title: Analysis of immune activation and clinical events in acute infectious mononucleosis.
abstract: The symptoms of infectious mononucleosis (IM) are thought to be caused by T cell activation and cytokine production. Surface lymphocyte activation marker (SLAM)-associated protein (SAP) regulates lymphocyte activation via signals from cell-surface CD244 (2B4) and SLAM (CD150). We followed T cell activation via this SAP/SLAM/CD244 pathway in IM and analyzed whether the results were associated with clinical severity. At diagnosis, SAP, SLAM, and CD244 were significantly up-regulated on CD4 and CD8 T cells; expression decreased during IM, but CD244 and SLAM levels remained higher on CD8 cells 40 days later. There were significantly more lymphocytes expressing CD8 and CD244/CD8 in patients with severe sore throat. The expression of CD8 alone and CD244 on CD8 cells correlated with increased virus load. We suggest that T cells expressing CD244 and SLAM are responsible for the clinical features of IM but that the control of activation is maintained by parallel increased expression of SAP.
authors.affiliation: Clinical and Basic Virology Laboratory, School of Biomedical and Clinical Laboratory Sciences, University of Edinburgh, Summerhall, United Kingdom.
authors.forename: Hilary
authors.initials: H
authors.lastname: Williams
authors.forename: Karen
authors.initials: K
authors.lastname: Macsween
authors.forename: Karen
authors.initials: K
authors.lastname: McAulay
authors.forename: Craig
authors.initials: C
authors.lastname: Higgins
authors.forename: Nadine
authors.initials: N
authors.lastname: Harrison
authors.forename: Anthony
authors.initials: A
authors.lastname: Swerdlow
authors.forename: Kate
authors.initials: K
authors.lastname: Britton
authors.forename: Dorothy
authors.initials: D
authors.lastname: Crawford
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism*; D015704:CD4 Antigens / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016827:CD8 Antigens / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002352:Carrier Proteins / Q000378:metabolism*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000378:metabolism*; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism*; D007244:Infectious Mononucleosis / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D047908:Intracellular Signaling Peptides and Proteins; D008213:Lymphocyte Activation; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D010612:Pharyngitis / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D011956:Receptors, Cell Surface; D011971:Receptors, Immunologic / Q000378:metabolism*; D012720:Severity of Illness Index; D000071179:Signaling Lymphocytic Activation Molecule Associated Protein; D000071176:Signaling Lymphocytic Activation Molecule Family; D000071177:Signaling Lymphocytic Activation Molecule Family Member 1; D015854:Up-Regulation
chemical_list: D015703:Antigens, CD; C084093:CD244 protein, human; D015704:CD4 Antigens; D016827:CD8 Antigens; D002352:Carrier Proteins; D004279:DNA, Viral; D006023:Glycoproteins; D007136:Immunoglobulins; D047908:Intracellular Signaling Peptides and Proteins; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D011971:Receptors, Immunologic; C114953:SH2D1A protein, human; C000604059:SLAMF1 protein, human; D000071179:Signaling Lymphocytic Activation Molecule Associated Protein; D000071176:Signaling Lymphocytic Activation Molecule Family; D000071177:Signaling Lymphocytic Activation Molecule Family Member 1