在3名固体器官移植接受者中,捐赠者衍生的细胞巨乳病毒感染的动力学和演变与相同的多器官捐赠者
Fien Horsten1, Sunwen Chou2, Sarah Gillemot1
1Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, KU Leuven, Leuven, Belgium.
Transplantation
|September 30, 2024
概括
三名受移植者感染了相同的细胞巨乳病毒 (CMV) 菌株,发展了多种药物耐药性. 这凸显了需要在移植患者中仔细使用和监测抗病毒药物,以防止耐药性.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 移植医学 移植医学 移植医学
背景情况:
- 细胞巨乳病毒 (CMV) 感染对移植受体构成重大威胁,导致初级感染,再感染或重新激活.
- 移植受体的免疫抑制增加了对严重的CMV疾病的易感性.
研究的目的:
- 调查移植受体中细胞巨乳病毒 (CMV) 感染中药物耐药性的出现.
- 分析来自共同供体的CMV菌株抗病毒耐药性的遗传基础.
主要方法:
- 在接受来自单一已故捐赠者的器官的3名患者中分析CMV耐药性.
- 使用桑格测序识别病毒DNA聚合酶 (DP) 和蛋白激酶 (PK) 中的突变.
- 通过针对性下一代测序和评估新型DP-A505G替代品对药物敏感性的影响来量化DP和PK变异.
主要成果:
- 在所有患者样本中检测到DP-A505G替代,可能与自然多态有关.
- 冠状病毒感染呈现出不同的演变,患者发展出不同的耐药性模式:甘西克洛维尔/福斯卡内特耐药性 (2 DP 突变),没有基因型耐药性,以及甘西克洛维尔/马里巴维尔耐药性 (PK 突变).
- 在CMV基因组中观察到微小的患者间变异,样本在基因组上聚类,表明共同的起源.
结论:
- 所有3名患者都感染了相同的捐赠者衍生的CMV菌株,但表现出不同的药物敏感性概况.
- 谨慎使用抗病毒药物和警监测对于防止移植受体出现抗病毒耐药性至关重要.
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