Woo P C, Lo C Y, Lo S K, Siau H, Peiris J S, Wong S S, Luk W K, Chan T M, Lim W W, Yuen K Y
Department of Microbiology, The University of Hong Kong, Hong Kong.
Clin Diagn Lab Immunol. 1997 Sep;4(5):515-8. doi: 10.1128/cdli.4.5.515-518.1997.
A prospective study of the spectrum of glycoprotein B (gB) and glycoprotein H (gH) genotypes of cytomegalovirus (CMV) was conducted with five categories of patients: viremic bone marrow-transplant (BMT) recipients who developed CMV disease after BMT (n = 22), viremic BMT recipients without CMV disease (n = 11), viremic renal-transplant recipients who developed CMV disease after transplantation (n = 14), viremic renal-transplant recipients without CMV disease (n = 13), and premature babies with asymptomatic congenital CMV infections (n = 13). Genotypic stability was observed because the gB and gH genotypes of multiple isolates obtained from a single patient were identical. The distribution of gH genotypes in patients of all groups studied were similar. However, there was a unique distribution of the gB genotype in the first category of patients, i.e., BMT recipients with CMV disease, which was distinct from those of all other categories (P < 0.05). CMV isolates from 54% of BMT recipients with CMV disease exhibited gB type 2, while isolates from 46, 50, 69, and 77% of the BMT recipients without CMV disease, renal-transplant recipients with and those without CMV disease, and premature babies with congenital CMV infection, respectively, were of gB type 1. An analysis of the clinical characteristics of BMT recipients with CMV disease indicated that all underwent either an allogeneic or matched, unrelated donor transplant, and half had severe acute graft-versus-host disease (grades 2 to 4). The statistically significant genotypic difference between CMV isolates from BMT recipients with and without CMV disease was not observed between isolates from renal-transplant recipients with and without CMV disease. We speculate that differences in pathogenesis in different patient groups might account for these observations. These findings would also facilitate decision making about the choice of recombinant CMV glycoprotein vaccine required to immunize transplant donors and the subsequent adoptive transfer of immunity to BMT recipients. When the source of CMV DNA required for genotyping was investigated among renal-transplant recipients, direct use of peripheral blood leukocytes was 95% effective compared to the effectiveness of cells obtained from conventional culture of peripheral blood specimens.
对五类患者进行了一项关于巨细胞病毒（CMV）糖蛋白B（gB）和糖蛋白H（gH）基因型谱的前瞻性研究：发生骨髓移植（BMT）后出现CMV疾病的病毒血症BMT受者（n = 22）、未发生CMV疾病的病毒血症BMT受者（n = 11）、移植后出现CMV疾病的病毒血症肾移植受者（n = 14）、未发生CMV疾病的病毒血症肾移植受者（n = 13）以及无症状先天性CMV感染的早产儿（n = 13）。观察到基因型稳定性，因为从单个患者获得的多个分离株的gB和gH基因型是相同的。所有研究组患者中gH基因型的分布相似。然而，在第一类患者中，即患有CMV疾病的BMT受者，gB基因型存在独特的分布，这与所有其他类别不同（P < 0.05）。54%患有CMV疾病的BMT受者的CMV分离株表现为gB 2型，而分别来自46%、50%、69%和77%未患CMV疾病的BMT受者、患有和未患CMV疾病的肾移植受者以及先天性CMV感染早产儿的分离株为gB 1型。对患有CMV疾病的BMT受者的临床特征分析表明，所有患者均接受了同种异体或匹配的无关供体移植，且一半患者患有严重的急性移植物抗宿主病（2至4级）。在患有和未患CMV疾病的肾移植受者的分离株之间未观察到患有和未患CMV疾病的BMT受者的CMV分离株之间具有统计学意义的基因型差异。我们推测不同患者组发病机制的差异可能解释了这些观察结果。这些发现也将有助于就免疫移植供体所需的重组CMV糖蛋白疫苗的选择以及随后向BMT受者进行免疫的过继转移做出决策。当在肾移植受者中研究基因分型所需的CMV DNA来源时，直接使用外周血白细胞的有效性为95%，而从外周血标本的传统培养中获得细胞的有效性相比。
