The Paul-Bunnell heterophile antibody determinant in Epstein-Barr virus-associated disease

Roberto Patarca-Montero, Mary Ann Fletcher

Research output: Contribution to journalReview articlepeer-review


Reactivation of latent herpes viruses (notably Epstein-Barr virus, human herpesvirus-6) is commonly seen in chronic fatigue syndrome and it is believed to contribute to symptom perpetuation. Epstein-Barr virus (EBV), which was first isolated by Epstein, Barr and Achong (1964) from a cultured Burkitt's lymphoma lymphoblast cell line, is the etiological agent for infectious mononucleosis (IM), polyclonal and oligoclonal lymphomas associated with primary and acquired immunodeficiencies, and the complications of X-linked lymphopro-liferative syndrome (XLP) (Cantani and Mastrantoni, 1989; Englund, 1988; Ernberg et al., 1990; Jones and Straus, 1987; Okano et al., 1988; Purtilo, 1987; Purtilo et al., 1981; Rowe et al., 1986; Saemundsen et al., 1981) and nasopharyngeal cancer (Pearson et al., 1984). Furthermore, people who have had IM have higher rates of subsequent development of malignant lymphoproliferative disorders (Abo et al., 1982; Snydman et al., 1982) and Hodgkin's disease (Green et al., 1979; Mueller, 1987; Poppema et al., 1985; Weiss et al., 1989), while patients with XLP have a higher incidence of non-Hodgkin's malignant lymphoma (Harrington et al., 1987). The precise role of EBV in these diseases or in CFS is not well understood. Nonetheless, it is known that EBV infection triggers the formation of heterophile antibodies that, for many decades, have formed the basis for serologic diagnosis of IM. In this review, we discuss the discovery, species variation, and structure of the erythrocyte membrane-associated Paul-Bunnell (PB) heterophile antibody determinant, its implications to IM diagnosis, and its potential contribution to defective immune surveillance, such as that seen in chronic fatigue syndrome.

Original languageEnglish (US)
Pages (from-to)51-86
Number of pages36
JournalJournal Of Chronic Fatigue Syndrome
Issue number3-4
StatePublished - 2002


  • Chronic fatigue syndrome
  • Epstein-Barr virus
  • Hodgkin's disease
  • Infectious mononucleosis
  • T-cell proliferation

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology


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