Department of Pneumology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Institute of Virology, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Transplantation. 2019 Apr;103(4):815-822. doi: 10.1097/TP.0000000000002436.
Lung transplantation is the only therapeutic option in end-stage lung diseases; however, survival after transplantation is limited by acute and chronic rejection or infectious events being results of inappropriate immunosuppression. Torque Teno Viruses (TTVs) are ubiquitous DNA viruses in humans but not found to be causative for any disease. However, some reports suggest that TTV-DNA levels reflect the grade of immunosuppression with higher levels being found in more immunosuppressed individuals.
We investigated the TTV-DNA levels in 34 lung transplant recipients within their first year after transplantation by quantitative real-time polymerase chain reaction. Clinical data were extracted from charts.
In accordance with previous results TTV-DNA levels increase after lung transplantation reaching a steady state after 3 months. The TTV-DNA levels were not correlated with immunosuppressive trough levels and a selective increase was not observed with other DNA viruses. In steady state TTV-DNA levels were significantly higher in patients with infectious complications compared to the group of patients without. Additionally, TTV-DNA levels decreased significantly before biopsy-proven rejection. Sensitivity of a 10-fold decrease in TTV-DNA levels for a subsequent rejection episode was 0.74 with a specificity of 0.99.
In summary, TTV-DNA might be used as an additional tool to monitor immunosuppression in lung transplant recipients. Higher TTV-DNA levels reflect more intense immunosuppression, whereas the TTV-DNA kinetic (ie, decrease of TTV-DNA levels) indicate rejection.
肺移植是终末期肺部疾病的唯一治疗选择；然而，移植后的存活率受到急性和慢性排斥反应或感染事件的限制，这些是由于免疫抑制不当造成的。Torque Teno 病毒（TTVs）是人类普遍存在的 DNA 病毒，但尚未发现其与任何疾病有关。然而，一些报告表明，TTV-DNA 水平反映了免疫抑制的程度，免疫抑制程度越高的个体中发现的 TTV-DNA 水平越高。
我们通过定量实时聚合酶链反应（PCR）在肺移植后一年内的 34 名肺移植受者中检测 TTV-DNA 水平。从图表中提取临床数据。
与先前的结果一致，TTV-DNA 水平在肺移植后增加，3 个月后达到稳定状态。TTV-DNA 水平与免疫抑制谷值水平无关，并且未观察到其他 DNA 病毒的选择性增加。在稳定状态下，与无感染并发症的患者相比，患有感染性并发症的患者的 TTV-DNA 水平明显更高。此外，在活检证实排斥反应之前，TTV-DNA 水平显著下降。TTV-DNA 水平降低 10 倍对随后排斥事件的敏感性为 0.74，特异性为 0.99。
总之，TTV-DNA 可作为监测肺移植受者免疫抑制的附加工具。较高的 TTV-DNA 水平反映了更强的免疫抑制，而 TTV-DNA 动力学（即 TTV-DNA 水平的降低）则表明排斥反应。
