1. Pre-transplant assessment of pp65-specific CD4 T cell responses identifies CMV-seropositive patients treated with rATG at risk of late onset infection.
- Author
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López-Oliva, Maria O., Martínez, Virginia, Rodríguez-Sanz, Aranzazu, Álvarez, Laura, Santana, M. José, Selgas, Rafael, Jiménez, Carlos, and Bellón, Teresa
- Subjects
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T cells , *CYTOMEGALOVIRUS diseases , *KIDNEY transplantation , *TRANSPLANTATION of organs, tissues, etc. , *RECEIVER operating characteristic curves , *BK virus - Abstract
Assessment of CMV-specific T cell immunity might be a useful tool in predicting CMV infection after solid organ transplantation. We have investigated CD4 and CD8 T-cell responses to CMV pp65 and IE-1 antigens in a prospective study of 28 CMV-seropositive kidney transplant recipients who were administered lymphocyte-depleting antibodies (Thymoglobulin®) as induction treatment and with universal prophylaxis for CMV infection. The response was analyzed by intracellular flow cytometry analysis of IFN-γ production in pretransplant samples and at 1, 6, 12 and 24 months post-transplant. Overall, only pretransplant CD4 T-cell responses to pp65 were significantly lower (p =.004) in patients with CMV replication post-transplant. ROC curve analysis showed that pre-transplant frequencies of pp65-specific CD4 + T cells below 0.10% could predict CMV infection with 75% sensitivity and 83.33% specificity (AUC: 0.847; 95% CI: 0.693–1.001; p =.0054) and seem to be mandatory for efficient control of CMV viral replication by the host immune system. In conclusion, the functional assessment of CMV-specific CD4 T-cell immunity pretransplant in seropositive patients may allow the identification of Thymoglobulin®-treated kidney transplant recipients at risk of developing CMV infection post-transplantation. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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