TEMRA Vδ2neg γΔ T Cell Analysis to Predict Post-Transplant CMV DNAemia.

Abstract

Introduction: Monitoring of cytomegalovirus (CMV) immune response at baseline may help clinicians to better define the risk of post-transplant CMV infection or disease and then to better use prophylaxis. Vd2neg gd T cells are induced after CMV infection and play a major role for controlling the virus. The goal of this study was then to determine whether these cells at baseline could predict post-transplant CMV DNAemia in R+ kidney transplant recipients. Patients and methods: Vd2neg gd T cells were longitudinally analysed at baseline, day 15, month 1, month 3, and month 6 in 23 R+ kidney transplant recipients receiving a preemptive strategy. Naïve, central memory, TEMh and TEMRA subsets were also analysed within the Vd2neg gd T cells compartment. Results: Among the 23 R+ patients, 17 developed post-transplant CMV DNAemia. At baseline and day 15, TEMRA Vd2neg gd T cell percentages were significantly higher in patients who did not develop any CMV DNAemia than in patients with DNAemia <2000 copies/mL and those with DNAemia >2000 copies/mL (At day 15: 81.2%, 59%, 47.1%, respectively, p=0.04 and p=0.03, respectively). At day 15, 74.2% of TEMRA Vd2neg gd T cells predicted the absence of post-transplant CMV DNAemia with a sensibility of 100% and a specificity of 90%. Conclusion: This pilot study shows that the analysis of the TEMRA Vd2neg gd T cell percentage at baseline or day 15 could be a promising candidate for predicting the absence of post-transplant CMV DNAemia.