Borysiewicz L K, Haworth S J, Cohen J, Mundin J, Rickinson A, Sissons J G
Q J Med. 1986 Feb;58(226):111-21.
In a number of patients recovery from infectious mononucleosis (IM) following primary Epstein Barr virus (EBV) infection, is complicated by the persistence of symptoms for months or years. Normally recovery from infectious mononucleosis is associated with the development of EBV-specific antibodies and memory cytotoxic T-cells, which are present in the peripheral blood of all normal seropositive individuals. We studied four patients who had persistent symptoms for more than two years after infectious mononucleosis to determine if this abnormality was associated with a defect in EBV-specific or non-specific immune responses. All four patients had normal immunoglobulin concentrations, T- and B-cell numbers, T-cell proliferative responses and natural killer cell activity. However three of the four had reduced or absent antibodies to the EBV nuclear antigen (EBNA) although other EBV-specific antibody titres were normal. All four also had reduced EBV-specific cytotoxic T-cell activity as measured by the EBV regression assay. This defect was probably EBV-specific as alloreactive cytotoxic T-cell responses were normal. In addition, three of three patients tested had reduced in vitro antibody synthesis following pokeweed mitogen stimulation. These studies indicate that the syndrome of persistent symptoms following EBV mononucleosis may be associated with a defect in EBV-specific immunity, and thus suggest a possible immunological basis for the syndrome.
在一些原发性爱泼斯坦-巴尔病毒（EBV）感染后从传染性单核细胞增多症（IM）恢复的患者中，症状持续数月或数年，使病情复杂化。通常，从传染性单核细胞增多症恢复与EBV特异性抗体和记忆性细胞毒性T细胞的产生有关，这些细胞存在于所有血清反应阳性正常个体的外周血中。我们研究了四名传染性单核细胞增多症后症状持续两年以上的患者，以确定这种异常是否与EBV特异性或非特异性免疫反应缺陷有关。所有四名患者的免疫球蛋白浓度、T细胞和B细胞数量、T细胞增殖反应以及自然杀伤细胞活性均正常。然而，四名患者中有三名针对EBV核抗原（EBNA）的抗体减少或缺失，尽管其他EBV特异性抗体滴度正常。通过EBV回归试验测量，所有四名患者的EBV特异性细胞毒性T细胞活性也均降低。这种缺陷可能是EBV特异性的，因为同种异体反应性细胞毒性T细胞反应正常。此外，三名接受检测的患者中有三名在商陆有丝分裂原刺激后体外抗体合成减少。这些研究表明，EBV单核细胞增多症后持续症状综合征可能与EBV特异性免疫缺陷有关，因此提示了该综合征可能的免疫学基础。
