Screening for PTLD in lung and heart-lung transplant recipients by measuring EBV DNA load in bronchoalveolar lavage fluid using real time PCR
Screening for PTLD in lung and heart-lung transplant recipients by measuring EBV DNA load in bronchoalveolar lavage fluid using real time PCR
复制标题
DOI：
10.1111/j.1399-3046.2007.00835.x
复制
发表时间：
2008-06-01
影响因子：
1.3
通讯作者：
Michaels, Marian G.
中科院分区：
文献类型：
--
作者：
Michelson, Peter;Watkins, Bradley;Michaels, Marian G.
儿科L-HLTx接受者有发生PTLD的风险，肺部是主要疾病部位。我们假设BALF是一个比外周血更好的样本，用于测量这种高危人群中的EBV DNA载量。使用定量真实的时间TaqMan PCR检测试剂盒，对来自有和无PTLD的儿童L-HLTx接受者的存档BALF标本进行EBV DNA载量检测。将这些值与通过竞争性PCR测定在外周血中测定的值进行比较。对16例L-HLTx患者的55份BALF标本进行了评价。3例PTLD患者的平均BALF EBV DNA载量值几乎是无PTLD受试者的50倍（4.6 x 10（5）拷贝/mL vs. 1.0 x 10（4）拷贝/mL）。移植前EBV血清阴性的患者（即，与移植前EBV血清阳性患者相比，PTLD高风险患者的EBV DNA载量值升高，无论PTLD的诊断如何（平均值为3.2 x 10（5）拷贝/mL vs. 1.1 x 10（4）拷贝/mL）。最后，BALF分析确定了所有PTLD受试者，而外周血分析仅确定了其中一例。因此，可以得出结论，监测L-HLTx后BALF中的EBV DNA载量有助于检测高危患者的PTLD，可能上级外周血检测。
Pediatric L-HLTx recipients are at risk for developing PTLD with the lung being a primary site of disease. We hypothesized that BALF is a better sample than peripheral blood for measuring EBV DNA load in this high-risk population. Archived BALF specimens from pediatric L-HLTx recipients with and without PTLD were assayed for EBV DNA load using a quantitative real time TaqMan PCR assay. These values were compared with values determined in peripheral blood by a competitive PCR assay. Fifty-five BALF specimens from 16 L-HLTx patients were evaluated. Three patients with PTLD had mean BALF EBV DNA load values almost 50-fold higher than subjects without PTLD (4.6 x 10(5) copies/mL vs. 1.0 x 10(4) copies/mL). Patients who were EBV seronegative pretransplantation (i.e., high risk for PTLD) had elevated EBV DNA load values vs. patients who were EBV seropositive pretransplantation, regardless of the diagnosis of PTLD (mean values of 3.2 x 10(5) copies/mL vs. 1.1 x 10(4) copies/mL). Lastly, BALF analysis identified all subjects with PTLD, whereas peripheral blood analysis identified only one of these cases. Therefore, it can be concluded that monitoring EBV DNA load in BALF following L-HLTx facilitates detection of PTLD in high-risk patients and may be superior to peripheral blood assays.