Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Transpl Int. 2024 Jan 5;36:11527. doi: 10.3389/ti.2023.11527. eCollection 2023.
Non-specific interferon-gamma (IFN-γ) enzyme-linked immunosorbent (ELISpot) responses after solid organ transplant (SOT) and their relationship with cytomegalovirus (CMV) reactivation have hardly been investigated. Adult kidney transplant (KT) recipients underwent measurement of IFN-γ-producing T cells using the ELISpot assay before and 1 month after transplantation. Data for CMV infection episodes were collected. Risk factors for post-transplant CMV infection, based on IFN-γ responses, were analyzed using a Cox proportional hazards model. A total of 93 KT recipients were enrolled in the study and 84 evaluable participants remained at 1 month post KT. Thirty-three (39%) recipients developed subsequent CMV infection within 6 months post-transplant. At 1-month post-transplant, IFN-γ-producing T cells with <250 spot-forming units (SFUs)/2.5 × 10 peripheral blood mononuclear cells (PBMCs) were significantly associated with CMV infection (HR 3.1, 95% CI 1.4-7.1, = 0.007). On multivariable analysis, posttransplant IFN-γ-producing T cells with <250 SFUs/2.5 × 10 PBMCs remained independently associated with CMV infection (HR 3.1, 95% CI 1.2-7.8, = 0.019). Conclusions: KT recipients with low IFN-γ-producing T cells measured by the ELISpot assay are more likely to develop CMV infection after transplantation. Therefore, measurement of nonspecific cell-mediated immunity ELISpot responses could potentially stratify recipients at risk of CMV infection (Thai Clinical Trials Registry, TCTR20210216004).
实体器官移植（SOT）后非特异性干扰素-γ（IFN-γ）酶联免疫吸附（ELISpot）反应及其与巨细胞病毒（CMV）再激活的关系几乎未被研究过。成人肾移植（KT）受者在移植前和移植后 1 个月接受 IFN-γ产生 T 细胞的 ELISpot 检测。收集 CMV 感染发作的数据。使用 Cox 比例风险模型分析基于 IFN-γ反应的移植后 CMV 感染风险因素。本研究共纳入 93 例 KT 受者，84 例可评估参与者在 KT 后 1 个月仍可评估。33 例（39%）受者在移植后 6 个月内发生后续 CMV 感染。移植后 1 个月，IFN-γ产生 T 细胞<250 个斑点形成单位（SFUs）/2.5×10 个外周血单个核细胞（PBMC）与 CMV 感染显著相关（HR 3.1，95%CI 1.4-7.1，=0.007）。多变量分析显示，移植后 IFN-γ产生 T 细胞<250 SFUs/2.5×10 PBMC 与 CMV 感染独立相关（HR 3.1，95%CI 1.2-7.8，=0.019）。结论：通过 ELISpot 测定，IFN-γ产生 T 细胞低的 KT 受者在移植后更有可能发生 CMV 感染。因此，非特异性细胞介导免疫 ELISpot 反应的测量可能会分层 CMV 感染风险受者（泰国临床试验注册中心，TCTR20210216004）。
