RT Journal Article
T1 Circulatory follicular helper T lymphocytes associate with lower incidence of CMV infection in kidney transplant recipients
A1 Suárez Fernández, Patricia
A1 Utrero Rico, Alberto
A1 Sandonis, Virginia
A1 García Ríos, Estéfani
A1 Arroyo Sánchez, Daniel
A1 Fernández Ruiz, Mario
A1 Andrés, Amado de
A1 Polanco, Natalia
A1 González Cuadrado, Cecilia
A1 Almendro Vazquez, Patricia
A1 Pérez Romero, Pilar
A1 Aguado, José María
A1 Paz Artal, Estela
A1 Laguna Goya, Rocío
AB Primary infection and/or reactivation of cytomegalovirus (CMV) in kidney transplant recipients (KTR) favor rejection and mortality. T follicular helper cells (TFH) could contribute to protection against CMV. Circulatory TFH (cTFH) were studied pretransplant and early posttransplant in 90 CMV seropositive KTR not receiving antithymocyte globulin or antiviral prophylaxis, followed-up for 1 year. Patients who presented CMV infection had significantly lower cTFH and activated cTFH pretransplant and early posttransplant. Pretransplant activated cTFH were also lower within patients who developed CMV disease. Pre- and 14 days posttransplant activated cTFH were an independent protective factor for CMV infection (HR 0.41, p = .01; and 0.52, p = .02, respectively). KTR with low cTFH 7 days posttransplant (<11.9%) had lower CMV infection-free survival than patients with high cTFH (28.2% vs. 67.6%, p = .002). cTFH were associated with CMV-specific neutralizing antibodies (Nabs). In addition, IL-21 increased interferon-γ secretion by CMV-specific CD8+ T cells in healthy controls. Thus, we show an association between cTFH and lower incidence of CMV infection, probably through their cooperation in CMV-specific Nab production and IL-21-mediated enhancement of CD8+ T cell activity. Moreover, monitoring cTFH pre- and early posttransplant could improve CMV risk stratification and help select KTR catalogued at low/intermediate risk who could benefit from prophylaxis.
PB Wiley
SN 1600-6135
YR 2021
FD 2021-06-21
LK https://hdl.handle.net/20.500.14352/6829
UL https://hdl.handle.net/20.500.14352/6829
LA eng
NO CRUE-CSIC (Acuerdos Transformativos 2021)
NO Instituto de Salud Carlos III (ISCIII)/ MICINN/ FEDER
NO Instituto de Salud Carlos III (ISCIII)
DS Docta Complutense
RD 1 sept 2024