Abstract

Human cytomegalovirus (HCMV) reactivation remains a relevant complication after hematopoietic stem cell transplantation (HSCT) despite the great progress made in prophylaxis and treatment. Adaptive Natural Killer (NK) cells undergo a persistent reconfiguration in response to HCMV reactivation however, the exact role of adaptive NK cells in HCMV surveillance is currently unknown. We studied the relationship between HCMV reactivation and adaptive NK cells in 70 patients monitored weekly until day +100 after HSCT. Absolute cell counts of adaptive NK cells increased significantly after resolution of HCMV-reactivation compared to patients without reactivation. Patients with HCMV-reactivation had an early reconstitution of adaptive NK cells (“Responders”) and had mainly a single reactivation (75% Responders vs 48% Non-Responders). Adaptive NK cells eliminated HCMV-infected human foreskin fibroblasts (HFF) in vitro and recruited T cells in an in vitro transwell migration assay. An extensive cytokine/chemokine panel demonstrated strongly increased secretion of CXCL10/IP-10, IFN-α, IL-1α, IL-1β, IL-5, IL-7 and CCL4. Thus, adaptive NK cells may control viral spread and T cell expansion and survival during HCMV-reactivation. Taken together, we have demonstrated the potential of adaptive NK cells in the control of HCMV reactivation both by direct cytotoxicity and by recruitment of other immune cells.

Highlights

  • Allogeneic hematopoietic stem cell transplantation (HSCT) remains a curative treatment for malignant and even some non-malignant hematological disorders [1]

  • Adaptive Natural Killer (NK) cells expand and persist during and after Human cytomegalovirus (HCMV) reactivation Peripheral blood (PB) samples from 70 HCMV-seropositive patient/ donor pairs were examined for differential reconstitution of adaptive NK cells weekly up to day +100 after HSCT

  • Here we explored the immune responses of adaptive NK cells triggered by HCMV reactivation

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Summary

INTRODUCTION

Allogeneic hematopoietic stem cell transplantation (HSCT) remains a curative treatment for malignant and even some non-malignant hematological disorders [1]. Different viruses will promote the expansion of different NK cell subpopulations and trigger different cytotoxic/regulatory approaches These tailored responses have been described for several viral infections, included among others, HCMV, Hepatitis B virus, Epstein-Barr virus and Human Immunodeficiency virus. Adaptive NK cells are detected in healthy HCMV-seropositive individuals, but are quite heterogeneous which may be due to the peptide-specific recognition of HCMV strains [18] It is still unknown how adaptive NK cells are able to respond to HCMV but their potential role in the immune reconstitution after HSCT is of great interest [19]. We analyzed the reconstitution, expansion and function of adaptive NK cells in the context of HCMV reactivation in HCMV-seropositive donors and/or recipients pairs after HSCT

RESULTS
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DISCUSSION
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