| Research purpose:Infectious mononucleosis(IM)is a common febrile disease of childhood caused by Epstein-Barr virus(EBV)infection,and immune mechanisms play an important role in its development and progression.Programmed death cell receptor-1(PD-1)is an immunosuppressive factor that has received much attention in recent years and plays a role in malignancies,immune diseases and infectious diseases.PD-1 plays an important role in immunosuppression and promotion of immune tolerance by regulating the activation,proliferation and apoptosis of immune cells.There are very few and controversial studies about PD-1 and IM,and the role of PD-1 in IM is still unclear.In this experiment,we investigated the role of PD-1 in IM by detecting the expression of PD-1 in children with IM.Research objects and methods:In this prospective study,33 children with IM diagnosed in our hospital from April2022 to February 2023 were included in the experimental group,while 30 healthy children who were examined in our outpatient clinic were included in the healthy control group.The clinical information of both groups was collected,including general information such as gender and age,whether the children with IM had fever and its duration,whether they had pharyngitis,cervical lymph node enlargement,hepatosplenomegaly,whether they had liver function impairment,clinical manifestations of other systems such as respiratory system(e.g.,acute bronchitis,pneumonia,etc.),hematological system(e.g.,thrombocytopenia,anemia,etc.)and heterogeneous lymphocytes.Percentage of atypical lymphocytes(ALY%),lymphocyte subpopulation,aspartate aminotransferase(AST),alanine aminotransferase(ALT),etc.Laboratory test indexes.The children with IM were divided into acute and recovery stages according to their different disease stages,mild and severe groups according to their different severity,and grouped according to their different ages,fever duration,presence or absence of liver function impairment and different ALY%.Peripheral blood was collected from IM children and healthy controls for corresponding antibody labeling staining,and the expression level of PD-1 was detected by flow cytometry.The data were statistically analyzed using SPSS26.0 statistical software.Results:1.PD-1 expression levels were significantly higher in children with IM in the acute phase(62.58±9.02)% and in the recovery phase(40.36±9.24)% compared to healthy children(31.84±5.16)%,and there was a statistical difference(P<0.05).2.The level of PD-1 expression in children with IM was significantly higher in the acute phase(62.58±9.02)% compared with the recovery phase(40.36±9.24)%,and there was a statistical difference(P<0.05).3.PD-1 expression levels were significantly higher in IM children in the mild group(62.46±9.09)% and in the severe group(62.91±9.36)% compared with healthy children(31.84±5.16)%,with statistical differences(P<0.05).However,there was no statistical difference in PD-1 expression levels in the IM severe group(62.91±9.36)% compared to the mild group(62.46±9.09)%(P>0.05).4.The expression levels of PD-1 in children with acute IM were(61.09±6.33)%,(62.89±10.40)%,and(64.79±10.87)% between the three groups of 1-3,4-6,and 7-14 years old,respectively,and the analysis showed no statistical difference in the expression levels of PD-1 between the three groups when compared between the two groups(P>0.05).5.In children with IM,there was no statistical difference in the expression level of PD-1 between the two groups with fever duration <7 days(63.05±8.82)% and fever duration ≥7 days(62.28±10.45)%(P>0.05).6.There was no statistical difference in the expression level of PD-1 in children with combined hepatic impairment in the IM group(63.96±11.76)% compared with children without hepatic impairment(61.68±6.90)%(P>0.05).7.The expression levels of PD-1 in children with IM were(60.59±4.93)%,(59.55±10.82)%,and(65.07±8.69)% among children with 0% < ALY% < 10%,10% ≤ALY% < 15%,and ALY% ≥ 15%,respectively,and there was no statistical difference in the expression levels of PD-1 between the three groups when comparing two groups(P>0.05).Conclusion:1.Increased PD-1 expression in children with IM suggests that PD-1 may be involved in the pathogenesis of IM.2.PD-1 is expressed differently in different periods of the disease,and may be used as a monitoring indicator of the disease course.3.There was no significant difference in PD-1 expression levels between children with IM with mild and severe disease in this experiment,and its significance as a guide to determine the severity of disease is unclear;the role of PD-1 expression levels in different ages,different fever ranges,different ALY% and liver injury needs to be further explored. |
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