Pass R F, Reynolds D W, Whelchel J D, Diethelm A G, Alford C A
J Infect Dis. 1981 Feb;143(2):259-65. doi: 10.1093/infdis/143.2.259.
Cell-mediated immunity was assessed in 38 seropositive recipients of renal transplants by measuring the in vitro lymphocyte transformation response (LTR) to cytomegalovirus (CMV) and to phytohemagglutinin; results were correlated with clinical course, viral excretion, and immunosuppressive treatment. Thirteen seropositive controls all responded to CMV with a mean stimulation index of 31 +/- 6; 14 seronegative controls all had stimulation indices of less than 3. LTR to CMV was found to require both thymus-derived lymphocytes and macrophages. Before immunosuppression, responses of patients were similar to those of controls. After renal transplantation mean LTRs to CMV were dramatically reduced up to 18 months postoperatively, especially in patients treated with antithymocyte globulin. Viremia and CMV-related illness were significantly more frequent in recipients of antithymocyte globulin. Although there was only a rough correlation between clinical events and LTR to CMV, five deaths were noted among seven patients (all treated with antithymocyte globulin) who failed to respond to phytohemagglutinin on two consecutive tests.
通过测量肾移植血清反应阳性受者对巨细胞病毒（CMV）和植物血凝素的体外淋巴细胞转化反应（LTR），评估其细胞介导的免疫；结果与临床病程、病毒排泄及免疫抑制治疗相关。13名血清反应阳性对照者均对CMV有反应，平均刺激指数为31±6；14名血清反应阴性对照者的刺激指数均小于3。发现对CMV的LTR需要胸腺来源的淋巴细胞和巨噬细胞。免疫抑制前，患者的反应与对照者相似。肾移植后，至术后18个月，对CMV的平均LTR显著降低，尤其是接受抗胸腺细胞球蛋白治疗的患者。抗胸腺细胞球蛋白受者的病毒血症和CMV相关疾病明显更常见。虽然临床事件与对CMV的LTR之间只有大致的相关性，但在连续两次试验中对植物血凝素无反应的7名患者（均接受抗胸腺细胞球蛋白治疗）中有5例死亡。
