Quinnan G V, Kirmani N, Rook A H, Manischewitz J F, Jackson L, Moreschi G, Santos G W, Saral R, Burns W H
N Engl J Med. 1982 Jul 1;307(1):7-13. doi: 10.1056/NEJM198207013070102.
We studied 58 recipients of bone-marrow transplants to evaluate immune responses to cytomegalovirus infection. Such infection developed in 43 patients; it was fatal in 12, nonfatal in 23, and present at death from other causes in eight. All patients had low or absent cytomegalovirus-specific cytotoxic lymphocyte activity before the onset of infection. Cytomegalovirus-specific cytotoxic responses developed in all survivors, whereas only two patients with fatal infection had even low-level cytomegalovirus-specific cytotoxic responses. Natural and antibody-dependent killer-cell activities were depressed both before and during infection in patients with fatal infections, but not in those who survived. The outcome of the infection did not correlate with the nature of the underlying disease, the type of transplant received, the pretransplantation cytomegalovirus-antibody status, or lymphocyte-proliferation responses to cytomegalovirus antigens or concanavalin A. The correlation between effective virus-specific cytotoxic response and recovery from infection indicates that these effector cells probably mediate recovery from cytomegalovirus infection.
我们研究了58例骨髓移植受者，以评估其对巨细胞病毒感染的免疫反应。43例患者发生了这种感染；其中12例死亡，23例非致命，8例在因其他原因死亡时存在感染。所有患者在感染发作前巨细胞病毒特异性细胞毒性淋巴细胞活性均较低或缺乏。所有幸存者均出现了巨细胞病毒特异性细胞毒性反应，而只有2例致命感染患者甚至出现了低水平的巨细胞病毒特异性细胞毒性反应。致命感染患者在感染前和感染期间自然杀伤细胞及抗体依赖性杀伤细胞活性均降低，但存活患者未出现这种情况。感染的结果与基础疾病的性质、所接受移植的类型、移植前巨细胞病毒抗体状态或对巨细胞病毒抗原或刀豆球蛋白A的淋巴细胞增殖反应均无相关性。有效的病毒特异性细胞毒性反应与感染恢复之间的相关性表明，这些效应细胞可能介导了从巨细胞病毒感染中恢复。
