Prospective Assessment of Cytomegalovirus Immunity in High-Risk Donor-Seropositive/Recipient-Seronegative Liver Transplant Recipients Receiving Either Preemptive Therapy or Antiviral Prophylaxis
| Autor: | Nina Singh, Bradley C. Edmison, Adam P. Geballe, Sam Chatterton-Kirchmeier, Ajit P. Limaye, Terry Stevens-Ayers, Michael Boeckh, Margaret L. Green |
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| Rok vydání: | 2019 |
| Předmět: |
CD4-Positive T-Lymphocytes
Male medicine.medical_specialty medicine.medical_treatment Congenital cytomegalovirus infection Cytomegalovirus Pilot Projects CD8-Positive T-Lymphocytes Liver transplantation Antiviral Agents Drug Administration Schedule Organ transplantation Immediate early protein Cell Line Major Articles and Brief Reports Immune system Risk Factors Transplantation Immunology medicine Humans Immunology and Allergy Prospective Studies Neutralizing antibody biology business.industry Immunity Epithelial Cells Middle Aged medicine.disease Tissue Donors Transplant Recipients Liver Transplantation Transplantation Infectious Diseases Cytomegalovirus Infections Immunology biology.protein Cytokines Female business CD8 |
| Zdroj: | J Infect Dis |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | The differential impact of preemptive therapy (PET) and antiviral prophylaxis (AP) on development of cytomegalovirus (CMV)–specific neutralizing antibody (nAb) and T-cell responses have not previously been directly compared in high-risk donor-seropositive/recipient-seronegative (D+R−) organ transplant recipients. We prospectively assessed T-cell and nAb responses 3 months after transplantation in cohorts of high-risk D+R− liver transplant recipients who received either PET (n = 15) or AP (n = 25) and a control group of CMV-seropositive transplant recipients (R+) (AP; n = 24). CMV phosphoprotein 65 (pp65)– and immediate early protein 1–specific multifunctional T-cell responses were determined by means of intracellular cytokine staining and nAbs against BADrUL131-Y4 CMV in adult retinal pigment epithelial cell line-19 human epithelial cells; nAbs were detected in 8 of 12 (67%) in the PET group, none of 17 in the AP group, and 20 of 22 (91%) in the R+ group. Multifunctional CD8 and CD4 T-cell responses to pp65 were generally similar between PET and R+ groups, and lower for the AP group; multifunctional CD4 responses were similar across all groups. Among D+R− liver transplant recipients, PET was associated with the development of greater nAb and multifunctional CD8 T-cell responses compared with AP, providing a potential mechanism to explain the relative protection against late-onset disease with PET. Future studies are needed to define specific immune parameters predictive of late-onset CMV disease with AP. |
| Databáze: | OpenAIRE |
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