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BMC Immunol ; 18(1): 15, 2017 03 07.
Article in English | MEDLINE | ID: mdl-28270092

ABSTRACT

BACKGROUND: Uncontrolled cytomegalovirus (CMV) replication in immunocompromised solid-organ transplant recipients is a clinically relevant issue and an indication of impaired CMV-specific cell-mediated immunity (CMI). Primary aim of this study was to assess the suitability of the immune monitoring tool T-Track® CMV to determine CMV-reactive CMI in a cohort of hemodialysis patients representative of patients eligible for renal transplantation. Positive and negative agreement of T-Track® CMV with CMV serology was examined in 124 hemodialysis patients, of whom 67 (54%) revealed a positive CMV serostatus. Secondary aim of the study was to evaluate T-Track® CMV performance against two unrelated CMV-specific CMI monitoring assays, QuantiFERON®-CMV and a cocktail of six class I iTAg™ MHC Tetramers. RESULTS: Positive T-Track® CMV results were obtained in 90% (60/67) of CMV-seropositive hemodialysis patients. In comparison, 73% (45/62) and 77% (40/52) positive agreement with CMV serology was achieved using QuantiFERON®-CMV and iTAg™ MHC Tetramer. Positive T-Track® CMV responses in CMV-seropositive patients were dominated by pp65-reactive cells (58/67 [87%]), while IE-1-responsive cells contributed to an improved (87% to 90%) positive agreement of T-Track® CMV with CMV serology. Interestingly, T-Track® CMV, QuantiFERON®-CMV and iTAg™ MHC Tetramers showed 79% (45/57), 87% (48/55) and 93% (42/45) negative agreement with serology, respectively, and a strong inter-assay variability. Notably, T-Track® CMV was able to detect IE-1-reactive cells in blood samples of patients with a negative CMV serology, suggesting either a previous exposure to CMV that yielded a cellular but no humoral immune response, or TCR cross-reactivity with foreign antigens, both suggesting a possible protective immunity against CMV in these patients. CONCLUSION: T-Track® CMV is a highly sensitive assay, enabling the functional assessment of CMV-responsive cells in hemodialysis patients prior to renal transplantation. T-Track® CMV thus represents a valuable immune monitoring tool to identify candidate transplant recipients potentially at increased risk for CMV-related clinical complications.


Subject(s)
Cytomegalovirus Infections/diagnosis , Cytomegalovirus/immunology , Immunocompromised Host , Kidney Failure, Chronic/diagnosis , Renal Dialysis , Adult , Aged , Aged, 80 and over , Antibodies, Viral/blood , Cells, Cultured , Cohort Studies , Cytomegalovirus Infections/immunology , Female , Humans , Immediate-Early Proteins/immunology , Immunity, Cellular , Immunoassay , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/therapy , Kidney Transplantation , Male , Middle Aged , Monitoring, Immunologic/methods , Observer Variation , Phosphoproteins/immunology , Sensitivity and Specificity , Viral Matrix Proteins/immunology , Waiting Lists
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