Epstein-Barr virus: From harmless to severe consequences

Scientists from the German Center for Infection Research (DZIF) are on a specific quest for the causes of and biomarkers for severe courses of Pfeiffer’s disease. The disease is caused by the Epstein-Barr virus.

Over 90 percent of the human population contract Epstein-Barr virus (EBV) infections over the course of their lives. The infection usually occurs symptom-free during childhood and has no consequences for most people. However, especially in adolescents and young adults, new infections can develop into so-called Pfeiffer’s disease (infectious mononucleosis). A kiss with transmission of saliva usually suffices for contracting the infection, giving rise to its nickname “kissing disease”. Typically, symptoms of Pfeiffer’s disease include fever, fatigue, throat-ache, swollen lymph nodes, but the course is usually harmless and generally resolves quickly. Some patients, however, develop life-threatening complications such as shortness of breath, spleen rupture or blood cell deficiency, or extremely long courses of disease such as the chronic fatigue syndrome. Additionally, the risk of developing multiple sclerosis or Hodgkin’s lymphoma appears to be higher for people who have suffered from Pfeiffer’s disease.

“In some patients, certain congenital immune defects have been identified as the cause of unusual courses of infection. In most cases, however, the causes remain unrecognised,” explains Prof Uta Behrends from the Technische Universität München. The paediatrician coordinates an extensive research study at the DZIF, aiming at identifying risk parameters and hence also improving the treatment options.

IMMUC study successfully initiated

The so-called IMMUC study was initiated half a year ago; it is a globally unique study as it includes very specific experimental expertise and numerous paediatric practices and hospitals. 50 young patients with newly diagnosed Pfeiffer’s disease have already been recruited into the study from 23 establishments in the Munich region. All patients will be examined with highly-modern virological and immunological tests and advised on their symptoms over six months.

“We expect to be in a position to answer many questions on the different courses of EBV infection with the data from this study and the tools we develop,” explains Behrends. In addition to the IMMUC study, the researchers also dedicate themselves to other benign and malignant EBV-associated diseases, as well as to further developing EBV specific cell-based therapy and a protective vaccine. As the EBV remains in the body for a lifetime after illness, it poses a particular threat to immunocompromised people. Here, the immune system is often unable to keep the virus in check. However, for reasons that have been unclear up to now, people with healthy immune systems also develop different EBV-associated types of cancer during the course of their lives.

EBV infections are a global problem.

The IMMUC study is an extensive study in search of new approaches to the diagnosis, follow-up, treatment and prevention of diseases caused by the globally problematic EBV. Together with the participating research groups from the Technische Universität München, Ludwig-Maximilians Universität München, Helmholtz Zentrum München, German Center for Infection Research, Hannover Medical School and the German Cancer Research Center Heidelberg, the scientists intend to continue the study with new participants over the next two years.

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