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Infectious mononucleosis fifty years after the discovery of the Paul-Bunnell test

Infektiöse Mononukleose 50 Jahre nach Entdeckung der Paul-Bunnell-Reaktion

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Summary

The Paul-Bunnell test, now 50 years old, is still of fundamental importance in the diagnosis of infectious mononucleosis, even though various immunologic methods have been developed in clinical practice to identify constituents of the Epstein-Barr virus (EBV). The demonstration of sheep red cell agglutinins in infectious mononucleosis (Paul-Bunnell) was in fact the first observation of the presence of heterophil antibodies in this viral disease which was later shown to evoke a polyclonal antibody response to a wide spectrum of autoantigens as well. The selective tropism of EBV for B lymphocytes and the reactivity of T lymphocytes to these infected B lymphocytes are the pathophysiological elements characteristic of infectious mononucleosis, and are the reason for this massive antibody response.

Zusammenfassung

Der Paul-Bunnell-Test ist nun 50 Jahre alt; trotz der Entwicklung verschiedener klinisch anwendbarer immunologischer Nachweisverfahren für Bestandteile des Epstein-Barr-Virus (EBV) ist er immer noch grundlegend wichtig für die Diagnose der infektiösen Mononukleose. Der Nachweis von Agglutininen gegen Schaferythrozyten bei der infektiösen Mononukleose (Paul-Bunnell) stellt im Grunde zugleich die erste Beobachtung von heterophilen Antikörpern bei dieser Viruskrankheit dar. Mehrere Jahrzehnte sind danach verstrichen, bis nachgewiesen wurde, daß die infektiöse Mononukleose eine polyklonale Antikörperbildung hervorruft, die auch gegen ein breites Spektrum von Autoantigenen gerichtet ist. Der selektive Tropismus des EBV für B-Lymphozyten und die Reaktionen der T-Lymphozyten gegen die infizierten B-Lymphozyten sind Ursache für diese massive Antikörperantwort und die charakteristischen pathophysiologischen Elemente der infektiösen Mononukleose.

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  1. Department of Pediatrics, University of Pavia, S. Matteo Hospital, I-127100, Pavia

    G. R. Burgio &  V. Monafo

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  1. G. R. Burgio
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  2. V. Monafo
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Burgio, G.R., Monafo, V. Infectious mononucleosis fifty years after the discovery of the Paul-Bunnell test. Infection 11, 1–5 (1983). https://doi.org/10.1007/BF01651349

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