Changes in the immune responses against human herpesvirus-8 in the disease course of posttransplant Kaposi sarcoma
Changes in the immune responses against human herpesvirus-8 in the disease course of posttransplant Kaposi sarcoma
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DOI：
10.1097/tp.0b013e318184112c
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发表时间：
2008-09-15
期刊：
影响因子：
6.2
通讯作者：
Luppi, Mario
中科院分区：
文献类型：
--
作者：
Barozzi, Patrizia;Bonini, Chiara;Luppi, Mario
在9例移植后卡波西肉瘤（KS）的T细胞对人类疱疹病毒（HHV）-8潜伏和裂解抗原的反应，如酶联免疫斑点（Elispot）试验所检测到的，在疾病发作时不存在。在减少钙调磷酸酶抑制剂（CI）后缓解的六名肾受者和两名没有KS的HHV-8血清阳性肾受者中检测到病毒特异性T细胞反应。在两个肝脏接受者从CI转换为西罗莫司（SRL），T细胞库的正常化和恢复HHV-8特异性效应和记忆T淋巴细胞与KS完全缓解。在肾受体接受SRL转换，HHV-8特异性效应，但不是记忆T淋巴细胞的早期恢复，仅与部分缓解。SRL转换后未观察到排斥反应或移植物功能的变化。HHV-8特异性T细胞反应是实现移植后KS缓解所必需的，并且可以在SRL下恢复，同时保持有效的免疫抑制。
In nine patients with posttransplant Kaposi sarcoma (KS) T-cell responses to human herpesvirus (HHV)-8 latent and lytic antigens, as detected by enzyme-linked-immunospot (Elispot) assay, were absent at disease onset. Virus-specific T-cell responses were detected in six renal recipients at remission after a reduction of calcineurin inhibitors (CIs), and in two HHV-8 seropositive renal recipients without KS. In two liver recipients undergoing switch from CIs to sirolimus (SRL), normalization of the T-cell repertoire and recovery of both HHV-8-specific effector and memory T lymphocytes were associated with complete KS remission. In a renal recipient undergoing SRL conversion, the early recovery of HHV-8-specific effector but not of memory T lymphocytes, was associated only with partial remission. Neither rejection nor changes in graft function were observed after SRL conversion. HHV-8-specific T-cell responses are required to achieve posttransplant KS remission, and may be restored under SRL, while maintaining effective immunosuppression.