Monitoring of adenovirus (<scp>ADV</scp>)‐specific T cells in a boy with <scp>ADV</scp> pneumonia and disseminated disease after lung transplantation

Schultze-Florey, R. E.; Tischer, Sabine; Schwerk, Nicolaus; Heim, Albert; Maecker‐Kolhoff, Britta

doi:10.1111/tid.12569

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…123,127,128 Infection in lung recipients is common (up to 22% in 1 series) and there are multiple reports of severe infection, including graft loss, progression to BOS, and death. 125,[129][130][131][132] Infection in HSCT recipients can be severe and associated with significant mortality. In 14 adult HSCT recipients with adenovirus viremia, most of whom were treated with antivirals, almost 50% developed invasive adenoviral disease and 23% died of the infection.…”

Section: Adenovirusmentioning

confidence: 99%

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Paulsen

Danziger‐Isakov

2017

Clinics in Chest Medicine

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Respiratory viruses are common in solid organ and hematopoietic stem cell transplant recipients and a recognized cause of significant morbidity and mortality. Epidemiology, risk factors, and attributable mortality in both populations are reviewed. In addition, virus-specific prevention and treatment options, including emerging investigational therapies, are discussed for respiratory syncytial virus, influenza, adenovirus, parainfluenza, and other respiratory viruses.

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Section: Adenovirusmentioning

confidence: 99%

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Paulsen

Danziger‐Isakov

2017

Clinics in Chest Medicine

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“…Cytokines, chemokines [15,16] ImmunoKnow-Assay [17][18][19][20][21] TorqueTenoVirus [16,[22][23][24][25][26][27][28][29] Virus-specific T cells [30][31][32][33][34] Ahlenstiel-Grunow and Pape Molecular and Cellular Pediatrics (2021) 8:8…”

Section: Methods Studiesmentioning

confidence: 99%

Novel ways to monitor immunosuppression in pediatric kidney transplant recipients—underlying concepts and emerging data

Ahlenstiel-Grunow

Pape

2021

Mol Cell Pediatr

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After pediatric kidney transplantation, immunosuppressive therapy is given to avoid acute and chronic rejections. However, the immunosuppression causes an increased risk of severe viral complications and bacterial infections and is associated with serious side effects. It is therefore crucial to achieve the optimal individual balance between over- and under-immunosuppression and thereby avoid unnecessary exposure to immunosuppressive drugs. In routine use, steering of immunosuppressants is performed primarily by monitoring of trough levels that mirror pharmacokinetics (although not, however, pharmacodynamics). Other diagnostic and prognostic markers to assess the individual intensity of immunosuppression are missing. Potential methods to determine immune function and grade of immunosuppression, such as analysis of the torque teno virus (TTV) load, QuantiFERON Monitor®, and ImmuKnow® as well as virus-specific T cells (Tvis), are currently being evaluated. In some studies TTV load, QuantiFERON Monitor® and ImmuKnow® were associated with the risk for post-transplant rejections and infections, but randomized controlled trials after pediatric kidney transplantation are not available. Post-transplant monitoring of Tvis levels seem to be promising because Tvis control virus replication and have been shown to correlate with virus-specific as well as general cellular immune defense, which represents the individual’s susceptibility to infections. Additional Tvis-monitoring provides an innovative opportunity to personalize the antiviral management and the dosing of the immunosuppressive therapy after pediatric kidney transplantation to avoid unnecessary therapeutic interventions and identify over-immunosuppression.

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“…Some data on ADV-specific T cells was generated by ELISpot in a small group of children after liver transplantation [50]. In one child with ADV pneumonia, ADV-specific T cells were measured after lung transplantation and the possibility of steering antiviral therapy using ADV-specific T cells is reported [11]. In our own cohort of 37 pediatric kidney recipients aged between 1 and 17 years (median 13 years), the pretransplant prevalence of ADV-specific CD4 T cells was 76% (data not published) without any ADV-associated complications after kidney transplantation.…”

Section: Adenovirus-specific T Cellsmentioning

confidence: 99%

“…Virus-specific T cells have been shown to play a significant role in control of virus replication [7]: Virus-specific CD4positive T cells detect viral epitopes which are presented on major histocompatibility complex (MHC) class II molecules on antigen-presenting cells such as B lymphocytes, dendritic cells and macrophages, and CD8-positive T cells locate and destroy virus-infected cells which present viral antigens by MHC class I molecules. Several studies, mainly in adults, have shown that the number of virus-specific T cells is associated with the risk of virus-specific complications [8][9][10][11][12][13][14][15][16][17][18][19]. Therefore, prophylaxis, diagnosis, and treatment of viral infections after kidney transplantation may be improved by the implementation of virus-specific T cells in routine monitoring [7].…”

Section: Introductionmentioning

confidence: 99%

Virus-specific T cells in pediatric renal transplantation

Ahlenstiel-Grunow

Pape

2020

Pediatr Nephrol

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After pediatric kidney transplantation, immunosuppressive therapy causes an increased risk of severe viral complications, especially from cytomegalovirus (CMV), BK polyomavirus (BKPyV) or Epstein-Barr virus (EBV), and less frequent from adenovirus (ADV). However, suitable predictive markers for the individual outcome of viral infections are missing and the therapeutic management remains a challenge to the success of pediatric kidney transplantation. Virus-specific T cells are known for controlling viral replication and there is growing evidence that virus-specific T cells may serve as a prognostic marker to identify patients at risk for viral complications. This review provides an overview of the usability of virus-specific T cells for improving diagnostic and therapeutic management of viral infections with reference to the necessity of antiviral prophylaxis, timing of pre-emptive therapy, and dosing of immunosuppressive medication after pediatric kidney transplantation. Several studies demonstrated that high levels of virus-specific T cells are associated with decrease of virus load and favorable outcome, whereas lack of virus-specific T cells coincided with virus-induced complications. Accordingly, the additional monitoring of virus-specific T cells aims to personalize the management of antiviral therapy, identify overimmunosuppression, and avoid unnecessary therapeutic interventions. Prospective randomized trials in pediatric kidney recipients comparing standard antiviral and immunosuppressive regimens with T cell-guided therapeutic interventions are needed, before monitoring of virus-specific T cells is implemented in the routine care of pediatric kidney graft recipients.

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Monitoring of adenovirus (ADV)‐specific T cells in a boy with ADV pneumonia and disseminated disease after lung transplantation

Cited by 10 publications

References 15 publications

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Novel ways to monitor immunosuppression in pediatric kidney transplant recipients—underlying concepts and emerging data

Virus-specific T cells in pediatric renal transplantation

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