Section of Microbiology, Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, 40138 Bologna, Italy.
Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy.
Viruses. 2021 May 1;13(5):816. doi: 10.3390/v13050816.
Cytomegalovirus-specific cell-mediated immunity (CMV-CMI) in actively infected healthy immunocompetent hosts has been poorly investigated. Conversely, correlates of maternal protective immunity for the fetus after primary infection in pregnancy continue to be studied. The kinetics and magnitude of CMV-specific CMI in immunocompetent primary CMV-infected adults are described. A literature review on CMV-CMI in primarily infected pregnant women and its correlation to the risk of vertical virus transmission is included. Immunological measurements after infection were performed by enzyme-linked ImmunoSPOT assay enumerating IFN-γ secreting CMV-specific T cells, at a single cell level, upon in vitro stimulation with viral antigens. Simultaneously, serological and virological profiles of infected patients were investigated. Patients displayed mild-to-moderate clinical and laboratory profiles for infection, and all showed positive EliSpot results in the early stage of infection (<20 days after onset). The virus-CMI was strong in the majority of patients (58.8%) in which the lowest CMV-DNAemia levels (<300 copies/mL) were detected. Significantly higher viral loads were observed in patients with weak CMV-CMI at the same time-point post-infection (up to 15,104 copies/mL; < 0.001). T cell response magnitudes to IE-1 and pp65-UL83 peptides were overlapping and stable over time. In these case series, the early presence of CMV-CMI was probably pivotal in controlling viral replication and led to spontaneous viral clearance.
巨细胞病毒特异性细胞介导免疫(CMV-CMI)在活动性感染的健康免疫宿主中研究甚少。相反,母体在妊娠期间初次感染后对胎儿的保护性免疫相关因素仍在研究中。本研究描述了初次感染巨细胞病毒的免疫功能正常的成年人中 CMV 特异性 CMI 的动力学和幅度。文中纳入了关于初次感染孕妇的 CMV-CMI 及其与垂直病毒传播风险相关性的文献综述。感染后通过酶联免疫斑点试验(ELISPOT)进行免疫测定,该试验在体外用病毒抗原刺激时,以单细胞水平计数分泌 IFN-γ的 CMV 特异性 T 细胞。同时,还对感染患者的血清学和病毒学特征进行了研究。患者表现出感染的轻度至中度临床和实验室特征,所有患者在感染早期(发病后<20 天)均显示出阳性的 EliSpot 结果。在大多数患者(58.8%)中,病毒-CMI 较强,在同一时间点检测到的 CMV-DNA 血症水平较低(<300 拷贝/mL;<0.001)。在同一时间点,CMV-CMI 较弱的患者中观察到显著更高的病毒载量(高达 15,104 拷贝/mL)。IE-1 和 pp65-UL83 肽的 T 细胞反应幅度重叠且随时间稳定。在这些病例系列中,CMV-CMI 的早期存在可能对控制病毒复制至关重要,并导致病毒的自发清除。
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