학술논문

Advancing cytomegalovirus prevention in solid organ transplant recipients: The promise of cell-mediated immune assays.
Document Type
Academic Journal
Author
Beechar VB; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.; Phadke VK; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.; Pouch SM; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.; Woodworth MH; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
Source
Publisher: Munksgaard Country of Publication: Denmark NLM ID: 100883688 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3062 (Electronic) Linking ISSN: 13982273 NLM ISO Abbreviation: Transpl Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Cytomegalovirus (CMV) infections are a major source of morbidity and mortality in solid organ transplant recipients. Prophylactic, preemptive, and hybrid prevention strategies have traditionally been the mainstay of CMV prevention but there is growing interest in the use of CMV cell-mediated immune assays to inform novel approaches to risk stratification. Recent evidence suggests that CMV interferon-gamma release assays can offer predictive insights into the risk for CMV-related illnesses, raising the potential for tailored CMV prevention strategies anchored to each individual's unique CMV immune profile. However, the predictive capacity of these assays for CMV-related illnesses can be profoundly influenced by when they are performed relative to transplant, and the induction immunosuppressive regimen the patient has received. In this review, we explore the relevant literature shaping our understanding of the optimal use of these assays. Furthermore, we also highlight the benefits of quantifying the CD4+ and CD8+ T-Cell responses to CMV, which is offered by some interferon-gamma release assays utilizing intracellular cytokine staining, for providing a holistic assessment of the recovery of cell-mediated immunity post-induction immunosuppression.
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