Comparison of the Commercial QuantiFERON-CMV and Overlapping Peptide-based ELISPOT Assays for Predicting CMV Infection in Kidney Transplant Recipients.
- Author:
Ji Soo KWON
1
;
Taeeun KIM
;
Sun Mi KIM
;
Heungsup SUNG
;
Sung SHIN
;
Young Hoon KIM
;
Eui Cheol SHIN
;
Sung Han KIM
;
Duck Jong HAN
Author Information
- Publication Type:Original Article
- Keywords: Cytomegalovirus; Cell-mediated Immunity; Enzyme-linked immunospot assay; Interferon-gamma Release Test
- MeSH: Cytomegalovirus; Enzyme-Linked Immunospot Assay*; Humans; Immunity, Cellular; Immunosuppression; Incidence; Interferon-gamma Release Tests; Kidney*; Opportunistic Infections; Peptides; Prospective Studies; Tissue Donors; Transplant Recipients*
- From:Immune Network 2017;17(5):317-325
- CountryRepublic of Korea
- Language:English
- Abstract: Cytomegalovirus (CMV) is one of the most important opportunistic infections in transplant recipients. Tests for CMV-specific T cell responses have been proposed to change the current risk stratification strategy using CMV assays. We evaluated the usefulness of pre-transplant CMV-specific T cell assays in kidney transplant (KT) candidates for predicting the development of CMV infection after transplantation comparing the results of the overlapping peptides (OLPs)-based enzyme-linked immunospot (ELISPOT) assay and the commercial QuantiFERON-CMV assay. We prospectively enrolled all cases of KT over a 5-month period, except donor CMV-seropositive and recipient seronegative transplants that are at highest risk of CMV infection. All the patients underwent QuantiFERON-CMV, CMV OLPs-based pp65, and immediate-early 1 (IE-1)-specific ELISPOT assays before transplantation. The primary outcome was the incidence of CMV infection at 6 months after transplant. The total of 47 KT recipients consisted of 45 living-donor KTs and 2 deceased-donor KTs. There was no association between positive QuantiFERON-CMV results and CMV infection. However, 10 of 34 patients with phosphoprotein 65 (pp65)- or IE-1-specific ELISPOT results higher than cut-off value developed CMV infections compared with none of 13 patients with results lower than cut-off value developed CMV. The OLPs-based ELISPOT assays are more useful than the QuantiFERON-CMV assay for predicting CMV infection. Patients with higher CMV-specific T cell immunity at baseline appear to be more likely to develop CMV infections after KT, suggesting that the abrupt decline in CMV-specific T cell responses after immunosuppression, or high CMV-specific T cell responses due to frequent CMV activation before KT, may promote CMV infection.
