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Pre-transplant assessment of pp65-specific CD4 T cell responses identifies CMV-seropositive patients treated with rATG at risk of late onset infection.

pp65-specific CD4 + T细胞应答的移植前评估鉴定了用rATG治疗的CMV血清阳性患者具有迟发性感染的风险。

  • 影响因子:3.12
  • DOI:10.1016/j.clim.2019.108329
  • 作者列表:"López-Oliva MO","Martínez V","Rodríguez-Sanz A","Álvarez L","Santana MJ","Selgas R","Jiménez C","Bellón T
  • 发表时间:2020-02-01
Abstract

:Assessment of CMV-specific T cell immunity might be a useful tool in predicting CMV infection after solid organ transplantation. We have investigated CD4 and CD8 T-cell responses to CMV pp65 and IE-1 antigens in a prospective study of 28 CMV-seropositive kidney transplant recipients who were administered lymphocyte-depleting antibodies (Thymoglobulin®) as induction treatment and with universal prophylaxis for CMV infection. The response was analyzed by intracellular flow cytometry analysis of IFN-γ production in pretransplant samples and at 1, 6, 12 and 24 months post-transplant. Overall, only pretransplant CD4 T-cell responses to pp65 were significantly lower (p = .004) in patients with CMV replication post-transplant. ROC curve analysis showed that pre-transplant frequencies of pp65-specific CD4 + T cells below 0.10% could predict CMV infection with 75% sensitivity and 83.33% specificity (AUC: 0.847; 95% CI: 0.693-1.001; p = .0054) and seem to be mandatory for efficient control of CMV viral replication by the host immune system. In conclusion, the functional assessment of CMV-specific CD4 T-cell immunity pretransplant in seropositive patients may allow the identification of Thymoglobulin®-treated kidney transplant recipients at risk of developing CMV infection post-transplantation.

摘要

: 评估CMV特异性T细胞免疫可能是预测实体器官移植后CMV感染的有用工具。我们研究了CD4和CD8 T细胞对CMV pp65和IE-1抗原的反应,对28例CMV血清阳性肾移植受者进行了一项前瞻性研究,这些受者接受了淋巴细胞消耗抗体 (胸腺球蛋白®) 作为CMV感染的诱导治疗和普遍预防。通过细胞内流式细胞术分析移植前样品和移植后1、6、12和24个月时IFN-γ 产生的反应。总体而言,只有移植前cd4t细胞对pp65的反应在移植后具有CMV复制的患者中显著较低 (p =.004)。ROC曲线分析显示,pp65-specific CD4 + t细胞移植前频率低于0.10% 可预测CMV感染,灵敏度为75%,特异度为83.33% (AUC: 0.847; 95% CI: 0.693-1.001; P =.0054) 并且似乎是通过宿主免疫系统有效控制CMV病毒复制的强制性要求。总之,血清阳性患者移植前CMV特异性CD4 T细胞免疫的功能评估可能允许鉴定胸腺球蛋白®-接受治疗的肾移植受者在移植后有发生CMV感染的风险。

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