Carbone Javier, Lanio Nallibe, Gallego Antonio, Sarmiento Elizabeth
Immunology Department, Clinical Immunology Unit, Transplant Immunology Group, University Hospital Gregorio Marañon, Dr. Esquerdo 46, Madrid, Spain.
Curr Drug Saf. 2008 May;3(2):91-9. doi: 10.2174/157488608784529260.
Infections are relevant complications that cause morbidity in solid organ transplantation and autoimmune diseases. Infection represents a leading single cause of death in these patients. Identification of patients at risk for development of infections and specific intervention to decrease infection risk might lead to better outcomes, though one needs first to evaluate the presence of risk factors for infection. Underlying disease itself, activity of the disease, presence of co-morbidities, transplantation procedures along with immunosuppressive and immunomodulatory therapies may be associated with an increased risk of infections. Among host factors, there are no reliable immunological markers to predict infections. Immune monitoring (assessment of immunocompetence) to estimate the risk of infection has so far not been performed routinely, with the only exception of neutrophil counts, tuberculin skin testing and serological evaluation of donor and recipients of transplants for anti-cytomegalovirus IgG antibodies. However, alterations of specific and non specific humoral and cellular immunity may be associated with a higher risk of infection among immunosuppressed patients. We review studies that have been designed to assess immune monitoring for prediction of infections in patients with selected solid organ transplantations and systemic autoimmune diseases.
感染是实体器官移植和自身免疫性疾病中导致发病的相关并发症。感染是这些患者死亡的首要单一原因。识别有感染风险的患者并采取特定干预措施以降低感染风险可能会带来更好的结果，不过首先需要评估感染风险因素的存在情况。基础疾病本身、疾病活动度、合并症的存在、移植手术以及免疫抑制和免疫调节治疗可能与感染风险增加有关。在宿主因素中，尚无可靠的免疫标志物来预测感染。迄今为止，除了中性粒细胞计数、结核菌素皮肤试验以及对移植供体和受体进行抗巨细胞病毒IgG抗体的血清学评估外，尚未常规进行用于评估感染风险的免疫监测（免疫能力评估）。然而，特异性和非特异性体液及细胞免疫的改变可能与免疫抑制患者较高的感染风险相关。我们回顾了旨在评估免疫监测以预测特定实体器官移植和系统性自身免疫性疾病患者感染情况的研究。
