Bae Seongman, Jung Jiwon, Kim Sun-Mi, Kang Young-Ah, Lee Young-Shin, Chong Yong Pil, Sung Heungsup, Lee Sang-Oh, Choi Sang-Ho, Kim Yang Soo, Woo Jun Hee, Lee Jung-Hee, Lee Je-Hwan, Lee Kyoo-Hyung, Kim Sung-Han
Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Ulsan University Hospital, Ulsan 44033, Korea.
Immune Netw. 2018 Jan 22;18(2):e2. doi: 10.4110/in.2018.18.e2. eCollection 2018 Apr.
The detailed kinetics of the cytomegalovirus (CMV)-specific T cell response in hematopoietic stem cell transplant (HCT) recipients have not yet been fully assessed. We evaluated these kinetics of CMV-specific T cell response and factors associated with high CMV-specific T cell responses 1 year after HCT. In HCT recipients, CMV pp65 and IE1-specific ELISPOT assay were performed before HCT (D0), and at 30 (D30), 90 (D90), 180 (D180), and 360 (D360) days after HCT. Of the 51 HCT recipients with donor-positive (D)/recipient-positive (R) serology, 26 (51%) developed CMV infections after HCT. The patterns of post-transplantation reconstitution for CMV-specific T cell response were classified into 4 types: 1) an initial decrease at D30 followed by gradual T cell reconstitution without CMV infection (35%), 2) an initial decrease at D30 followed by gradual T cell reconstitution preceded by CMV infection (35%), 3) failure of gradual or constant T cell reconstitution (26%), and 4) no significant T cell reconstitution (4%). There was no significant difference between ELISPOT counts of D360 and those of D0. High CMV-specific T cell responses at D360 were not associated with high CMV-specific T cell response at D0, CMV infection, ganciclovir therapy, graft versus host disease (GVHD), and immunosuppressant use. In conclusion, there are 4 distinct patterns of reconstitution of the CMV-specific T cell response after HCT. In addition, reconstituted donor-origin CMV-specific T cell responses appeared to be constant until day 360 after HCT, regardless of the level of the pre-transplant CMV-specific T cell response, CMV infection, and immunosuppressant use.
造血干细胞移植（HCT）受者中巨细胞病毒（CMV）特异性T细胞反应的详细动力学尚未得到充分评估。我们评估了HCT后1年CMV特异性T细胞反应的这些动力学以及与高CMV特异性T细胞反应相关的因素。在HCT受者中，于HCT前（D0）以及HCT后30天（D30）、90天（D90）、180天（D180）和360天（D360）进行CMV pp65和IE1特异性ELISPOT检测。在51例供体阳性（D）/受者阳性（R）血清学的HCT受者中，26例（51%）在HCT后发生了CMV感染。移植后CMV特异性T细胞反应的重建模式分为4种类型：1）D30时初始下降，随后在无CMV感染的情况下T细胞逐渐重建（35%），2）D30时初始下降，随后在CMV感染之前T细胞逐渐重建（35%），3）T细胞逐渐或持续重建失败（26%），4）无明显T细胞重建（4%）。D360时的ELISPOT计数与D0时的计数之间无显著差异。D360时高CMV特异性T细胞反应与D0时高CMV特异性T细胞反应、CMV感染、更昔洛韦治疗、移植物抗宿主病（GVHD）及免疫抑制剂使用均无关。总之，HCT后CMV特异性T细胞反应有4种不同的重建模式。此外，重建的供体来源CMV特异性T细胞反应在HCT后360天之前似乎保持稳定，与移植前CMV特异性T细胞反应水平、CMV感染及免疫抑制剂使用无关。
