BACKGROUND: Immunologic monitoring of pediatric transplant (Tx) recipients, who are at increased risk of Epstein-Barr virus (EBV)-driven posttransplant lymphoproliferative disease, is an important goal in clinical transplantation. Here, we investigated the impact of EBV load on T-cell immunity from pediatric Tx recipients, using clinically applicable tests for improved assessment of T-cell immune competence. METHODS: Thirty-five asymptomatic pediatric thoracic Tx patients were categorized into three groups according to their EBV load levels as follows: undetectable viral load (UVL), chronic low viral load (LVL) and chronic high viral load (HVL). Global and EBV-specific T-cell immunity were assessed by ATP release using Cylex Immuknow and T Cell Memory assays. RESULTS: UVL patients exhibited normal ATP release to Concanavalin A (ConA) and phytohemagglutinin (PHA; 190+/-86 ng/mL, 328+/-163 ng/mL) and detectable EBV-specific (37+/-34 ng/mL) ATP responses. LVL patients displayed significantly stronger responses to ConA (373+/-174 ng/mL), PHA (498+/-196 ng/mL) and EBV (152+/-179 ng/mL), when compared with UVL or to HVL patients (ConA 185+/-114 ng/mL, PHA 318+/-173 ng/mL, and EBV 33+/-42 ng/mL). Moreover, HVL patients displayed significant inverse correlation between CD4+ T-cell ATP levels and EBV loads. CONCLUSIONS: Evaluation of global and EBV-specific T-cell immunity provides a rapid assessment of patients' immune competence. It is still unclear whether selective oversuppressed ATP release by CD4+ T cells reflects HVL patients at risk of posttransplant lymphoproliferative disease. Further longitudinal studies will determine the importance of Immuknow test in identifying asymptomatic HVL patients vulnerable to EBV complications.
BACKGROUND: Immunologic monitoring of pediatric transplant (Tx) recipients, who are at increased risk of Epstein-Barr virus (EBV)-driven posttransplant lymphoproliferative disease, is an important goal in clinical transplantation. Here, we investigated the impact of EBV load on T-cell immunity from pediatric Tx recipients, using clinically applicable tests for improved assessment of T-cell immune competence. METHODS: Thirty-five asymptomatic pediatric thoracic Tx patients were categorized into three groups according to their EBV load levels as follows: undetectable viral load (UVL), chronic low viral load (LVL) and chronic high viral load (HVL). Global and EBV-specific T-cell immunity were assessed by ATP release using Cylex Immuknow and T Cell Memory assays. RESULTS: UVL patients exhibited normal ATP release to Concanavalin A (ConA) and phytohemagglutinin (PHA; 190+/-86 ng/mL, 328+/-163 ng/mL) and detectable EBV-specific (37+/-34 ng/mL) ATP responses. LVL patients displayed significantly stronger responses to ConA (373+/-174 ng/mL), PHA (498+/-196 ng/mL) and EBV (152+/-179 ng/mL), when compared with UVL or to HVL patients (ConA 185+/-114 ng/mL, PHA 318+/-173 ng/mL, and EBV 33+/-42 ng/mL). Moreover, HVL patients displayed significant inverse correlation between CD4+ T-cell ATP levels and EBV loads. CONCLUSIONS: Evaluation of global and EBV-specific T-cell immunity provides a rapid assessment of patients' immune competence. It is still unclear whether selective oversuppressed ATP release by CD4+ T cells reflects HVL patients at risk of posttransplant lymphoproliferative disease. Further longitudinal studies will determine the importance of Immuknow test in identifying asymptomatic HVL patients vulnerable to EBV complications.
Authors: A Zeevi; S Husain; K J Spichty; K Raza; J B Woodcock; D Zaldonis; L M Carruth; R J Kowalski; J A Britz; K R McCurry Journal: Am J Transplant Date: 2007-02 Impact factor: 8.086
Authors: Timothy C Lee; Barbara Savoldo; Neal R Barshes; Cliona M Rooney; Helen E Heslop; Adrian P Gee; Yvette Caldwell; Jaymee D Scott; John A Goss Journal: Clin Transplant Date: 2006 May-Jun Impact factor: 2.863
Authors: Richard J Kowalski; Diane R Post; Roslyn B Mannon; Anthony Sebastian; Harlan I Wright; Gary Sigle; James Burdick; Kareem Abu Elmagd; Adriana Zeevi; Mayra Lopez-Cepero; John A Daller; H Albin Gritsch; Elaine F Reed; Johann Jonsson; Douglas Hawkins; Judith A Britz Journal: Transplantation Date: 2006-09-15 Impact factor: 4.939
Authors: Steven A Webber; David C Naftel; F Jay Fricker; Pamela Olesnevich; Elizabeth D Blume; Linda Addonizio; James K Kirklin; Charles E Canter Journal: Lancet Date: 2006-01-21 Impact factor: 79.321
Authors: Timothy C Lee; John A Goss; Cliona M Rooney; Helen E Heslop; Neal R Barshes; Yvette M Caldwell; Adrian P Gee; Jaymee D Scott; Barbara Savoldo Journal: Clin Transplant Date: 2006 Nov-Dec Impact factor: 2.863
Authors: Camila Macedo; Steven A Webber; Albert D Donnenberg; Iulia Popescu; Yun Hua; Michael Green; David Rowe; Louise Smith; Maria M Brooks; Diana Metes Journal: J Immunol Date: 2011-04-01 Impact factor: 5.422