Linking CMV Serostatus to Episodes of CMV Reactivation Following Lung Transplantation by Measuring CMV-Specific CD8+ T-Cell Immunity

Authors

  • G. P. Westall,

    1. Heart and Lung Transplant Unit, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, and Monash University Medical School, Melbourne, Victoria, Australia
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  • N. A. Mifsud,

    1. Department of Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia
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  • T. Kotsimbos

    Corresponding author
    1. Heart and Lung Transplant Unit, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, and Monash University Medical School, Melbourne, Victoria, Australia
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* Corresponding author: Tom Kotsimbos, T.Kotsimbos@alfred.org.au

Abstract

CMV-specific immunity was assessed in a longitudinal cohort of 39 lung transplant recipients (LTR) who were followed prospectively from the time of transplant using a novel assay. At the time of surveillance bronchoscopy, CMV-specific CD8+ T-cell responses were assessed in the peripheral blood, using the QuantiFERON®-CMV assay, which measures IFN-γ-secreting T cells following stimulation with CMV peptides. In total, 297 samples were collected from 39 LTR (CMV D+/R−, n = 8; D+/R+, n = 18; D−/R+, n = 6; D−/R−, n = 7). CMV-specific T-cell immunity was not detected in any of the CMV D−/R− LTR. In CMV seropositive LTR levels of CMV immunity were lowest early posttransplant and increased thereafter. While levels of CMV-specific immunity varied between LTR, measurements at any one time point did not predict episodes of CMV reactivation. In CMV mismatched (D+/R−) LTR, primary CMV immunity was not observed during the period of antiviral prophylaxis, but typically developed during episodes of CMV reactivation. Measuring CMV-specific CD8+ T-cell function with the QuantiFERON®-CMV assay provides insights into the interrelationship between CMV immunity and CMV reactivation in individual LTR. A better understanding of these dynamics may allow the opportunity to individualize antiviral prophylaxis in the future.

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