EBV感染及STING/TBK1信号通路与儿童传染性单核细胞增多症临床表现的关系  

Relationship between EBV infection,STING/TBK1 signaling pathways and clinical manifestations of children with infectious mononucleosis

作　　者：王莉娟 李丹[2] 王芳 董洁 赵荣 WANG Li-juan;LI Dan;WANG Fang;DONG Jie;ZHAO Rong(Xi’an Children’s Hospital,Xi'an,Shaanxi 710003,China)

机构地区：[1]西安市儿童医院感染科三病区,陕西西安710003 [2]西安市儿童医院感染科二病区,陕西西安710003

出　　处：《中华医院感染学杂志》2022年第21期3331-3335,共5页Chinese Journal of Nosocomiology

基　　金：陕西省重点研发计划基金资助项目(2020SF-114)。

摘　　要：目的分析Epstein-Barr病毒(EBV)感染及外周血干扰素基因刺激蛋白/TANK结合激酶1(STING/TBK1)信号通路表达与儿童传染性单核细胞增多症(IM)临床表现的关系。方法选取2019年1月-2021年1月西安市儿童医院收治的EBV感染患儿263例,其中IM患儿143例为研究组,单纯EBV感染患儿120例为对照组。入院检测血浆中EBV DNA载量,分为低载量组、中载量组和高载量组,采用蛋白印迹法检测外周血磷酸化STING(p-STING)和p-TBK1表达,分析EBV DNA载量及STING/TBK1信号通路表达与儿童IM临床表现的关系。结果研究组患儿血浆EBV DNA载量、外周血单个核细胞(PBMCs)中p-STING、p-TBK1的相对表达量均高于对照组(P<0.05);不同EBV DNA载量IM患儿临床表现中肝脏肿大、脾脏肿大及肝功能异常情况的比较,差异有统计学意义(P<0.05);其中高载量组肝脏肿大、脾脏肿大及肝功能异常检出率最高,中载量组次之,低载量组最低;存在肝脏肿大、脾脏肿大及肝功能异常IM患儿p-STING、p-TBK1相对表达量分别高于无肝脏肿大、脾脏肿大及肝功能异常IM患儿(P<0.05)。结论EBV DNA载量及STING/TBK1信号通路表达与IM患儿肝脏肿大、脾脏肿大及肝功能异常情况密切相关,监测上述指标有助于IM的临床评估。OBJECTIVE To explore the relationship between Epstein-Barr virus(EBV)infection,expressions of stimulator of interferon gene/TANK binding kinase 1(STING/TBK1)signaling pathways in peripheral blood and clinical manifestations of children with infectious mononucleosis(IM).METHODS A total of 263 children with EBV infection who were treated in Xi’an Children’s Hospital from Jan 2019 to Jan 2021 were enrolled in the study,143 of whom had IM and were assigned as the study group,and 120 had simple EBV infection and were assigned as the control group.The plasma EBV-DNA load was detected at the admission to hospital,the patients were divided into the low-load group,medium-load group and the high-load group,the expression levels of peripheral blood phosphorylated STING(p-STING)and p-TBK1 were detected by Western blot,and the relationship between EBV-DNA load,expression of STING/TBK1 signaling pathway and clinical manifestations of the children with IM was observed.RESULTS The plasma EBV-DNA load and relative expression levels of p-STING and p-TBK1 in peripheral blood mononuclear cells(PBMCs)were higher in the study group than in the control group(P<0.05).There were significant differences in the clinical manifestations hepatomegaly,splenomegaly and liver function abnormalities among the IM children with different EBV-DNA loads(P<0.05).The detection rates of hepatomegaly,splenomegaly and liver function abnormalities were the highest in the high-load group,followed by the medium-load group,the low-load group the lowest.The relative expression levels of the IM children with hepatomegaly,splenomegaly and liver function abnormalities were significantly higher than those of the IM children without hepatomegaly,splenomegaly and liver function abnormalities(P<0.05).CONCLUSION The EBV DNA load and the expression of STING/TBK1 signaling pathway are closely associated with hepatomegaly,splenomegaly and liver function abnormalities of the IM children,and the monitoring of above indexes may facilitate clinical assessment of IM.

关 键 词：EB病毒 DNA载量 干扰素基因刺激蛋白/TANK结合激酶1信号通路 儿童传染性单核细胞增多症 临床表现 

分 类 号：R725.5[医药卫生—儿科]