Mechanisms of Epstein–Barr Virus Infection in Dysregulating the Omentin-1–Immune Axis

Background & Objective: Epstein–Barr Virus (EBV) has been associated with immune dysregulation and changes in the levels of adipokines; however, its effect on omentin-1–immune axis among Iraqi faces limited investigation. This study was aimed to determine the effect of EBV infection to influence serum omentin-1 and other adipokines as well as pro-inflammatory cytokines, and their diagnostic usefulness.

Materials & Methods: One hundred and fifty-seven clinically diagnosed EBV patients along with 75 healthy controls were involved in this study, which is conducted in teaching hospitals clinics in Kirkuk (June–September 2025). The VCA-IgG, VCA-IgM and EBNA-IgG by ELISA kits were employed. Plasma omentin-1, chemerin, vaspin, IL-6, TNF-α and IFN-γ levels were determined. The relationships of adipokines and cytokines were analyzed, and diagnostic values were estimated according to ROC analysis.

Results: EBV positive status was found in 45 (28.6%) patients. Cytokine levels IL-6 (29.4 ± 6.1 pg/mL), TNF-α (21.7 ± 5.3 pg/mL) and IFN-γ (25.9 ± 6.7 pg/mL) in EBV-positive patients were significantly higher than in controls (p < 0.001). Omentin-1 was decreased (5.7 ± 1.2 µg/mL versus 8.2 ± 1.3 µg/mL in controls, p < 0.001), while modest reductions were found for chemerin and vaspin as well. There was an inverse relationship between omentin-1 and cytokines (IL-6 r = −0.38, TNF-α r = −0.31, IFN-γ r = −0.29, p < 0.01). ROC analysis indicated that IL-6 and omentin-1 best discriminated between EBV infected cases (AUC 0.81 and AUC 0.78, respectively).

Conclusions: The EBV contact in Iraqi patients was accompanied by marked pro-inflammatory status and inhibition of omentin-1, which links systemic inflammation to adipokine disturbance. Serum omentin-1 and IL-6 may be biomarkers for EBV infection.