Early detection of active cytomegalovirus (CMV) infection after heart and kidney transplantation by testing for immediate early antigenemia and influence of cellular immunity on the occurrence of CMV infection

Boland, Greet J.; Gast, Gijsbert C. de; Hené, Ronald J.; Jambroes, G; Donckerwolcke, R. A.; Mudde, GC

doi:10.1128/jcm.28.9.2069-2075.1990

Cited by 47 publications

(22 citation statements)

References 27 publications

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“…Another interesting finding was that primary CMV infection was first detected by antigenemia in 12 of the 14 patients. This indicated that not only in secondary CMV infections [2] but also in primary CMV infections this method is the first to detect active CMV infection. Antigenemia occurred significantly earlier than IgM, IgG seroconversion and CMV excretion.…”

Section: Discussionmentioning

confidence: 98%

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Early detection of primary cytomegalovirus infection after heart and kidney transplantation and the influence of hyperimmune globulin prophylaxis

Boland¹,

Ververs²,

Hené³

et al. 1993

Transplant Int

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A randomized study of prophylaxis with hyperimmune globulin (HIg) was performed in 28 cytomegalovirus (CMV)-seronegative heart and kidney recipients with CMV-seropositive donors who were extensively monitored for active CMV infection and CMV disease. Detection of CMV antigen in peripheral blood granulocytes (antigenemia) was the first sign of primary CMV infection, generally occurring several weeks before IgM or IgG anti-CMV antibodies were detected and before positive cultures appeared. A correlation was found between rejection treatment with OKT3 or ATG, severity of CMV disease, and graft loss. Rejection treatment had no influence on incidence of CMV transmission. Primary CMV infection occurred most often in older patients with older donors. No beneficial effects were seen with HIg prophylaxis, which was administered from week 1 until week 7 after transplantation. Incidence of primary CMV infection was equal in both groups (50%) and no influence on the severity of primary CMV infection was seen. The only effect that was seen was on the time from transplantation to detection of active CMV infection, which was prolonged by HIg prophylaxis.

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Section: Discussionmentioning

confidence: 98%

“…In CMV-positive recipients, cellular immune responses are important for the prevention of active CMV infection [2]. Cellular immunity to CMV is absent in CMV-negative recipients of CMV-positive donors.…”

Section: Discussionmentioning

confidence: 99%

Early detection of primary cytomegalovirus infection after heart and kidney transplantation and the influence of hyperimmune globulin prophylaxis

Boland¹,

Ververs²,

Hené³

et al. 1993

Transplant Int

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“…Previous studies have shown that the detection of cytomegalovirus antigenaemia, which is the presence of CMV antigen in peripheral blood leucocytes, is a sensitive marker for the detection of an active CMV infection [2,3,[5][6][7][8]10,11,13]. In this study, we have optimized the detection of antigenaemia in two ways.…”

Section: Discussionmentioning

confidence: 99%

Detection improvement of cytomegalovirus antigen in human peripheral blood using monoclonal antibodies and automated reading of cell preparations

Boland¹,

Mesker²,

Doorn³

et al. 1995

Eur J Clin Investigation

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Abstract. One of the major drawbacks in cytomegalovirus (CMV)-antigenaemia detection for diagnosis of active CMV infection is the low number of CMVantigen positive cells present in peripheral blood. It is therefore necessary to screen large numbers of peripheral blood granulocytes to find only a few antigenpositive cells. We have optimized this detection by testing several monoclonal antibodies (mAb) to CMV-antigens (mAbs ClOjCl I , C12, BM222, El3 and SL20). In total 550 blood samples from 40 patients were investigated. More blood samples were found positive with mAb C12 than with the other mAbs. Also the average number of positive cells per slide was highest for mAb C 12. Furthermore, duplicate slides were examined automatically using an image analysis system (LEYTAS) and compared to visual detection (cytospin slides). The detection sensitivity of both screening methods was compared for mAb C12. In total 360 slides were analysed, from positive as well as negative blood samples. The sensitivity of the automated screening was 93% and for the visual evaluation of the cytospin slides 73%. In conclusion, mAb C12 was the most suitable of the mAbs tested for detection of antigenaemia, and automatic detection of CMV antigenaemia with image analysis of slides is a sensitive method due to the large numbers of cells that can be screened.

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“…Stimulation indices (SI) were calculated for CMV compared with uninfected fetal fibroblasts, and for Candida and PHA compared with culture medium. Lymphocyte proliferation tests with SI = 3 and with a net pulse of at least 1000 ct/min (stimulated culture minus control) were considered to be positive [13].…”

Section: Lymphocyte Proliferationmentioning

confidence: 99%

“…Scrum levels below 5 arbitrary units (AU) were considered negative. A rise in serum IgG was considered significant when antibody titres rose by at least 25 AU and remained high [13].…”

Section: Serologymentioning

confidence: 99%

Evidence for transfer of cellular and humoral immunity to cytomegalovirus from donor to recipient in allogeneic bone marrow transplantation

Boland

Vlieger

Ververs

et al. 1992

Clinical and Experimental Immunology

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SUMMARYIn order to study the importance ofthe immune status ofthe donor in the development of immunity after allogeneic bone marrow transplantation (BMT), we monitored 23 cytomegalovirus (CMV) antibody-positive BMT recipients for humoral and cellular immunity to CMV, of whom 12 had a CMV antibody-positive and 11 a CMV antibody-negative marrow donor. Lymphocyte proliferation to CMV recovered significantly earlier after BMT in recipients of marrow from a CMV+ donor (10-4 weeks after BMT) compared with the recipients of marrow from CMV" donors (16-7 weeks after BMT, /'<0-05). This seemed to be specific, as lymphocyte proliferation to phytohaemagglutinin and Candida were not different between the two groups. IgM responses after active infection were seen in both groups, but initial IgG rises without IgM were seen only in recipients of marrow from CMV+ donors (/'<0-05). Lymphocyte proliferative or humoral immune responses to CMV were not detected in any ofthe patients in a control group consisting of nine CMV" recipients. These results indicate that T cell memory to CMV is transferred with donor marrow from CMV+ donors, leading in most patients to direct IgG anti-CMV responses and to quicker recovery of cellular immunity to CMV.

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Early detection of active cytomegalovirus (CMV) infection after heart and kidney transplantation by testing for immediate early antigenemia and influence of cellular immunity on the occurrence of CMV infection

Cited by 47 publications

References 27 publications

Early detection of primary cytomegalovirus infection after heart and kidney transplantation and the influence of hyperimmune globulin prophylaxis

Early detection of primary cytomegalovirus infection after heart and kidney transplantation and the influence of hyperimmune globulin prophylaxis

Detection improvement of cytomegalovirus antigen in human peripheral blood using monoclonal antibodies and automated reading of cell preparations

Evidence for transfer of cellular and humoral immunity to cytomegalovirus from donor to recipient in allogeneic bone marrow transplantation

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