Virologic, immunologic, and clinical observations on a patient during the incubation, acute, and convalescent phases of infectious mononucleosis

Svedmyr, Erik; Ernberg, Ingemar; Seeley, Janet K.; Weiland, Ola; Masucci, Giuseppe; Tsukuda, Koji; Szigeti, Robert; Masucci, Maria G.; Blomgren, Henric; Berthold, Wolfgang; Henle, Werner; Klein, George

doi:10.1016/0090-1229(84)90029-1

Cited by 82 publications

(30 citation statements)

References 23 publications

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“…As the symptoms of infectious mononucleosis become apparent 4 to 8 weeks after exposure to EBV, viral dissemination and transmission between compartments has likely already occurred (19,27). Therefore, it is quite striking that in 10 of 13 subjects, unique strains were detected in the oral cavity that were not detected in the blood, and the other three subjects (MO11, MO13, and MO14) contained unique strains in the blood that were not detected in the oral cavity.…”

Section: Discussionmentioning

confidence: 96%

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

Sitki-Green

Covington²,

Raab‐Traub

2003

J Virol

113

108

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Infection with the Epstein-Barr virus (EBV) is often subclinical in the presence of a healthy immune response; thus, asymptomatic infection is largely uncharacterized. This study analyzed the nature of EBV infection in 20 asymptomatic immunocompetent hosts over time through the identification of EBV strain variants in the peripheral blood and oral cavity. A heteroduplex tracking assay specific for the EBV gene LMP1 precisely identified the presence of multiple EBV strains in each subject. The strains present in the peripheral blood and oral cavity were often completely discordant, indicating the existence of distinct infections, and the strains present and their relative abundance changed considerably between time points. The possible transmission of strains between the oral cavity and peripheral blood compartments could be tracked within subjects, suggesting that reactivation in the oral cavity and subsequent reinfection of B lymphocytes that reenter the periphery contribute to the maintenance of persistence. In addition, distinct virus strains persisted in the oral cavity over many time points, suggesting an important role for epithelial cells in the maintenance of persistence. Asymptomatic individuals without tonsillar tissue, which is believed to be an important source of virus for the oral cavity, also exhibited multiple strains and a cyclic pattern of transmission between compartments. This study revealed that the majority of patients with infectious mononucleosis were infected with multiple strains of EBV that were also compartmentalized, suggesting that primary infection involves the transmission of multiple strains. Both the primary and carrier states of infection with EBV are more complex than previously thought.Epstein-Barr virus (EBV) is a human herpesvirus that establishes a life-long persistent infection in more than 90% of the world's population. Primary infection with the virus is usually asymptomatic but can result in the self-limiting disease infectious mononucleosis. EBV is associated with numerous pathologies that develop in B lymphocytes and epithelial cells, including Burkitt's lymphoma, Hodgkin's disease, AIDS-associated and posttransplant lymphomas, nasopharyngeal carcinoma, hairy leukoplakia, and several others (21).EBV persists in memory B lymphocytes, which may expand in response to their cognate antigen and subsequently differentiate into plasma cells, in which viral reactivation and replication may occur (1, 2). The role of EBV replication in the maintenance of persistent infection is not well characterized. Viral proteins indicative of replication have been detected in lymphocytes in the tonsillar tissue, and replicating virus has been detected in sloughed oropharyngeal epithelial cells (1,14,17,23,29). The replication and subsequent release of virus into the oral cavity permit transmission of the virus to a new host and possibly reinfection of oropharyngeal epithelial cells and B lymphocytes. The virus detected in the oropharynx is thought to be released from epithelial cells or ly...

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Section: Discussionmentioning

confidence: 96%

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

Sitki-Green

Covington²,

Raab‐Traub

2003

J Virol

113

108

View full text Add to dashboard Cite

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“…IFN-y has been shown to be elevated in the serum of a patient following primary infection; however, it was only detectable during the incubation period and not when symptoms of acute IM developed (65). This suggests that the TH1 response may be important in controlling the early infection, but is normally downregulated, probably by the TH2 response, resulting in persistent humoral immunity, as is normally observed.…”

Section: Hypothesismentioning

confidence: 87%

X-Linked Lymphoproliferative Disease: Twenty-Five Years after the Discovery

et al. 1995

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“…No responses were detected at weeks 2 and 4 (data not shown). The incubation period for EBV has been reported to be 38 days for one individual (56), which suggests that vaccinee 14 became infected within a few weeks of the first immunization. This vaccinee complained of a severe sore throat and fatigue, which lasted about 2 to 3 weeks and began at about week 7.…”

Section: Resultsmentioning

confidence: 99%

Phase I Trial of a CD8⁺T-Cell Peptide Epitope-Based Vaccine for Infectious Mononucleosis

Elliott

Suhrbier

Miles

et al. 2008

J Virol

135

101

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Virologic, immunologic, and clinical observations on a patient during the incubation, acute, and convalescent phases of infectious mononucleosis

Cited by 82 publications

References 23 publications

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

X-Linked Lymphoproliferative Disease: Twenty-Five Years after the Discovery

Phase I Trial of a CD8⁺T-Cell Peptide Epitope-Based Vaccine for Infectious Mononucleosis

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Virologic, immunologic, and clinical observations on a patient during the incubation, acute, and convalescent phases of infectious mononucleosis

Cited by 82 publications

References 23 publications

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers

X-Linked Lymphoproliferative Disease: Twenty-Five Years after the Discovery

Phase I Trial of a CD8+T-Cell Peptide Epitope-Based Vaccine for Infectious Mononucleosis

Contact Info

Product

Resources

About

Phase I Trial of a CD8⁺T-Cell Peptide Epitope-Based Vaccine for Infectious Mononucleosis