Rittà Massimo, Costa Cristina, Sidoti Francesca, Ballocco Cinzia, Ranghino Andrea, Messina Maria, Biancone Luigi, Cavallo Rossana
S.C. Microbiologia e Virologia U, University Hospital "Città della Salute e della Scienza di Torino", Italy;
Department of Public Health and Pediatrics, University of Turin, Italy;
New Microbiol. 2015 Jul;38(3):329-35. Epub 2015 Jul 6.
Cytomegalovirus (CMV) primary infection or re-activation in solid organ transplant (SOT) recipients is associated with increased morbidity and mortality, with patients with IgG-CMV D+/R- sero-matching at greater risk. The impact of pre-transplant CMV-specific host cellular immunity on the long-term risk of CMV replication in kidney transplants (KT) was prospectively evaluated in eighty patients by CMV-EliSpot assay. The study population included 54 male and 26 female recipients, with CMV-IgG distribution: 60 D+/R+, 11 D-/R+, 7 D+/R-, 2 D-/R-. At pre-transplantation, 49 KT (61.3%) were CMV-responders by EliSpot. At 3-month follow up, 16 (32.7%) out of 49 CMV-responders showed CMV blood infection, compared to 8 (25.8%) out of 31 non-responders. No further episode of CMV viraemia was reported in the responder group, in comparison to 15 out 31 non-responders (48.4%) showing at least one episode of CMV-DNAemia at 12-month follow-up. Baseline CMV-IgG serology showed a strong correlation with EliSpot determinations; KT recipients exhibiting at least one episode of CMV viraemia at 12-month follow-up showed lower baseline CMV-EliSpot values than those without signs of CMV replication. The study suggests that monitoring CMV-specific T-cell responses at pre-transplantation by EliSpot assay may be useful for predicting the post-transplantation risk of CMV infection and reactivation.
巨细胞病毒（CMV）在实体器官移植（SOT）受者中的初次感染或再激活与发病率和死亡率增加相关，IgG-CMV D+/R-血清匹配的患者风险更高。通过CMV-EliSpot试验对80例患者前瞻性评估了移植前CMV特异性宿主细胞免疫对肾移植（KT）中CMV复制长期风险的影响。研究人群包括54名男性和26名女性受者，CMV-IgG分布情况为：60例D+/R+，11例D-/R+，7例D+/R-，2例D-/R-。移植前，通过EliSpot检测，49例KT（61.3%）为CMV反应者。在3个月的随访中，49例CMV反应者中有16例（32.7%）出现CMV血液感染，相比之下，31例非反应者中有8例（25.8%）出现感染。反应者组未报告进一步的CMV病毒血症发作，而31例非反应者中有15例（48.4%）在12个月随访时至少出现一次CMV-DNA血症。基线CMV-IgG血清学与EliSpot检测结果显示出强烈相关性；在12个月随访时出现至少一次CMV病毒血症的KT受者，其基线CMV-EliSpot值低于无CMV复制迹象的受者。该研究表明，通过EliSpot试验在移植前监测CMV特异性T细胞反应可能有助于预测移植后CMV感染和再激活的风险。
