LOCAL IMMUNITY STATUS IN ADULT PATIENTS UNDERGOING TREATMENT FOR STREPTOCOCCAL TONSILLITIS IN THE CONTEXT OF CHRONIC EPSTEIN-BARR VIRAL INFECTION

Objective: The aim of the study was to assess the impact of treatment on local responses in patients with both streptococcal tonsillitis and chronic Epstein-Barr virus (EBV) infection, by analyzing changes in immune indicators within oropharyngeal secretions at early and advanced treatment stages. Methods: A study was conducted involving 110 adult patients in the main group (MG) aged 18 to 67 years, who were hospitalized for moderate infectious mononucleosis (IM) and streptococcal tonsillitis. The control group (CG) consisted of 75 individuals, aged 18 to 65 years, who did not have IM or EBV, as confirmed by laboratory test results. Local immunity response in both groups was assessed by measuring the levels of lactoferrin, α-interferon-I, and tumor necrosis factor-α (TNF-α) in oropharyngeal secretions. Results: The comparative analysis of lactoferrin levels between patients of the MG and the CG indicated that the lactoferrin level in patients with IM (4107.2±117.8 ng/mL) was significantly higher (p<0.05) than that in individuals in the CG (762.9±16.2 ng/mL). Similarly, the levels of α-interferon-I also showed a statistically significant difference between the MG and CG, with values of 27.1±1.4 pg/mL and 11.7±1.2 pg/mL, respectively (p<0.05). Fourteen days after admission, lactoferrin levels in MG patients changed insignificantly, going from 4107.2±117.8 ng/mL to 5457.8±132.6 ng/mL (p>0.05). However, the levels of α-interferon-I in MG patients showed a statistically significant decrease after 14 days, dropping from 27.1±1.4 pg/mL to 12.3±1.3 pg/mL (p<0.05). Initially, the average TNF-α levels in both the MG and CG patients were found to be within the normal range (0 to 10.0 pg/mL) and did not show a statistically significant difference. At the time of admission, the TNF-α level in the MG was measured at 9.96 [8.71; 11.21] pg/mL. After 14 days of treatment, this level had significantly decreased to 1.89 [1.57; 2.21] pg/mL (p<0.05). Conclusion: Based on the study's results, a method was developed to assess the degree of immunological disorders. This method allows for monitoring the effectiveness of therapy for both IM in adults caused by EBV and streptococcal tonsillitis. Additionally, it enhances the accuracy of the prognosis regarding treatment outcomes. Keywords: Streptococcal tonsillitis, infectious mononucleosis, Epstein-Barr virus, α-interferon-I, lactoferrin.