title: The immunology of Epstein-Barr virus-induced disease.
abstract: Epstein-Barr virus (EBV) is usually acquired silently early in life and carried thereafter as an asymptomatic infection of the B lymphoid system. However, many circumstances disturb the delicate EBV-host balance and cause the virus to display its pathogenic potential. Thus, primary infection in adolescence can manifest as infectious mononucleosis (IM), as a fatal illness that magnifies the immunopathology of IM in boys with the X-linked lymphoproliferative disease trait, and as a chronic active disease leading to life-threatening hemophagocytosis in rare cases of T or natural killer (NK) cell infection. Patients with primary immunodeficiencies affecting the NK and/or T cell systems, as well as immunosuppressed transplant recipients, handle EBV infections poorly, and many are at increased risk of virus-driven B-lymphoproliferative disease. By contrast, a range of other EBV-positive malignancies of lymphoid or epithelial origin arise in individuals with seemingly intact immune systems through mechanisms that remain to be understood.
authors.affiliation: School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; email: g.s.taylor@bham.ac.uk , h.m.long@bham.ac.uk , j.m.brooks@bham.ac.uk , a.b.rickinson@bham.ac.uk , a.d.hislop@bham.ac.uk.
authors.forename: Graham S
authors.initials: GS
authors.lastname: Taylor
authors.forename: Heather M
authors.initials: HM
authors.lastname: Long
authors.forename: Jill M
authors.initials: JM
authors.lastname: Brooks
authors.forename: Alan B
authors.initials: AB
authors.lastname: Rickinson
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hislop
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D002353:Carrier State; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology* / Q000502:physiology; D006801:Humans; D007113:Immunity, Innate; D016867:Immunocompromised Host; D007153:Immunologic Deficiency Syndromes / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology
keywords: adaptive immunity; autoimmunity; immunodeficiency; immunotherapy; innate immunity; malignancy