IntroductionHuman cytomegalovirus (HCMV) infection is highly prevalent in healthy persons and the virus remains in a lifelong latent state, undergoing occasional reactivation and causing an important morbidity in immunocompromised patients. 1 An effective defense against CMV infection requires the participation of both T and NK cells. 2 To escape T cell-mediated recognition, CMV interferes with the expression of major histocompatibility complex molecules and antigen presentation. 3 The loss of human leukocyte antigen (HLA) class I molecules in infected cells impairs the engagement of inhibitory receptors, thus promoting the activation of NK-cell effector functions. Reciprocally, the virus has developed different strategies to escape NK-cell surveillance, preventing the expression of ligands for some activating receptors (ie, NKG2D, DNAM-1) 4-9 or selectively maintaining inhibitory receptors for HLA class I molecules engaged. The UL18 glycoprotein binds with high affinity to the LILRB1 inhibitory receptor expressed in different leukocytes 10 ; yet, formal experimental evidence for its function in immune evasion remains elusive. 11 In the same line, a leader signal peptide of the UL40 HCMV protein was shown to stabilize the surface expression of HLA-E, thus repressing NK-cell activation by engagement of the inhibitory CD94/NKG2A receptor. 12,13 On the other hand, the NK-cell subset bearing the CD94/NKG2C triggering molecule tends to expand in peripheral blood from HCMV ϩ persons 14 and on in vitro coculture of peripheral blood mononuclear cells (PBMCs) with HCMV-infected fibroblasts. 15 A CD94/NKG2C ϩ NK lymphocytosis was detected in a patient with a selective T-cell deficiency, coinciding with an acute HCMV infection and associated with a reduction of viremia. 16 Altogether, these results suggest that the CD94/NKG2C ϩ NK-cell subset may play an active role in the response to HCMV.Information on the nature of NK-cell receptor (NKR)-ligand interactions involved in the response against HCMV-infected cells is scarce, and most studies have been performed in infected fibroblasts, not fully representative of the different cell types susceptible to in vivo infection. Cells of the myeloid lineage are considered reservoirs for HCMV latency, and differentiation of myeloid progenitors to dendritic cells (DCs) may reactivate the virus. 17 Furthermore, monocyte-derived DCs (moDCs) appear susceptible to in vitro HCMV infection by endothelial cell (EC)-adapted viral strains. 18 Infection of moDCs has been reported to impair their maturation, inhibiting surface expression of major histocompatibility complex class I and II, costimulatory molecules, and chemokine receptors (ie, CCR1 and CCR5), thus interfering with the development of virus-specific T-cell responses. [19][20][21] Beyond their key role in antigen presentation, DCs may establish a cross-talk with NK cells that reciprocally regulates their Submitted August 9, 2010; accepted October 13, 2010. Prepublished online as Blood First Edition paper, October 28, 2010; DOI 10.118...