Premium
Prospective Analysis of Human Cytomegalovirus DNAemia and Specific CD8+ T Cell Responses in Lung Transplant Recipients
Author(s) -
Weseslindtner L.,
Kerschner H.,
Steinacher D.,
Nachbagauer R.,
Kundi M.,
Jaksch P.,
Simon B.,
HatosAgyi L.,
Scheed A.,
Klepetko W.,
PuchhammerStöckl E.
Publication year - 2012
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2012.04076.x
Subject(s) - human cytomegalovirus , medicine , cd8 , immunology , cytotoxic t cell , virology , t cell , betaherpesvirinae , exact test , immune system , herpesviridae , viral disease , virus , biology , biochemistry , in vitro
In lung transplant recipients (LuTRs), human cytomegalovirus (HCMV) DNAemia may be associated with HCMV disease and reduced survival of the allograft. Because T cells are essential for controlling HCMV replication, we investigated in this prospective study whether the kinetics of plasma HCMV DNA loads in LuTRs are associated with HCMV‐specific CD8+ T cell responses, which were longitudinally assessed using a standardized assay. Sixty‐seven LuTRs were monitored during the first year posttransplantation, with a mean of 17 HCMV DNA PCR quantifications and 11.5 CD8+ T cell tests performed per patient. HCMV‐specific CD8+ T cell responses displayed variable kinetics in different patients, differed significantly before the onset of HCMV DNAemia in LuTRs who subsequently experienced episodes of DNAemia with high (>1000 copies/mL) and low plasma DNA levels (p = 0.0046, Fisher's exact test), and were absent before HCMV disease. In HCMV‐seropositive LuTRs, high‐level DNAemia requiring preemptive therapy occurred more frequently when HCMV‐specific CD8+ T cell responses fluctuated, were detected only after HCMV DNA detection, or remained undetectable (p = 0.0392, Fisher's exact test). Thus, our data indicate that HCMV‐specific CD8+ T cells influence the magnitude of HCMV DNAemia episodes, and we propose that a standardized measurement of CD8+ T cell immunity might contribute to monitoring the immune status of LuTRs posttransplantation.