Evaluation of Cytomegalovirus (CMV)-Specific T Cell Immune Reconstitution Revealed That Baseline Antiviral Immunity, Prophylaxis, or Preemptive Therapy but not Antithymocyte Globulin Treatment Contribute to CMV-Specific T Cell Reconstitution in Kidney Transplant Recipients

被引：96

作者：

Abate, Davide ^{[1
]}

Saldan, Alda ^{[1
]}

Fiscon, Marta ^{[1
]}

Cofano, Simona ^{[1
]}

Paciolla, Adriana ^{[3
]}

Furian, Lucrezia ^{[2
]}

Ekser, Burcin ^{[2
]}

Biasolo, Maria Angela ^{[1
]}

Cusinato, Riccardo ^{[1
]}

Mengoli, Carlo ^{[1
]}

Bonfante, Luciana ^{[3
]}

Rossi, Barbara ^{[4
]}

Rigotti, Paolo ^{[2
]}

Sgarabotto, Dino ^{[5
]}

Barzon, Luisa ^{[1
]}

Palu, Giorgio ^{[1
]}

机构：

[1] Univ Padua, Dept Histol Microbiol & Med Biotechnol, Padua Gen Hosp, Sch Med, I-35121 Padua, Italy

[2] Univ Padua, Dept Gen Surg & Solid Organ Transplantat, Padua Gen Hosp, Sch Med, I-35121 Padua, Italy

[3] Univ Padua, Dept Surg & Med Sci Nephrol 1, Padua Gen Hosp, Sch Med, I-35121 Padua, Italy

[4] Univ Padua, Dept Hemodialysis & Nephrol 2, Padua Gen Hosp, Sch Med, I-35121 Padua, Italy

[5] Univ Padua, Transplant Infect Dis Unit, Padua Gen Hosp, Sch Med, I-35121 Padua, Italy

来源：

JOURNAL OF INFECTIOUS DISEASES | 2010年 / 202卷 / 04期

关键词：

SOLID-ORGAN; INFECTION; DISEASE; RESPONSES; RISK; SIROLIMUS; OUTCOMES;

D O I：

10.1086/654931

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The ultimate goal of organ transplantation is the reestablishment of organ function and the restoration of a solid immunity to prevent the assault of potentially deadly pathogens. T cell immunity is crucial in controlling cytomegalovirus (CMV) infection. It is still unknown how preexisting antiviral T cell levels, prophylaxis, or preemptive antiviral strategies and pharmacological conditioning affect immune reconstitution. Methods. Seventy preemptively treated CMV-seropositive recipients, 13 prophylaxis-treated CMV-seronegative recipients of seropositive donor transplants, 2 seropositive recipients of seronegative donor kidneys, and 27 pre-transplant subjects were enrolled in a cross-sectional study and analyzed for CMV viremia (DNAemia) and CMV-specific T cell response (interferon-gamma enzyme-linked immunospot assay) before transplantation and at 30, 60, 90, 180, and 360 days after transplantation. Results. CMV-seropositive transplant recipients displayed a progressive but heterogeneous pattern of immune reconstitution starting from day 60 after transplantation. CMV-seronegative recipients did not mount a detectable T cell response throughout the prophylaxis regimen. A single episode of CMV viremia (CMV copy number, 7000-170,000 copies/mL) was sufficient to prime a protective T cell immune response in CMV-seronegative recipients. Antithymocyte globulin treatment did not significantly affect CMV-specific T cell response. Conclusions. Baseline immunity, antiviral therapy but not antithymocyte globulin treatments profoundly influence T cell reconstitution in kidney transplant recipients.

引用

页码：585 / 594

页数：10

共 27 条

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