IMMUNOLOGICAL DETECTION OF EPSTEIN-BARR VIRUS ANTIGEN AND EVALUATION OF TNF-Α AND IL-10 IN PATIENTS WITH Β-THALASSEMIA MAJOR
Downloads
Objective: This study aims to detect Epstein–Barr virus antigens using the ELISA technique and to evaluate the immune status by measuring the levels of inflammatory cytokines, namely Tumor Necrosis Factor (TNF) and Interleukin-10 (IL-10). Method: This study was conducted on 150 patients previously diagnosed with major β-thalassemia by physicians at the hospital. Special kits were used to detect viral antigens, in addition to other kits used for measuring cytokine levels. Statistical analysis was also performed to evaluate the cytokine data. Results: The virus was detected in 82% of the total number of patients. The highest rate was recorded in patients aged between 11-20 years and females showed a higher infection rate compared to males. Regarding cytokines, there was a statistically significant increase in the levels of Interleukin-10 and Tumor Necrosis Factor in patients compared to the control group, p-values of 0.0048 and 0.0035, respectively. Novelty: The results revealed the presence of immune regulatory dysfunction in this group of patients, as they exhibited signs of both immune activation and suppression simultaneously. This underscores the importance of continuous immunological monitoring for this category of patients.
Y. Wong, M. T. Meehan, S. R. Burrows, D. L. Doolan, and J. J. Miles, “Estimating the global burden of Epstein–Barr virus-related cancers,” J. Cancer Res. Clin. Oncol., vol. 148, no. 1, pp. 31–46, 2022.
A. Riaz, K. Murtaz-ul-Hasan, and N. Akhtar, “Recent understanding of the classification and life cycle of herpesviruses: a review,” Sci. Lett., vol. 5, pp. 195–207, 2017.
M. F. Haddad, A. A. Al Taie, and B. A. Abdullah, “Relation between Epstein–Barr virus (EBV) with some biochemical variables in high-risk aborted women in Mosul city, Iraq,” J. Appl. Nat. Sci., vol. 15, no. 4, pp. 1332–1338, 2023.
M. A. Epstein, G. Henle, B. G. Achong, and Y. M. Barr, “Morphological and biological studies on a virus in cultured lymphoblasts from Burkitt's lymphoma,” J. Exp. Med., vol. 121, no. 5, pp. 761–770, 1965.
H. S. Abdulkareem and A. A. AlTaie, “Detection of Epstein–Barr virus (EBV) among thyroid disorders patients using enzyme-linked immunoassay (ELISA) and indirect immunofluorescence assay (IFA) in Mosul city, Iraq,” Malays. J. Microbiol., vol. 20, no. 6, pp. 253–257, 2024.
S. K. Dunmire, P. S. Verghese, and H. H. Balfour Jr., “Primary Epstein–Barr virus infection,” J. Clin. Virol., vol. 102, pp. 84–92, 2018.
M. Kalla and W. Hammerschmidt, “Human B cells on their route to latent infection – early but transient expression of lytic genes of Epstein–Barr virus,” Eur. J. Cell Biol., vol. 91, no. 1, pp. 65–69, 2012.
B. Zhang, Y. Zong, J. He, B. Zhong, and S. Lin, “Primary nasopharyngeal non-Hodgkin lymphoma and its relationship with Epstein–Barr virus infection,” Chin. Med. J., vol. 116, no. 6, pp. 913–917, 2003.
D. J. Moss, S. R. Burrows, S. L. Silins, I. Misko, and R. Khanna, “The immunology of Epstein–Barr virus infection,” Philos. Trans. R. Soc. Lond. B Biol. Sci., vol. 356, no. 1408, pp. 475–488, 2001.
T. Shi, L. Huang, L. Luo, Q. Yu, and J. Tian, “Diagnostic value of serological and molecular biological tests for infectious mononucleosis by EBV in different age stages and course of the disease,” J. Med. Virol., vol. 93, no. 6, pp. 3824–3834, 2021.
A. A. Al Taie, M. A. Ibraheem, and K. B. Fadhil, “Epstein–Barr virus infection in Thalassemia patients related to blood group in Mosul, Iraq,” Ann. Trop. Med. Public Health, vol. 22, p. 136, 2019.
S. Tischer et al., “Evaluation of suitable target antigens and immunoassays for high-accuracy immune monitoring of cytomegalovirus and Epstein–Barr virus-specific T cells as targets of interest in immunotherapeutic approaches,” J. Immunol. Methods, vol. 408, pp. 101–113, 2014.
R. F. Souza, M. A. F. Caetano, H. I. R. Magalhães, and P. Castelucci, “Study of tumor necrosis factor receptor in the inflammatory bowel disease,” World J. Gastroenterol., vol. 29, no. 18, pp. 2733–2746, 2023.
N. M. Gálvez, K. Bohmwald, G. A. Pacheco, C. A. Andrade, L. J. Carreño, and A. M. Kalergis, “Type I natural killer T cells as key regulators of the immune response to infectious diseases,” Clin. Microbiol. Rev., vol. 34, no. 2, pp. 10–1128, 2021.
G. Van Loo and M. J. Bertrand, “Death by TNF: a road to inflammation,” Nat. Rev. Immunol., vol. 23, no. 5, pp. 289–303, 2023.
H. Islam, H. Neudorf, A. L. Mui, and J. P. Little, “Interpreting ‘anti‐inflammatory’ cytokine responses to exercise: focus on interleukin‐10,” J. Physiol., vol. 599, no. 23, pp. 5163–5177, 2021.
R. Incrocci, M. McCormack, and M. Swanson-Mungerson, “Epstein–Barr virus LMP2A increases IL-10 production in mitogen-stimulated primary B-cells and B-cell lymphomas,” J. Gen. Virol., vol. 94, no. 5, pp. 1127–1133, 2013.
A. Bazi, I. Shahramian, H. Yaghoobi, M. Naderi, and H. Azizi, “The role of immune system in thalassemia major: a narrative review,” J. Pediatr. Rev., vol. 6, no. 2, pp. 29–36, 2018.
E. M. Walker and S. M. Walker, “Effects of iron overload on the immune system,” Ann. Clin. Lab. Sci., vol. 30, no. 4, pp. 354–365, 2000.
R. A. Kathem, A. H. Kareem, and N. T. Altaee, “The frequency of Epstein–Barr virus among hemodialysis patients,” Int. J. Virol., vol. 15, no. 2, pp. 85–91, 2019.
E. A. Ihsan, L. M. Mohammed, and W. M. Ali, “Prevalence of Epstein–Barr virus among hemodialysis patients in Kirkuk city,” NTU J. Pure Sci., vol. 2, no. 4, pp. 17–22, 2023.
S. Ni, Y. Yuan, Y. Kuang, and X. Li, “Iron metabolism and immune regulation,” Front. Immunol., vol. 13, p. 816282, 2022.
S. Puntarulo, “Iron, oxidative stress and human health,” Mol. Aspects Med., vol. 26, no. 4–5, pp. 299–312, 2005.
B.-N. Ding, Y.-L. Wu, Y.-Y. Zhang, and Y.-G. Li, “Association between Epstein–Barr virus infection and serum positivity rate of anti-nuclear antibodies in Chongqing, China: A cross-sectional observational study,” Medicine (Baltimore), vol. 103, no. 32, p. e39233, 2024.
S. Haghpanah et al., “Cytokine levels in patients with β-thalassemia major and healthy individuals: A systematic review and meta-analysis,” Clin. Lab., vol. 68, no. 11, pp. 1201–1210, 2022.
G. Ceccarelli et al., “Reassessing the risk of severe parvovirus B19 infection in the immunocompetent population: A call for vigilance in the wake of resurgence,” Viruses, vol. 16, no. 9, p. 1352, 2024. [Online]. Available: https://www.mdpi.com/1999-4915/16/9/1352. [Accessed: Jul. 4, 2025].
D. I. Tanyong, P. Panichob, W. Kheansaard, and S. Fucharoen, “Effect of tumor necrosis factor-alpha on erythropoietin- and erythropoietin receptor-induced erythroid progenitor cell proliferation in β-thalassemia/hemoglobin E patients,” Turk. J. Hematol., vol. 32, no. 4, pp. 304–310, 2015.
S. Balouchi, M. Gharagozloo, N. Esmaeil, B. Moayedi, and E. Nafiseh, “Serum levels of TGF-β, IL-10, IL-17, and IL-23 cytokines in β-thalassemia major patients: The impact of silymarin therapy,” Immunopharmacol. Immunotoxicol., vol. 36, no. 4, pp. 271–274, 2014.
V. Carlini et al., “The multifaceted nature of IL-10: Regulation, role in immunological homeostasis and its relevance to cancer, COVID-19 and post-COVID conditions,” Front. Immunol., vol. 14, p. 1161067, 2023. [Online]. Available: https://www.frontiersin.org/articles/10.3389/fimmu.2023.1161067/full. [Accessed: Jul. 4, 2025].
A. Gluba-Brzóźka, B. Franczyk, M. Rysz-Górzyńska, R. Rokicki, M. Koziarska-Rościszewska, and J. Rysz, “Pathomechanisms of immunological disturbances in β-thalassemia,” Int. J. Mol. Sci., vol. 22, no. 18, p. 9677, 2021.
Copyright (c) 2025 Ghofran Saad Mahmood, Anmar A Al-Taie
This work is licensed under a Creative Commons Attribution 4.0 International License.
