Jacobson Mark A, Maecker Holden T, Orr Patricia L, D'Amico Ron, Van Natta Mark, Li Xiao-Dong, Pollard Richard B, Bredt Barry M
Positive Health Program, Department of Medicine, and San Francisco General Hospital General Clinical Research Center, University of California San Francisco, San Francisco, California, USA.
J Infect Dis. 2004 Apr 15;189(8):1362-73. doi: 10.1086/382964. Epub 2004 Mar 31.
To evaluate the potential clinical utility of a cytomegalovirus (CMV)-specific CD8+/interferon (IFN)- gamma+ cytokine flow cytometry (CFC) assay for patients with CMV retinitis (CMVR), stored peripheral blood mononuclear cell specimens were obtained from patients with active CMVR (i.e., having clinical evidence of absent CMV-protective immunity), as well as from highly active antiretroviral therapy-treated patients with CMVR who were able to discontinue anti-CMV therapy without subsequent progression of retinitis (i.e., having clinical evidence of restored CMV-protective immunity). Positive CD8+/IFN- gamma+ T lymphocyte responses to CMV phosphoprotein 65 or immediate early peptide-pool stimulation were present in specimens from only 3 of 10 patients with active CMVR but were present in at least 1 specimen from all 20 patients with immunorestored CMVR, with a mean of 2.4 specimens/patient tested, spanning up to 6 months of observation (P = .0001). Among the patients with immunorestored CMVR, positive responses were present in all longitudinal specimens from 15 of the 20 patients. These data suggest that further testing of the CMV-specific CD8+/IFN- gamma+ CFC assay, for clinical utility in predicting incident and progressive CMVR disease, is warranted.
为评估巨细胞病毒（CMV）特异性CD8⁺/干扰素（IFN）-γ⁺细胞因子流式细胞术（CFC）检测对CMV视网膜炎（CMVR）患者的潜在临床应用价值，我们获取了活动性CMVR患者（即无CMV保护性免疫临床证据者）以及接受高效抗逆转录病毒治疗且能停用抗CMV治疗而视网膜炎无后续进展（即有CMV保护性免疫恢复临床证据）的CMVR患者储存的外周血单个核细胞标本。仅10例活动性CMVR患者中的3例标本对CMV磷蛋白65或即刻早期肽池刺激有阳性CD8⁺/IFN-γ⁺T淋巴细胞反应，而所有20例免疫恢复的CMVR患者中至少有1例标本有阳性反应，平均每位患者检测2.4份标本，观察时间长达6个月（P = 0.0001）。在免疫恢复的CMVR患者中，20例患者中有15例的所有纵向标本均有阳性反应。这些数据表明，有必要进一步检测CMV特异性CD8⁺/IFN-γ⁺CFC检测在预测CMVR疾病发生和进展方面的临床应用价值。
