BK Polyomavirus-specific T cell immune responses in kidney transplant recipients diagnosed with BK Polyomavirus-associated nephropathy

Autor: Chompunut Klinmalai, Nopporn Apiwattanakul, Suradej Hongeng, Subencha Pinsai, Jackrapong Bruminhent, Surasak Kantachuvesiri, Supranart Srisala, Siriorn P. Watcharananan
Rok vydání: 2019
Předmět:
CD4-Positive T-Lymphocytes
Graft Rejection
Male
medicine.medical_treatment
BKPyV
CD8-Positive T-Lymphocytes
030230 surgery
Gastroenterology
0302 clinical medicine
Intracellular cytokine assay
Kidney transplantation
T cell immunity
Immunosuppression
Middle Aged
Infectious Diseases
medicine.anatomical_structure
Female
030211 gastroenterology & hepatology
Immunosuppressive Agents
Research Article
medicine.drug
Adult
medicine.medical_specialty
BKVAN
T cell
Tacrolimus
Mycophenolic acid
lcsh:Infectious and parasitic diseases
Nephropathy
Interferon-gamma
Viral Proteins
03 medical and health sciences
Immune system
Antigen
Internal medicine
medicine
Humans
Transplantation
Homologous
lcsh:RC109-216
Immune monitoring
BKPyVAN
Polyomavirus Infections
business.industry
medicine.disease
Kidney Transplantation
BK Virus
DNA
Viral
Nephritis
Interstitial
business
CD8
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-8 (2019)
BMC Infectious Diseases
ISSN: 1471-2334
DOI: 10.1186/s12879-019-4615-x
Popis: Background Adjustment of immunosuppression is the main therapy for BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) after kidney transplantation (KT). Studies of BKPyV-specific T cell immune response are scarce. Here, we investigated BKPyV-specific T cell immunity in KT recipients diagnosed with BKPyVAN. Methods All adult KT recipients with BKPyVAN diagnosed at our institution from January 2017 to April 2018 were included. Laboratory-developed intracellular cytokine assays measuring the percentage of IFN-γ-producing CD4+ and CD8+ T cells, after stimulation with large-T antigen (LT) and viral capsid protein 1 (VP1), were performed both at the time of diagnosis and after adjustment of immunosuppression. Results We included 12 KT recipients diagnosed with BKPyVAN (7 proven, 4 presumptive, and 1 possible). Those with presumptive BKPyVAN had a median plasma BKPyV DNA load of 5.9 log10 copies/ml (interquartile range [IQR]: 4.9–6.1). Adjusted dosing of mycophenolic acid and tacrolimus with (86%) or without (14%) adjunctive therapies were implemented after diagnosis. There was a significantly higher median percentage of IFN-γ-producing CD4+ T cells to LT at a median of 3 (IQR: 1–4) months after adjustment of immunosuppression compared with at the time of diagnosis (0.004 vs. 0.015; p = 0.047). However, the difference between the median percentage of IFN-γ-producing CD4+ T cells to VP1 and CD8+ T cells to LT and VP1 did not reach statistical significance. Four (33%) patients achieved plasma BKPyV DNA clearance, and the remaining eight (67%) patients had persistent BKPyV DNAemia. Although eight (67%) patients developed allograft dysfunction, none required hemodialysis. Conclusions We observed a marginal trend of BKPyV-specific CD4+ T cell recovery after adjustment of immunosuppression in KT recipients diagnosed with BKPyVAN. A further study would be benefited to confirm and better assess BKPyV-specific immune response after KT.
Databáze: OpenAIRE
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