| Autor: |
Higdon, L. E., Trofe‐Clark, J., Liu, S., Margulies, K. B., Sahoo, M. K., Blumberg, E., Pinsky, B. A., Maltzman, J. S. |
| Zdroj: |
American Journal of Transplantation; August 2017, Vol. 17 Issue: 8 p2045-2054, 10p |
| Abstrakt: |
Cytomegalovirus (CMV) is a major cause of morbidity and mortality in solid organ transplant recipients. Approximately 60% of adults are CMVseropositive, indicating previous exposure. Following resolution of the primary infection, CMVremains in a latent state. Reactivation is controlled by memory T cells in healthy individuals; transplant recipients have reduced memory T cell function due to chronic immunosuppressive therapies. In this study, CD8+T cell responses to CMVpolypeptides immediate‐early‐1 and pp65 were analyzed in 16 CMV‐seropositive kidney and heart transplant recipients longitudinally pretransplantation and posttransplantation. All patients received standard of care maintenance immunosuppression, antiviral prophylaxis, and CMVviral load monitoring, with approximately half receiving T cell–depleting induction therapy. The frequency of CMV‐responsive CD8+T cells, defined by the production of effector molecules in response to CMVpeptides, increased during the course of 1 year posttransplantation. The increase commenced after the completion of antiviral prophylaxis, and these T cells tended to be terminally differentiated effector cells. Based on this small cohort, these data suggest that even in the absence of disease, antigenic exposure may continually shape the CMV‐responsive T cell population posttransplantation. The proportion of polyfunctional CD8+T cells identified by in vitrostimulation with cytomegalovirus peptides increases during the first year following heart or kidney transplantation, despite the absence of clinically appreciated viremia. |
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