Clinical Correlation of Cytomegalovirus Infection With CMV-specific CD8+ T-cell Immune Competence Score and Lymphocyte Subsets in Solid Organ Transplant Recipients
| Autor: | Roshini S. Abraham, Raymund R. Razonable, Atibordee Meesing |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty T cell Cytomegalovirus CD8-Positive T-Lymphocytes 030230 surgery Gastroenterology 03 medical and health sciences 0302 clinical medicine Immune system Interquartile range Internal medicine medicine Humans Cytotoxic T cell Transplantation Lung business.industry virus diseases Organ Transplantation Middle Aged Lymphocyte Subsets medicine.anatomical_structure Cytomegalovirus Infections Female 030211 gastroenterology & hepatology Histopathology Immunocompetence business CD8 |
| Zdroj: | Transplantation. 103:832-838 |
| ISSN: | 0041-1337 |
| Popis: | BACKGROUND Control of cytomegalovirus (CMV) infection after solid organ transplantation (SOT) requires a functional immune system. We assessed the association between quantitation and function of CMV-specific CD8+ T cells and CMV infection in SOT recipients. METHODS During a 10-year period, selected kidney, heart, lung, pancreas, liver, and composite tissue recipients were tested for CMV-specific CD8+ T cells immune competence (CMV-CD8+), as measured by enumeration, interferon-gamma production, and CD107a/b degranulation. Quantitative and functional data were used to assemble T-cell immune competence (TIC) score. CMV infection was diagnosed by polymerase chain reaction in blood and other samples or histopathology. RESULTS Of 130 patients tested, 59 had CMV infection or disease. The median onset to CMV infection was 10.5 months (interquartile range [IQR], 5.5-18.7). Gastrointestinal disease (28.8%), pneumonia (20.3%), and CMV syndrome (17%) were most common presentation. An impaired nonspecific or CMV-CD8+ TIC score was associated with tissue-invasive disease (hazard risk, 2.84, 95% confidence interval, 1.03-11.81; P = 0.04). Patients with impaired CMV-CD8+ TIC score had longer viremia duration (42.4 days vs 18.8 d; P < 0.001). Patients with impaired nonspecific or CMV-CD8+ TIC score had higher risk of relapse (68.8% vs 27.9%; hazard risk, 2.56; 95% confidence interval, 1.09-5.89; P = 0.03). Patients with CMV infection or disease had lower median absolute lymphocyte count (380 [IQR, 240-540] vs 940 [IQR, 551-1210] cells/mm; P < 0.0001) and CD4+ T cell count (29 cells/mm [IQR, 1.3-116.0] vs 325.5 cells/mm [IQR, 151.5-589.8]; P < 0.0001). CONCLUSIONS Nonspecific and CMV-specific CD8+ T-cell function correlated with the course of CMV after SOT, and measuring these has the potential to assist in its clinical management. |
| Databáze: | OpenAIRE |
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