肾移植受者巨细胞病毒血症后基因表达的急性和慢性变化。
Acute and Chronic Changes in Gene Expression After CMV DNAemia in Kidney Transplant Recipients.
机构信息
Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, CA, United States.
Institute for Quantitative and Computational Biosciences, University of California Los Angeles, Los Angeles, CA, United States.
出版信息
Front Immunol. 2021 Nov 15;12:750659. doi: 10.3389/fimmu.2021.750659. eCollection 2021.
Cytomegalovirus (CMV) viremia continues to cause significant morbidity and mortality in kidney transplant patients with clinical complications including organ rejection and death. Whole blood gene expression dynamics in CMV viremic patients from onset of DNAemia through convalescence has not been well studied to date in humans. To evaluate how CMV infection impacts whole blood leukocyte gene expression over time, we evaluated a matched cohort of 62 kidney transplant recipients with and without CMV DNAemia using blood samples collected at multiple time points during the 12-month period after transplant. While transcriptomic differences were minimal at baseline between DNAemic and non-DNAemic patients, hundreds of genes were differentially expressed at the long-term timepoint, including genes enriching for pathways important for macrophages, interferon, and IL-8 signaling. Amongst patients with CMV DNAemia, the greatest amount of transcriptomic change occurred between baseline and 1-week post-DNAemia, with increase in pathways for interferon signaling and cytotoxic T cell function. Time-course gene set analysis of these differentially expressed genes revealed that most of the enriched pathways had a significant time-trend. While many pathways that were significantly down- or upregulated at 1 week returned to baseline-like levels, we noted that several pathways important in adaptive and innate cell function remained upregulated at the long-term timepoint after resolution of CMV DNAemia. Differential expression analysis and time-course gene set analysis revealed the dynamics of genes and pathways involved in the immune response to CMV DNAemia in kidney transplant patients. Understanding transcriptional changes caused by CMV DNAemia may identify the mechanism behind patient vulnerability to CMV reactivation and increased risk of rejection in transplant recipients and suggest protective strategies to counter the negative immunologic impact of CMV. These findings provide a framework to identify immune correlates for risk assessment and guiding need for extending antiviral prophylaxis.
巨细胞病毒(CMV)病毒血症持续导致接受肾移植的患者出现显著的发病率和死亡率,临床并发症包括器官排斥和死亡。到目前为止,尚未在人类中对从 DNA 血症发病到康复期间的 CMV 病毒血症患者的全血基因表达动态进行很好的研究。为了评估 CMV 感染如何随时间推移影响全血白细胞基因表达,我们使用在移植后 12 个月期间收集的多个时间点的血液样本,评估了一组匹配的 62 例肾移植受者的队列,这些受者患有 CMV DNA 血症或无 CMV DNA 血症。虽然在基线时 DNA 血症和非 DNA 血症患者之间的转录组差异很小,但在长期时间点上有数百个基因表达差异,包括丰富的途径,包括对巨噬细胞、干扰素和 IL-8 信号传导很重要的途径。在患有 CMV DNA 血症的患者中,在基线和 DNA 血症后 1 周之间发生的转录组变化最大,干扰素信号和细胞毒性 T 细胞功能的途径增加。对这些差异表达基因进行时间过程基因集分析表明,大多数富集途径具有显著的时间趋势。虽然在 1 周时显著下调或上调的许多途径恢复到基线水平,但我们注意到,在 CMV DNA 血症消退后,几个在适应性和先天细胞功能中很重要的途径仍然上调。差异表达分析和时间过程基因集分析揭示了肾移植患者对 CMV DNA 血症免疫反应相关基因和途径的动态变化。了解由 CMV DNA 血症引起的转录变化可能会确定患者对 CMV 再激活和移植受者排斥风险增加的易感性背后的机制,并提出保护策略来抵消 CMV 的负面免疫影响。这些发现为识别免疫相关性提供了框架,可用于风险评估和指导是否需要延长抗病毒预防。