Abstract
Chronic kidney disease may alter antiviral T cell immunity. In the current study, we assessed in 63 patients prior to kidney transplantation how humoral and cellular immunity against cytomegalovirus (CMV) correlated using an interferon (IFN)-γ ELISpot (T-Track® CMV, Mikrogen, Neuried, Germany). The cohort comprised 24 patients with negative and 39 with positive CMV IgG. Whereas none of the patients with negative CMV IgG showed detectable responses to the T-Track® CMV, 26 out of 39 patients with positive CMV IgG had positive ELISpot responses. The median response to CMV pp65 in the CMV seronegative group was 0 spot forming units (SFU) per 200,000 PBMC (range 0–1) and in the seropositive group 43 SFU (range 0–750). Thus, 13 out of 39 patients with positive CMV serostatus (33%) had undetectable T cell immunity and may be at an increased risk of CMV reactivation. CMV pp65-specific ELISpot responses were 29.3-fold higher in seropositive patients with vs. without dialysis and 5.6-fold higher in patients with vs. without immunosuppressive therapy, but patients with dialysis and immunosuppressive therapy showed, as expected, lower responses to phytohemagglutinin, the positive control. This finding may be caused by (subclinical) CMV-DNAemia and a “booster” of CMV-specific T cells.
Highlights
In kidney transplant recipients, infection with herpesviruses, especially with cytomegalovirus (CMV), can lead to severe illnesses such as interstitial pneumonitis, hepatitis, colitis and encephalitis [1], and it can trigger allograft rejection [2]
IgG, CMV IgM, age, sex, cause of kidney failure, dialysis, prior kidney transplantation or immunosuppressive therapy had an influence on CMV-specific ELISpot responses
The total cohort of 63 patients with chronic kidney disease consisted of 24 patients with negative and 39 with positive CMV IgG
Summary
Infection with herpesviruses, especially with cytomegalovirus (CMV), can lead to severe illnesses such as interstitial pneumonitis, hepatitis, colitis and encephalitis [1], and it can trigger allograft rejection [2]. CMV-specific T cell immunity was detected in kidney transplant patients without CMV IgG antibodies [6]. The quantification of cellular CMV immunity may help to stratify the risk of CMV infection or reactivation and thereby guide pre-emptive and prophylactic antiviral treatment after transplantation [11,12,13,14,15,16,17,18,19,20,21,22,23,24]. Specific immunity against CMV may be important in transplant recipients and in patients awaiting kidney transplantation. We addressed the question how humoral and cellular CMV immunity correlated in 63 patients awaiting kidney transplantation. IgG, CMV IgM, age, sex, cause of kidney failure, dialysis, prior kidney transplantation or immunosuppressive therapy had an influence on CMV-specific ELISpot responses
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