Pre-transplant plasma Torque Teno virus load and increase dynamics after lung transplantation.
Pre-transplant plasma Torque Teno virus load and increase dynamics after lung transplantation.
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DOI：
10.1371/journal.pone.0122975
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Puchhammer-Stöckl E
中科院分区：
文献类型：
--
作者：
Görzer I;Jaksch P;Kundi M;Seitz T;Klepetko W;Puchhammer-Stöckl E
人细野扭矩病毒（TTV）在大多数免疫活性个体中引起持续性病毒血症。实体器官移植后观察到TTV水平升高，并且与免疫抑制的程度相关，特别是在维持免疫抑制阶段。然而，移植后早期TTV增加与患者免疫抑制状态相关的程度尚不清楚。在这项研究中，我们详细评估了在肺移植后的前三个月内，在一个定义的免疫抑制方案下，并与移植前TTV水平的TTV增加动力学。46例肺移植受者（LTR）被纳入这项前瞻性纵向研究。所有患者均接受Alemtuzumab诱导联合他克莫司和皮质类固醇免疫抑制治疗。在移植前和移植后的前三个月内定期监测血浆TTV DNA（n = 320个样本;平均采样间隔：12.2天）。在43/46例LTR（93%）中，TTV DNA在移植前可检出（中位数4.4 log 10拷贝/mL;范围：2.0-6.4）。所有46例LTR均显示移植后TTV增加，在中位数第67天（范围：41-92）达到中位数峰值水平9.4 log 10拷贝/mL（范围：7.6-10.7）之前，TTV呈S形曲线。个体TTV DNA倍增时间（范围：1.4-20.1天）与移植后30或60天计算的移植前TTV水平显著相关（r分别为0.61，0.54;均P < 0.001），但与他克莫司平均血药浓度无关。移植前TTV水平与患者移植后TTV峰值负荷的时间和水平无关。TTV水平仅在患者达到初始峰值TTV水平后才可用于反映免疫抑制状态。
The human Torque Teno virus (TTV) causes persistent viremia in most immunocompetent individuals. Elevated TTV levels are observed after solid organ transplantation and are related to the extent of immunosuppression especially during the phase of maintenance immunosuppression. However, the extent to which the TTV increase in the early phase post-transplantation is associated with the patient’s immunosuppressive state is unclear. In this study, we assessed the TTV increase dynamics in detail during the first three months after lung transplantation under a defined immunosuppressive regimen and in relation to the pre-transplant TTV level. Forty-six lung transplant recipients (LTRs) were included in this prospective longitudinal study. All received alemtuzumab induction combined with tacrolimus and corticosteroids immunosuppressive therapy. Plasma TTV DNA was monitored before transplantation and regularly within the first three months post-transplantation (n = 320 samples; mean sampling interval: 12.2 days). In 43/46 LTRs (93%), TTV DNA was detectable before transplantation (median 4.4 log10 copies/mL; range: 2.0–6.4). All 46 LTRs showed a TTV increase post-transplantation, which followed a sigmoidal-shaped curve before the median peak level of 9.4 log10 copies/mL (range: 7.6–10.7) was reached at a median of day 67 (range: 41–92). The individual TTV DNA doubling times (range: 1.4–20.1 days) significantly correlated with the pre-transplant TTV levels calculated over 30 or 60 days post-transplantation (r = 0.61, 0.54, respectively; both P < 0.001), but did not correlate with the mean tacrolimus blood levels. Pre-transplant TTV levels were not associated with time and level of the patients’ post-transplant TTV peak load. The TTV level may be used to mirror the state of immunosuppression only after the patients’ initial peak TTV level is reached.
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影响因子：
4.8
作者：
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