医院儿科，黑龙江双鸭山 155100
武凌智	双鸭山市人民医院儿科，黑龙江双鸭山 155100
田雪	佳木斯妇幼保健院儿科，黑龙江佳木斯 154000

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中文摘要:

目的分析传染性单核细胞增多症( IM)病儿 EB病毒 DNA(EBV DNA)载量与 B淋巴细胞免疫抑制因子程序性死亡受体 1(PD-1)、程序性死亡受体 -1配体( PD-L1)、细胞毒性 T淋巴细胞相关抗原 4(CTLA-4)、T细胞免疫球蛋白和 ITIM结构域蛋白(TIGIT)的相关性。方法选取 2020年 1月至 2023年 1月双鸭山市人民医院就诊 120例的 IM病儿作为观察组， 120例体检的健康儿童作为健康组，检测 PD-1、PD-L1、CTLA-4、TIGIT表达，分析在观察组、健康组中的表达差异。根据 IM病儿血 EBV DNA载量结果中位数，将病儿分为低 EBV DNA载量组( <6.3×105copies/mL)68例，高 EBV DNA载量组( ≥6.3×105copies/ml)52例，比较两组临床特征、 PD-1、PD-L1、CTLA-4、TIGIT表达差异，分析 EBV DNA载量与 PD-1、PD-L1、CTLA-4、TIGIT的相关性。结果观察组 B淋巴细胞中 PD-1、PD-L1、CTLA-4、TIGIT表达量分别为(5.66±0.87)%、(6.95±1.12)%、(4.34±0.58)%、(7.43±0.98)%，显著高于健康组的(0.79±0.13)%、(0.88±0.27)%、(0.43±0.08)%、(1.24±0.35)%(P<0.05)；急性期 IM病儿 B淋巴细胞中 PD-1、PD-L1、 CTLA-4、TIGIT表达量分别为( 6.78±1.12)%、(7.64±1.43)%、(5.85±0.83)%、(8.54±1.43)%，显著高于恢复期 IM病儿的( 4.72±0.68)%、(5.51±0.79)%、(3.23±0.46)%、(6.17±0.96)%(P<0.05)；高 EBV DNA载量组热程、发热、淋巴结肿大发生率、血液系统急性并发症发生率、白细胞计数、淋巴细胞计数( LYM)异型淋巴细胞、淀粉样蛋白 A(SAA)、 C反应蛋白( CRP)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶( AST)、乳酸脱氢酶( LDH)显著高、于低 EBV DNA载量组( P<0.05)。在儿童 IM中， EBV DNA载量与热程、白细胞计数、 LYM、异型淋巴细胞、 SAA、CRP、LDH、ALT、AST均呈显著正相关( P<0.05)；高 EBV DNA载量组 B淋巴细胞中 PD-1、PD-L1、CTLA-4、TIGIT表达量显著高于低 EBV DNA载量组( P<0.05)。结论 B淋巴细胞中免疫抑制因子 PD-1、PD-L1、 CTLA-4、TIGIT表达过量，与 IM病儿 EBV DNA载量显著相关，可用于儿童 IM病情的评估。

英文摘要:

Objective To analyze the correlation between EBV DNA load and programmed death receptor 1 (PD-1), programmed death receptor 1 ligand (PD-L1), cytotoxic T lymphocyte associated antigen 4 (CTLA-4), T cell immunoglobulin and ITIM domain pro. tein (TIGIT) in children with infectious mononucleosis (IM).Methods A total of 120 IM children treated in Shuangyashan People'sHospital from January 2020 to January 2023 were selected as the observation group, and 120 healthy children who underwent physicalexamination were selected as the healthy group. The expressions of PD-1, PD-L1, CTLA-4 and TIGIT were detected, and the expressiondifferences between the observation group and the healthy group were analyzed. According to the median blood EBV DNA load of chil.dren with IM, 68 cases were assigned into low EBV DNA load group (< 6.3×105 copies/mL) and 52 cases into high EBV DNA load group (≥6.3×105 copies/mL). The clinical features and expression differences in PD-1, PD-L1, CTLA-4 and TIGIT were compared be. tween the two groups, and the correlation of EBV DNA load with PD-1, PD-L1, CTLA-4, and TIGIT were analyzed.Results The ex. pression levels of PD-1, PD-L1, CTLA-4, and TIGIT in B lymphocytes of the observation group were (5.66±0.87)% , (6.95±1.12)% ,(4.34±0.58)%, and (7.43±0.98)%, respectively, which were significantly higher than those of the healthy group [(0.790.13)%, (0.88±0.27)%, (0.43±0.08)%, (1.24±0.35)%, respectively] (P<0.05). The expression levels of PD-1, PD-L1, CTLA-4, and TIGIT in B lympho. cytes of IM children were (6.78±1.12)%, (7.64±1.43)%, (5.85±0.83)%, and (8.54±1.43)%, respectively, which were significantly higherthan those of IM children in the recovery period [(4.72±0.68)%, (5.51±0.79)%, (3.23±0.46)%, (6.17±0.96)%, respectively] (P<0.05).The high EBV DNA load group had longer duration of fever , higher incidence of fever, lymphadenopathy, acute hematological compli.cations, higher white blood cell count, lymphocyte count (LYM), atypical lymphocytes, and higher expression levels of serum amyloid A(SAA), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH)than the low EBV DNA load group (P<0.05). In children with IM, EBV DNA load was significantly positively correlated with fever dura.tion, white blood cell count, LYM, atypical lymphocytes, SAA, CRP, LDH, ALT, and AST (P<0.05). The expression levels of PD-1, PD-L1, CTLA-4, and TIGIT in B lymphocytes of the high EBV DNA load group were significantly higher than those of the low EBV DNAload group (P<0.05). Conclusion The overexpression of immunosuppressive factors PD-1, PD-L1, CTLA-4, and TIGIT in B lympho.cytes is significantly associated with EBV DNA load in children with IM, which can be used for the evaluation of IM in children.

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