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Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
[Indirect effects of cytomegalovirus infection]
Juan José Castón Osorio1, Felipe Zurbano Goñi
1Unidad de Enfermedades Infecciosas, Hospital General Universitario de Ciudad Real, Ciudad Real, España. juanjoco2005@yahoo.es
Abstract:
Despite improvements in prevention strategies, cytomegalovirus (CMV) continues to be the main cause of infection in solid organ transplant recipients. In these patients, in addition to direct effects, such as viral syndrome or invasive organ disease, CMV can cause indirect effects resulting from the interaction of the virus with the host's immune system. This interaction may increase immunosuppression, with a consequent rise in opportunistic infections and the risk of malignancies (Epstein-Barr virus-associated posttransplantation lymphoproliferative disease) and graft dysfunction. Currently, a direct causal relation between CMV and most of the indirect effects described cannot be established. However, numerous experimental and clinical studies have found an association between the development of these effects and CMV. Moreover, some of these effects, such as the development of opportunistic infections, have been reduced by CMV prophylaxis.
Insights
Cytomegalovirus (CMV) remains a primary infection risk for solid organ transplant recipients, causing direct harm and indirect immune effects. CMV prophylaxis can reduce associated opportunistic infections and improve graft outcomes.
Area of Science:
- Virology
- Immunology
- Transplant Medicine
Context:
- Cytomegalovirus (CMV) is a significant pathogen in solid organ transplant (SOT) recipients.
- Despite preventive measures, CMV infection remains a leading cause of morbidity and mortality in this population.
- CMV infection presents direct effects (viral syndrome, organ disease) and indirect immunological consequences.
Purpose:
- To review the direct and indirect effects of cytomegalovirus (CMV) in solid organ transplant recipients.
- To highlight the association between CMV and increased immunosuppression, opportunistic infections, malignancies, and graft dysfunction.
- To discuss the impact of CMV prophylaxis on mitigating these adverse outcomes.
Summary:
- CMV infection in SOT recipients leads to direct viral effects and indirect immunological alterations.
- Indirect effects include heightened immunosuppression, increasing risks of opportunistic infections, Epstein-Barr virus-associated posttransplantation lymphoproliferative disease, and graft dysfunction.
- While direct causality is complex, strong associations exist between CMV and these indirect effects, with prophylaxis showing benefit.
Impact:
- Understanding CMV's indirect effects is crucial for optimizing SOT recipient care.
- CMV prophylaxis strategies can mitigate severe complications, improving patient survival and graft longevity.
- Further research into the mechanisms linking CMV and indirect effects may reveal novel therapeutic targets.
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