Cecilia Martín-Gandul1,2, Pilar Pérez-Romero1,2, Damián Mena-Romo1,2, Alejandro Molina-Ortega1,2, Francisco M González-Roncero3, Marta Suñer3, Gabriel Bernal3, Elisa Cordero1,2. 1. Clinical Unit of Infectious Diseases, Microbiology and Medicine Preventive, Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain. 2. Spanish Network for Research in Infectious Diseases (REIPI RD12/0015/0001; RD12/0015/0012; RD16/0016/0009), Instituto de Salud Carlos III, Madrid, Spain. 3. Clinical Unit of Nephro-Urology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Abstract
BACKGROUND: Some studies have suggested that rATG treatment may be associated with an increased incidence of CMV infection and delayed CMV immune response. However, the evidences supporting this matter are scarce. This study aims to characterize the kinetic of the CMV-specific T-cell immune response before and after rATG induction therapy and the relationship with the development of CMV infection in CMV-seropositive kidney transplant recipients. METHODS: An observational prospective study of CMV-seropositive kidney transplant patients that received rATG induction therapy was performed. A pretransplant sample was obtained before the surgery to determine the CMV-specific immunity. CMV viral load (by PCR) and CMV-specific T-cell immune response (by flow cytometry) were determined during the follow-up at 0.5, 1, 2, 3, 6, and 12 months post transplantation. RESULTS: A total of 23 patients were included in the study. CMV prophylaxis was administrated for a media of 90 days after transplantation. At the end of follow-up, 18 (78.3%) patients had CMV-specific immunity with a median value of 0.31% CD8+ CD69+ INF-γ+ T cells at a median of 16 weeks post transplantation. Five patients never acquired CMV-specific immunity. No statistically significant association between CMV infection and CMV-specific T-cell immune response (P = .086) was observed. However, patients with positive pretransplant CMV-specific immunity developed earlier immunity and achieved higher levels of CD8+ CD69+ INF-γ+ T-cell post-transplantation than patients with negative pretransplant immunity. CONCLUSIONS: CMV-specific immune monitoring in addition to CMV-serology may be useful to stratify patient's risk of CMV infection before transplantation.
BACKGROUND: Some studies have suggested that rATG treatment may be associated with an increased incidence of CMV infection and delayed CMV immune response. However, the evidences supporting this matter are scarce. This study aims to characterize the kinetic of the CMV-specific T-cell immune response before and after rATG induction therapy and the relationship with the development of CMV infection in CMV-seropositive kidney transplant recipients. METHODS: An observational prospective study of CMV-seropositive kidney transplant patients that received rATG induction therapy was performed. A pretransplant sample was obtained before the surgery to determine the CMV-specific immunity. CMV viral load (by PCR) and CMV-specific T-cell immune response (by flow cytometry) were determined during the follow-up at 0.5, 1, 2, 3, 6, and 12 months post transplantation. RESULTS: A total of 23 patients were included in the study. CMV prophylaxis was administrated for a media of 90 days after transplantation. At the end of follow-up, 18 (78.3%) patients had CMV-specific immunity with a median value of 0.31% CD8+ CD69+ INF-γ+ T cells at a median of 16 weeks post transplantation. Five patients never acquired CMV-specific immunity. No statistically significant association between CMV infection and CMV-specific T-cell immune response (P = .086) was observed. However, patients with positive pretransplant CMV-specific immunity developed earlier immunity and achieved higher levels of CD8+ CD69+ INF-γ+ T-cell post-transplantation than patients with negative pretransplant immunity. CONCLUSIONS: CMV-specific immune monitoring in addition to CMV-serology may be useful to stratify patient's risk of CMV infection before transplantation.
Authors: Lauren E Higdon; Steven Schaffert; Huang Huang; Maria E Montez-Rath; Marc Lucia; Alokkumar Jha; Naresha Saligrama; Kenneth B Margulies; Olivia M Martinez; Mark M Davis; Purvesh Khatri; Jonathan S Maltzman Journal: J Immunol Date: 2021-09-22 Impact factor: 5.426
Authors: Lauren E Higdon; Steven Schaffert; Rachel H Cohen; Maria E Montez-Rath; Marc Lucia; Naresha Saligrama; Kenneth B Margulies; Olivia M Martinez; Jane C Tan; Mark M Davis; Purvesh Khatri; Jonathan S Maltzman Journal: J Immunol Date: 2021-09-22 Impact factor: 5.426
Authors: Lauren E Higdon; Ayah A Ahmad; Steven Schaffert; Kenneth B Margulies; Jonathan S Maltzman Journal: Front Immunol Date: 2022-06-28 Impact factor: 8.786
Authors: Lauren E Higdon; Claire E Gustafson; Xuhuai Ji; Malaya K Sahoo; Benjamin A Pinsky; Kenneth B Margulies; Holden T Maecker; Jorg Goronzy; Jonathan S Maltzman Journal: Front Immunol Date: 2021-05-27 Impact factor: 7.561