Surveillance of γδ T Cells Predicts Cytomegalovirus Infection Resolution in Kidney Transplants.

Abstract : Cytomegalovirus (CMV) infection in solid-organ transplantation is associated with increased morbidity and mortality, particularly if a CMV mutant strain with antiviral resistance emerges. Monitoring CMV-specific T cell response could provide relevant information for patient care. We and others have shown the involvement of Vδ2(neg) γδ T cells in controlling CMV infection. Here, we assessed if Vδ2(neg) γδ T cell kinetics in peripheral blood predict CMV infection resolution and emergence of a mutant strain in high-risk recipients of kidney transplants, including 168 seronegative recipients receiving organs from seropositive donors (D+R-) and 104 seropositive recipients receiving antithymocyte globulins (R+/ATG). Vδ2(neg) γδ T cell percentages were serially determined in patients grafted between 2003 and 2011. The growing phase of Vδ2(neg) γδ T cells was monitored in each infected patient, and the expansion rate during this phase was estimated individually by a linear mixed model. A Vδ2(neg) γδ T cell expansion rate of ˃0.06% per day predicted the growing phase. The time after infection at which an expansion rate of 0.06% per day occurred was correlated with the resolution of CMV DNAemia (r=0.91; P<0.001). At 49 days of antiviral treatment, Vδ2(neg) γδ T cell expansion onset was associated with recovery, whereas absence of expansion was associated with recurrent disease and DNAemia. The appearance of antiviral-resistant mutant CMV strains was associated with delayed Vδ2(neg) γδ T cell expansion (P<0.001). In conclusion, longitudinal surveillance of Vδ2(neg) γδ T cells in recipients of kidney transplants may predict CMV infection resolution and antiviral drug resistance.
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Submitted on : Wednesday, June 17, 2015 - 2:49:13 PM
Last modification on : Tuesday, September 18, 2018 - 4:24:01 PM

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Hannah Kaminski, Isabelle Garrigue, Lionel Couzi, Benjamin Taton, Thomas Bachelet, et al.. Surveillance of γδ T Cells Predicts Cytomegalovirus Infection Resolution in Kidney Transplants.. Journal of the American Society of Nephrology, American Society of Nephrology, 2015, pp.00. ⟨10.1681/ASN.2014100985⟩. ⟨hal-01164667⟩

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