Gao Ying, Zheng Yan, Zhang Wei-Hua, Li Yu
Department of Hematology, Shaanxi Provincial People's Hospital, The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, Shaanxi Province, China.
Department of Infectious Diseases, Shaanxi Provincial People's Hospital, The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, Shaanxi Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Feb;31(1):268-273. doi: 10.19746/j.cnki.issn.1009-2137.2023.01.042.
To investigate the cytokine/chemokine profile in patients with Epstein-Barr virus (EBV)-related hemophagocytic lymphohistiocytosis (HLH), and assess the prognostic value of survival.
Serum levels of thirty-eight cytokines/chemokines were measured by multiple cytokine assay kit in EBV-related HLH patients, EBV-infected patients, and controls. The expression profile of cytokines/chemokines was compared among groups. The changes of cytokine/chemokine expression in active and remission stage of EBV-related HLH patients were also compared, and the prognostic values for survival were evaluated.
Serum levels of interferon-α2 (IFN-α2), interleukin (IL)-6, and IL-7 in EBV-related HLH patients were 33.67(23.23-68.78) pg/ml, (74.95±25.53) pg/ml, and 35.35(19.50-63.55) pg/ml, respectively, which were significantly higher than those in EBV-infected patients［IFN-α2: 16.07(9.87-29.63); IL-6: 55.91±20.29; IL-7: 20.40(13.35-31.40)］ and controls ［IFN-α2: 11.02(4.67-21.25); IL-6:42.64±13.41; IL-7: 16.95(14.95-33.78)］(all <0.05). Serum levels of IL-8, IL-9, and marcophage-derived chemokine (MDC) in EBV-related HLH patients were 11.00(7.50-15.27) pg/ml, 81.30(40.79-111.0) pg/ml, and (512.6±128.7) pg/ml, respectively, which were significantly higher than those in controls ［IL-8: 6.80(5.56-8.38); IL-9: 41.30(29.82-67.91); MDC: 384.1±156.6］(all <0.05), but there was no remarkable differences compared with EBV-infected patients (>0.05). Serum IFN-α2, IL-6, IL-7, IL-8, IL-9, and MDC in survival and death groups of EBV-related HLH patients were analyzed by receiver operating characteristic curve with area under curve of 0.781, 0.778, 0.633, 0.805, 0.562, and 0.657, respectively (P=0.019, 0.021, 0.269, 0.015, 0.607, and 0.190). IFN-α2, IL-6, and IL-8 had good predictive effect on survival. Serum level of IFN-α2, IL-6, and MDC of EBV-related HLH patients in remission stage were significantly lower than those in active stage (<0.05), while IL-7, IL-8, and IL-9 were not different (>0.05).
IFN-α2, IL-6, IL-7, IL-8, IL-9, and MDC may take part in the pathogenesis of EBV-related HLH.
探讨爱泼斯坦-巴尔病毒（EBV）相关噬血细胞性淋巴组织细胞增生症（HLH）患者的细胞因子/趋化因子谱，并评估其对生存的预后价值。
采用多种细胞因子检测试剂盒，检测EBV相关HLH患者、EBV感染患者及对照组血清中38种细胞因子/趋化因子的水平。比较各组细胞因子/趋化因子的表达谱。同时比较EBV相关HLH患者活动期和缓解期细胞因子/趋化因子表达的变化，并评估其对生存的预后价值。
EBV相关HLH患者血清干扰素-α2（IFN-α2）、白细胞介素（IL）-6和IL-7水平分别为33.67（23.23 - 68.78）pg/ml、（74.95±25.53）pg/ml和35.35（19.50 - 63.55）pg/ml，显著高于EBV感染患者［IFN-α2：16.07（9.87 - 29.63）；IL-6：55.91±20.29；IL-7：20.40（13.35 - 31.40）］和对照组［IFN-α2：11.02（4.67 - 21.25）；IL-6：42.64±13.41；IL-7：16.95（14.95 - 33.78）］（均P<0.05）。EBV相关HLH患者血清IL-8、IL-9和巨噬细胞衍生趋化因子（MDC）水平分别为11.00（7.50 - 15.27）pg/ml、81.30（40.79 - 111.0）pg/ml和（512.6±128.7）pg/ml，显著高于对照组［IL-8：6.80（5.56 - 8.38）；IL-9：41.30（29.82 - 67.91）；MDC：384.1±156.6］（均P<0.05），但与EBV感染患者相比无显著差异（P>0.05）。采用受试者工作特征曲线分析EBV相关HLH患者生存组和死亡组血清IFN-α2、IL-6、IL-7、IL-8、IL-9和MDC，曲线下面积分别为0.781、0.778、0.633、0.805、0.562和0.657（P = 0.019、0.021、0.269、0.015、0.607和0.190）。IFN-α2、IL-6和IL-8对生存有较好的预测作用。EBV相关HLH患者缓解期血清IFN-α2、IL-6和MDC水平显著低于活动期（P<0.05），而IL-7、IL-8和IL-9无差异（P>0.05）。
IFN-α2、IL-6、IL-7、IL-8、IL-9和MDC可能参与EBV相关HLH的发病机制。
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