Humoral and cellular immune responses in children 3–6 years old with infectious mononucleosis caused by primary and reactivation of Epstein–Barr viral infection


In various sources there is not enough information about the features of immunological changes in children according to the critical periods of the development of the immune system. Infectious mononucleosis (IM) in primary Epstein–Barr virus infection (EBVI) with a favorable course in the acute period is characterized by increased levels of CD3+, CD4+, CD8+, CD16+, HLA-DR+, CD95+, CD20+-lymphocytes, serum immunoglobulins, and pro-inflammatory cytokines. An imbalance of the cytokine system occurs with a decrease of lymphocyte subpopulations, a decrease in the functional activity of neutrophils, an accumulation of CD38+-lymphocytes, IgM and circulating immune complexes when EBV is reactivated.

Aim – to compare humoral and cellular immune responses in children aged 3–6 years with infectious mononucleosis in primary and reactivation of Epstein–Barr virus infection.

Material and methods. According to the results of ELISA and PCR blood tests, 2 groups of patients were formed: 18 children with primary Epstein–Barr virus infection, 14 children with IM caused by the reactivation of Epstein–Barr virus infection. Statistical analysis was carried out using parametric and nonparametric methods in the Statistica 10.0 software.

Results and discussion. We have identified differences in the immune response of children aged 3–6 years during primary and reactivation of EBVI. During primary infection, we recorded a pronounced activation of the cellular component of the immune response and an increase in the content of CD7+, CD8+, CD16+, CD11b+, CD54+ and HLA-DR+ T cells. The response of humoral immunity to primary Epstein–Barr viral infection was a deficiency of B cells expressed CD20+, CD23+, serum IgA and IgG, and an increase of CD38+ B cells, IgM and CICs. We determined a significant decrease the most parameters of the cellular immune response (CD7+, CD3+, CD8+, CD54+, HLA-DR+) in the group of children with reactivation of EBVI. In addition, in this group we detected an increase in CD4+/CD8+, IgA, and small CICs.

Conclusion. We found multidirectional reactions of the immune system in children aged 3–6 years with infectious mononucleosis because of primary and reactivation of EBVI. On the one hand, we recorded the tension of cellular immunity during EBVI reactivation, on the other hand, depression of cellular factors and an increase in CD4/CD8 in primary EBVI. These changes were found in children in the 4th critical period of the formation of the immune system. The combination of this factor with the revealed depression of the cellular component of immunity suggests that children aged 3–6 years with EBVI reactivation are a group of increased risk of chronic infectious mononucleosis.

Keywords:Epstein–Barr virus; infectious mononucleosis; children; reactivation; T cells; B cells; immune response

Funding. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest. The authors declares that there is no conflict of interest.

Contribution. The concept and design of the study – Drozdova T.G.; collection and processing of material – Antonova M.V., Che- khova Yu.S., Ogoshkova N.V.; statistical data processing – Antonova M.V., Khanipova L.V. Beltikova A.A.; writing the text – Kashuba E.A., Antonova M.V.; editing – Lyubimtseva O.A.; approval of the final version of the article – Kashuba E.A., Richkova O.A.; responsibility for the integrity of all parts of the article – Antonova M.V.

For citation: Kashuba E.A., Antonova M.V., Drozdova T.G., Richkova O.A., Lyubimtseva O.A., Khanipova L.V., Ogoshkova N.V., Che- khova Yu.S., Beltikova A.A. Humoral and cellular immune responses in children 3–6 years old with infectious mononucleosis caused by primary and reactivation of Epstein–Barr viral infection. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2022; 11 (2): 57–63. DOI:


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Yushchuk Nikolay Dmitrievich
Academician of the Russian Academy of Sciences, Professor, head of the Infectious Diseases and Epidemiology Department, President of the Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Board member of the National Scientific Infectiologists? Society.
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