Lilleri Daniele, Gerna Giuseppe, Bruno Francesca, Draghi Paola, Gabanti Elisa, Fornara Chiara, Meloni Federica
Laboratori Sperimentali di Ricerca, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
New Microbiol. 2013 Jul;36(3):267-77. Epub 2013 Jun 30.
It is debated whether human cytomegalovirus (HCMV) infection/disease of the pulmonary compartment in lung transplant recipients (LTRs) may be controlled by the HCMV-specific systemic T-cell response or requires a local (lung) T-cell response. Systemic and local HCMV loads were investigated in parallel by real-time PCR in 20 LTRs. T-cell responses were measured by intracellular cytokine staining of HCMV-specific IFN-? + CD4+ and CD8+ T-cells in PBMC, and by enzyme-linked immunospot (ELISpot) assay in lung (BAL) mononuclear cells. Patients were grouped at time of peak of infection based on viral load in blood and BAL. Immunological testing results showed that five patients with no HCMV infection (either local or systemic) had both local and systemic T-cell responses; four patients with systemic infection had no systemic T-cell response; five patients with both systemic and lung infection had neither local nor systemic T-cell responses; and six patients with lung infection had no local and a partial (only CD8+ in the absence of CD4+) systemic T-cell response. These results indicate that local immunity is associated with resolution of lung infection. Systemic T-cell response alone is not sufficient to provide lung protection from HCMV infection.
肺移植受者（LTRs）肺部的人巨细胞病毒（HCMV）感染/疾病是由HCMV特异性全身T细胞反应控制，还是需要局部（肺部）T细胞反应，目前仍存在争议。通过实时PCR对20例LTRs的全身和局部HCMV载量进行了平行研究。通过对PBMC中HCMV特异性IFN-γ + CD4+和CD8+ T细胞进行细胞内细胞因子染色，以及对肺（BAL）单核细胞进行酶联免疫斑点（ELISpot）分析来测量T细胞反应。根据血液和BAL中的病毒载量，在感染高峰期对患者进行分组。免疫检测结果显示，5例无HCMV感染（局部或全身）的患者同时具有局部和全身T细胞反应；4例全身感染患者无全身T细胞反应；5例全身和肺部感染患者既无局部也无全身T细胞反应；6例肺部感染患者无局部T细胞反应，仅有部分（仅CD8+，无CD4+）全身T细胞反应。这些结果表明，局部免疫与肺部感染的消退有关。仅全身T细胞反应不足以保护肺部免受HCMV感染。
