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fascinating study on the dynamics of acute infectious mononucleosis (AIM)

Discussion in 'Other Health News and Research' started by cfs since 1998, Apr 10, 2010.

  1. cfs since 1998

    cfs since 1998 *****

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    Published in 2008, I've never seen this one, very interesting. Full text is free.

    http://bloodjournal.hematologylibrary.org/cgi/content/long/111/3/1420


    On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis
    Vey Hadinoto, Michael Shapiro, Thomas C. Greenough, John L. Sullivan, Katherine Luzuriaga, and David A. Thorley-Lawson1

    Abstract:
    Memory B cells latently infected with Epstein-Barr virus (mBLats) in the blood disappear rapidly on presentation with acute symptomatic primary infection (acute infectious mononucleosis [AIM]). They undergo a simple exponential decay (average half-life: 7.5 3.7 days) similar to that of normal memory B cells. The cytotoxic T lymphocyte (CTL) response to immediate early (IE) lytic antigens (CTLIEs) also decays over this time period, but no such correlation was observed for the CTL response to lytic or latent antigens or to the levels of virions shed into saliva. We have estimated the average half-life of CTLIEs to be 73 ( 23) days. We propose that cycles of infection and reactivation occur in the initial stages of infection that produce high levels of mBLats in the circulation. Eventually the immune response arises and minimizes these cycles leaving the high levels of mBLats in the blood to decay through simple memory B-cell homeostasis mechanisms. This triggers the cells to reactivate the virus whereupon most are killed by CTLIEs before they can release virus and infect new cells. The release of antigens caused by this large-scale destruction of infected cells may trigger the symptoms of AIM and be a cofactor in other AIM-associated diseases.

    Here are the parts I thought were interesting (this is not meant to be a comprehensive summary but to point out particular things that struck me):

    From Introduction:

    "[If] infection is delayed until adolescence, it results in acute infectious mononucleosis (AIM) in 20% to 50% of cases."​

    "There is evidence that AIM itself rather than EBV infection, per se, is a key predisposing factor for at least some of the associated diseases."​

    "During AIM, the level of latently infected memory B cells can rise to half, and perhaps even higher, of the peripheral memory B-cell compartment."​

    From Results:

    "...acute infection had still not resolved to stable persistence even by 1 year later. These observations were subsequently confirmed" (a graph indicates that the number of infected B cells one year after infectious mononucleosis was still declining but more than 1 log, or 10 fold, higher than the number seen in healthy carriers of the virus).​

    From Discussion:

    "Our data show conclusively that by the time the clinical symptoms of AIM arise, the level of mBLats is always rapidly decreasing. Therefore, the emergence of clinical symptoms coincides with the massive cell death associated with the exponential decay of mBLats, not with infection per se."

    "[Our data imply] that 50% of mBLats, constituting 25% of the entire memory B-cell compartment, may be destroyed in 1 week at the height of the infection. This constitutes a massive, continuous deposition of cellular and viral antigens into the system. This action could be what is responsible for the long-term damage inflicted on the immune system and the predisposing factor for the AIM-associated diseases."​
     
  2. cfs since 1998

    cfs since 1998 *****

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    Considering how hard infectious mononucleosis is on the immune system, if you already have a retrovirus when you get it, that would be one heck of a disaster. A perfect storm so to speak -- or perfect infection in this case.
     
  3. Kati

    Kati Patient in training

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    I am not particularily happy to have had a perfect storm happening in my body in the last 17 months- IgM+ EBV at age 40 is no fun. Didn't even kiss anyone. :worried::tear::(
     
  4. cfs since 1998

    cfs since 1998 *****

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    Me neither! :eek:
    Me neither! :worried::tear::(

    ;)

    In all seriousness, if we can find something on what happens to HIV+ people if they get IM (as opposed to IM first then HIV), it might be interesting. But I couldn't find anything during a cursory search just now.
     
  5. heapsreal

    heapsreal iherb 10% discount code OPA989,

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  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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  7. August59

    August59 Daughters High School Graduation

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    I never remember ever having mono at any point in my life, but was probably when i was very young. So much for the kissing disease :D:D:D
     
  8. dancer

    dancer Senior Member

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    My CFS/ME/CFIDS began with a positive mono test - at age 48. (weird age to get mono - and I wasn't kissing anyone but my very healthy hubby.) Docs said it could be a "re-activated" mono - latent in me since teen years. EBV titers weren't high for "current infection" but the "early antibodies" WERE high for "recent infection"... and continued to be a year later. Doc said he didn't really know what that meant. Something weird is going on, that's for sure. It really is some sort of immune system perfect storm.
     
  9. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    hi dancer, you sound like u could be a good candidate for an antiviral like valtrex. I think it is common for cfs people to have this virus reactivate even if they cant remember getting mono or if it didnt start cfs, for me ebv and chicken pox started the cfs at the age of 32, a few months before getting these infection i remember feeling run down and unwell and was tested for ebv which was negative but did show up cmv, but this just showed antibodies from past infection so unsure if it was the cause of my symptoms then but was good to know i was negative to ebv at that stage as my test for ebv later was just an antibody test which was positive and was a good indication that it was a current infection as was previously negative. Ebv go's really well with chickenpox, knocks the stuffing out of ya .
    ps, the only person i was kissing was my wife and she didnt get mono, oh well she has to put up with me now, lol
     
  10. dancer

    dancer Senior Member

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    Thanks, heapsreal. :)

    I did do a trial of Valtrex, and didn't have any improvement. I was bummed because I'd read it often helped PWC who developed CFS/ME after EBV activation. But it seems that's just part of the picture.

    LDN, however, HAS been helping (from about 20 per cent function to 30 per cent) and I wonder if it's coaxed my immune system into a better balance.
     
  11. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    hi dancer, can i ask how long u were on antivirals. I initially did a 2 week course and got no results and was disappointed, then i read about people being on them for long periods of time. It took me 3 months to notice an effect and 18 months down the track have improved to 90% from about 60%. Im still on them, when i stop I get sick again, so i think i have to be on them for awhile, maybe indefinately.
     
  12. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Perhaps you had it when you were young and it was "chalked" up to something else, just sick as kids can often be? Not sure how I caught Mono either, was kissing a few ladies but 1 had had it like 20years before, so...?
     
  13. cfs since 1998

    cfs since 1998 *****

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    ggingues/August, if you had mono you would certainly remember it. Not everyone who gets infected with EBV gets mono, especially if you are infected as a child in which case it can be asymptomic.
     
  14. dancer

    dancer Senior Member

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    Midwest, USA
    Hi, heapsreal...
    my doc had me try it for a month, looking for ANY sign of any effect. He believed that you can usually see some effects if it's going to help...and if so, he would have prescribed it long term. But since nothing at all happened, we decided not to keep going long term.
     
  15. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    I had mono and I remember it almost 7 years ago exactly! This is when I became sick and have never been the same! Seems like you are agreeing with what I was saying CFS since 1998? or did you commit a typo or is my brain fogged? I even went for a bike ride during the 2 weeks I should have been resting more, but us Type A personalities get bored sitting around for a couple of weeks!
     

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