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巨细胞病毒(CMV)定量检测在肾移植后巨细胞病毒感染预测中的应用

Quantiferon-CMV test in prediction of cytomegalovirus infection after kidney transplantation.

作者信息

Lochmanova A, Lochman I, Tomaskova H, Marsalkova P, Raszka J, Mrazek J, Dedochova J, Martinek A, Brozmanova H, Grundmann M

机构信息

Department of Immunology and Allergy, Institute of Public Health, Partyzanske nam. 7, Ostrava 702 00, Czech Republic.

出版信息

Transplant Proc. 2010 Nov;42(9):3574-7. doi: 10.1016/j.transproceed.2010.07.101.

Abstract

Infection with cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunosuppressed patients, including organ and bone marrow transplant recipients. The majority of CMV disease is caused by reactivation of alatent infection rather that by newly acquired virus. Many techniques have been currently available to aid in the diagnostics of CMV disease. In this report we performed a prospective evaluation of Quantiferon-CMV assay (Cellestis) to determine whether the test is predictive of CMV disease. CD8+ T-cell CMV-specific immunity was assessed in a longitudinal cohort of 14 kidney transplant recipients. According to our data, subjects with higher cellular immune response measured with Quantiferon test had a lower risk of manifestation of CMV infection than subjects with lower responses. Despite the small number of patients and large intra- and interindividual variability of the data in the study, we observed the Quantiferon-CMV assay to be a sensitive specific test to detect a virus-specific T-cell response. We propose that this assay in combination with viral DNA load estimates may prove to be useful to stratify patients at risk of CMV disease.

摘要

巨细胞病毒(CMV)感染是免疫抑制患者发病和死亡的主要原因,这些患者包括器官移植受者和骨髓移植受者。大多数CMV疾病是由潜伏感染的重新激活引起的,而非新获得的病毒所致。目前已有许多技术可用于辅助诊断CMV疾病。在本报告中,我们对全血γ干扰素释放试验(Quantiferon-CMV检测,Cellestis公司)进行了前瞻性评估,以确定该检测是否能预测CMV疾病。我们在一个由14名肾移植受者组成的纵向队列中评估了CD8+ T细胞的CMV特异性免疫。根据我们的数据,与细胞免疫反应较低的受试者相比,通过全血γ干扰素释放试验测得细胞免疫反应较高的受试者出现CMV感染的风险较低。尽管本研究中的患者数量较少,且数据在个体内和个体间存在较大变异性,但我们观察到全血γ干扰素释放试验是一种检测病毒特异性T细胞反应的敏感且特异的检测方法。我们提出,该检测方法与病毒DNA载量估计相结合,可能被证明有助于对有CMV疾病风险的患者进行分层。

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