Quantification of Torque Teno Virus Load to Monitor Short-term Changes in Immunosuppressive Therapy in Kidney Transplant Recipients.

Autor:	Benning L; Department of Nephrology, Heidelberg University, Heidelberg, Germany., Reineke M; Department of Nephrology, Heidelberg University, Heidelberg, Germany., Bundschuh C; Department of Infectious Diseases, Virology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany., Klein JAF; Department of Infectious Diseases, Virology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany., Kühn T; Department of Nephrology, Heidelberg University, Heidelberg, Germany., Zeier M; Department of Nephrology, Heidelberg University, Heidelberg, Germany., Bartenschlager R; Department of Nephrology, Heidelberg University, Heidelberg, Germany.; Department of Infectious Diseases, Virology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.; Department of Infectious Diseases, Molecular Virology, Center for Integrative Infectious Diseases Research, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.; Division Virus-Associated Carcinogenesis, German Cancer Research Center, Heidelberg, Germany.; German Center for Infection Research, DZIF, Heidelberg Partner Site, Heidelberg, Germany.; Department of Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory, Heidelberg, Germany., Schnitzler P; Department of Infectious Diseases, Virology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.; German Center for Infection Research, DZIF, Heidelberg Partner Site, Heidelberg, Germany., Morath C; Department of Nephrology, Heidelberg University, Heidelberg, Germany.; German Center for Infection Research, DZIF, Heidelberg Partner Site, Heidelberg, Germany., Speer C; Department of Nephrology, Heidelberg University, Heidelberg, Germany.; Department of Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory, Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Dec 01; Vol. 107 (12), pp. e363-e369. Date of Electronic Publication: 2023 Oct 06.
DOI:	10.1097/TP.0000000000004816
Abstrakt:	Background: Quantification of torque teno virus (TTV) has been proposed as a surrogate parameter to monitor immunocompetence in kidney transplant recipients (KTRs) early after transplantation. However, its use in monitoring short-term changes of immunosuppression in KTRs late after transplantation requires further investigation. Methods: In this post hoc analysis, we quantified TTV load in sera of 76 KTRs, with 43 pausing mycophenolic acid (MPA) 1 wk before to 4 wk after COVID-19 vaccination to increase vaccine response. TTV load was quantified before, 4 wk, and 3 mo postvaccination. Results were compared to 33 KTRs with continued standard immunosuppressive therapy and with 18 hemodialysis as well as 18 healthy control subjects. Results: TTV load before vaccination was with a median (interquartile range) of 1.39 × 10 4 copies/milliliter (c/mL) (9.17 × 10 1 -2.66 × 10 5 c/mL) highest in KTRs compared to 1.73 × 10 3 c/mL (1.07 × 10 3 -1.31 × 10 4 c/mL) in hemodialysis patients and 1.53 × 10 2 c/mL (6.38-1.29 × 10 3 c/mL) in healthy controls. In KTRs with MPA withdrawal, TTV load decreased significantly from a median (interquartile range) of 1.11 × 10 4 c/mL (4.75 × 10 2 -1.92 × 10 5 c/mL) to 5.24 × 10 3 c/mL (6.92 × 10 2 -6.91 × 10 4 c/mL) 4-5 wk after initiation of MPA withdrawal ( P = 0.003). In patients with MPA withdrawal, TTV load was significantly inversely correlated with COVID-19 or SARS-CoV-2-specific antibodies 4 wk and 3 mo postvaccination ( P = 0.009 and P = 0.004). Conclusions: TTV load reflects changes in immunosuppressive therapy even late after transplantation, supporting its use to monitor immunocompetence in KTRs. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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