AI Article Synopsis
- Human cytomegalovirus (HCMV) is a significant pathogen that can impact the success of solid organ transplants, especially in cases where both the donor and recipient are infected.
- A study involving 52 kidney transplant recipients over two years revealed that recipients who received kidneys from HCMV-infected donors exhibited a greater expansion of CMV-specific lymphocytes compared to those with uninfected donors, despite experiencing higher rates of HCMV viremia.
- The findings suggest that HCMV infection leads to immune system deterioration in kidney transplant recipients, indicated by increased CD28-negative T lymphocytes, an inverted CD4/CD8 ratio, and shortened telomeres, particularly in patients who received kidneys from infected donors
Article Abstract
Human cytomegalovirus (HCMV) is considered to be a major pathogen that affects the outcome of solid organ transplantation (TX). Both recipient and donor may be HCMV positive, therefore HCMV re-infection is possible after TX. However, little is known how cytomegalovirus (CMV) transmitted from an infected donor to an infected recipient modulates the recipient's already suppressed immunity, and what the clinical consequences are. To investigate these issues, 52 kidney recipients were followed up for 2 years after TX. T, B and natural killer (NK) lymphocytes, naive and memory T subsets, CD28 expression, relative telomere length, CMV-specific lymphocytes and serum cytokines were measured several times post-TX. Patients were monitored for signs of CMV viremia and other infections. The most important observation was that CMV-specific lymphocytes expand vastly in HCMV-infected recipients who received kidneys from infected donors, in comparison with uninfected donors. Despite this, a higher rate of HCMV viremia was found. Immune deterioration was confirmed by an increased number of CD28-negative T lymphocytes, inverted CD4/CD8 index and shortened telomeres. This was superior in HCMV-infected recipients transplanted from infected donors, when compared with uninfected. In conclusion, CMV alters the immune system in kidney transplant recipients and promotes immune exhaustion.
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