晚期急性代移植排斥和无症状的细胞巨乳病毒感染
P Reinke1, E Fietze, S Ode-Hakim
1Medical Clinic V-Nephrology, Universitätsklinikum Charité, Berlin, Germany.
Lancet (London, England)
|December 24, 1994
概括
细胞巨乳病毒感染有助于移植排斥. 用甘西克洛维尔的抗病毒治疗改善了细胞巨乳病毒相关的晚急性排斥患者的移植功能,这表明了新的治疗策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 细胞巨乳病毒 (CMV) 感染在全移植损伤中的作用仍在争论中.
- 晚期急性排斥移植受体的一个子集对标准治疗反应不佳,导致高移植损失.
- 这些患者表现出特定的免疫特征,包括扩大记忆的CD8T细胞和CMV感染标志物.
研究的目的:
- 为了研究细胞巨乳病毒感染和移植接受者的晚急性排斥之间的关联.
- 评估抗病毒疗法的有效性,以管理CMV相关的全移植损伤.
主要方法:
- 在移植接受者的晚期急性排斥的组织学确认.
- 对记忆表型和干扰素-马mRNA表达的外周血液CD8 T细胞的分析.
- 使用PCR和抗原血样测试检测CMV感染.
- 对于证实了CMV相关排斥的患者,用甘西克洛维尔治疗.
主要成果:
- 患有耐治疗晚急性排斥的患者显示CMV感染率增加 (82%PCR阳性,42%抗原血症).
- 在这些患者中观察到表达干扰素-马mRNA的记忆型CD8 T细胞的扩张.
- 在21名患有CMV相关晚急性排斥的患者中,17名患者的甘西克洛维尔治疗导致了稳定或改善的移植功能.
结论:
- 细胞巨乳病毒感染在晚期急性代移植损伤中起着重要作用.
- 用甘西克洛维尔的抗病毒疗法代表了CMV相关的移植损伤的有前途的治疗方法.
- 这些发现强调了在特定移植群体中诊断和治疗CMV的临床重要性.
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