Ocular Outcomes after Treatment of Cytomegalovirus Retinitis Using Adoptive Immunotherapy with Cytomegalovirus-Specific Cytotoxic T Lymphocytes

Gupta, Mrinali P.; Koenig, Lisa R.; Doubrovina, Ekaterina; Hasan, Aisha; Dahi, Parastoo B.; O’Reilly, Richard J.; Koehne, Guenther; Orlin, Anton; Chan, Robison Vernon Paul; D’Amico, Donald J.; Park, Susanna S.; Burkholder, Bryn M.; Kiss, Szilárd

doi:10.1016/j.oret.2021.04.009

Cited by 18 publications

(20 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have shown resolution of CMV viremia after one to two doses of VSTs in approximately 85% of patients 16 . Gupta et al treated seven patients, aged 26-68 years, who had CMVR with VST with a 90% resolution of the disease with a median follow-up of 33 months 17 . Additionally, there is one case report of a 3-year-old who also achieved remission of CMVR following VSTs 18 .…”

Section: Discussionmentioning

confidence: 99%

Persistent Cytomegalovirus Retinitis following Hematopoietic Stem Cell Transplantation Treated with Viral-Specific T Cells

Montiel-Esparza

Michalak

et al. 2023

Preprint

View full text Add to dashboard Cite

Cytomegalovirus retinitis (CMVR) following hematopoietic stem cell transplantation (HCT) for a primary immunodeficiency is a rare but highly morbid condition with potential irreversible consequences despite optimal antiviral pharmacotherapy. Viral-specific T cells (VSTs) pose a promising and safe approach eradicating intractable viral disease. We describe the case of a 21-month-old male with Wiskott-Aldrich syndrome (WAS) and CMVR post-HCT with sustained long-term virologic and clinical response after CMV-specific T cell therapy. This case highlights the need to consider VSTs as an adjunct upfront strategy in refractory CMVR and for routine ophthalmologic screening and surveillance in high-risk patients post-HCT.

show abstract

Section: Discussionmentioning

confidence: 99%

Persistent Cytomegalovirus Retinitis following Hematopoietic Stem Cell Transplantation Treated with Viral-Specific T Cells

Montiel-Esparza

Michalak

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Until recently, several studies have verified that donor-derived CMV-CTLs can overcome drug resistance of CMV after HSCT ( 2 , 4 , 5 ). In addition, limited case reports disclose that CMV-CTLs in the blood can efficiently eliminate CMV inside the oculus and CNS, even though separated by BBB and blood-ocular barrier ( 8 , 12 ). Besides the perfect efficacy of the immune cells, donor-derived CMV-CTLs are safe for transplant recipients without the induction or aggravation of GVHD ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Donor-derived cytomegalovirus-cytotoxic T lymphocytes and leflunomide successfully control refractory cytomegalovirus infections and disease of multiple sites after allogeneic-hematopoietic stem cell transplantation: A case report

Liu²,

Sun³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

Drug-resistant cytomegalovirus (CMV) infection after hematopoietic stem cell transplantation (HSCT) often leads to morbidity and mortality. Several studies have shown that CMV-cytotoxic T lymphocytes (CTLs) can overcome drug-resistant CMV infection, but still many questions remain unanswered. Here, we present a case of refractory CMV infection after allogeneic HSCT (allo-HSCT). Donor-derived CMV-CTLs failed to eliminate the virus in unique peripheral blood on the first application, when 70 mg methylprednisolone (MP) was taken per day. After a second attempt with a combination of 8 mg MP with leflunomide, a complete and persisting clearance of all involved sites, including peripheral blood, urinary system, leptomeninges, and retina, was achieved. To summarize, intravenous infusion of CTLs can eliminate CMV in the oculi and central nervous system (CNS), and a low dosage of 8 mg MP has no interaction with CMV-CTLs.

show abstract

“…The HCMV persistent or progressive retinitis may be resolved by systemic administration of virus-specific cytotoxic T-cells (CTLs) [34]. HCMV-specific CTL therapy may become a novel monotherapy or adjunctive therapy, or both, for retinitis, especially in eyes that are resistant, refractory, or intolerant of antiviral therapies [34]. In addition, it has been demonstrated that HCMV strain-specific antibodies play an important role in preventing viral recrudescence after transplantation [29].…”

Section: Interventions Of Hcmv Ocular Diseasesmentioning

confidence: 99%

“…Antibodies, natural killer cells, and macrophages theoretically contribute to protective immune responses and are expected to interact and cooperate with T-cells to control HCMV replication. It was also recommended that studies of active immunization should proceed concurrently with passive immunotherapy using monoclonal antibodies with defined reactivity against specific proteins of HCMV against the resistance [34]. Recently, letermovir has been used in ganciclovir-resistant patients at doses of 720-960 mg, while intravitreal therapy with formic acid or ganciclovir was also used, and by monitoring continuous hematologic, renal, and hepatic function, some patients experienced an improvement in symptoms [32].…”

Section: Interventions Of Hcmv Ocular Diseasesmentioning

confidence: 99%

Ocular Infection of HCMV: Immunology, Pathogenesis, and Interventions

Yan¹,

Chen²

2023

Viral Outbreaks - Global Impact and Newer Horizons

View full text Add to dashboard Cite

Human cytomegalovirus (HCMV) retinitis accounts for 70% of herpesvirus-infected ocular diseases. Recent advances in knowledge of innate immune responses to viral infections have elucidated a complex network of the interplay between the invading virus, the target cells, and the host immune responses. Ocular cytomegalovirus latency exacerbates the development of choroidal neovascularization. Viruses have various strategies to evade or delay the cytokine response, and buy time to replicate in the host. Some signaling proteins impact the virologic, immunologic, and pathological processes of herpesvirus infection with particular emphasis on retinitis caused by HCMV. The accumulated data suggest that signaling proteins can differentially affect the severity of viral diseases in a highly cell-type-specific manner, reflecting the diversity and complexity of herpesvirus infection and the ocular compartment. By summarizing the immunological characteristics and pathogenesis of HCMV ocular infection, it will provide important information on the development of antiviral therapy, immunotherapy, and antidrug resistance.

show abstract

Ocular Outcomes after Treatment of Cytomegalovirus Retinitis Using Adoptive Immunotherapy with Cytomegalovirus-Specific Cytotoxic T Lymphocytes

Cited by 18 publications

References 11 publications

Persistent Cytomegalovirus Retinitis following Hematopoietic Stem Cell Transplantation Treated with Viral-Specific T Cells

Persistent Cytomegalovirus Retinitis following Hematopoietic Stem Cell Transplantation Treated with Viral-Specific T Cells

Donor-derived cytomegalovirus-cytotoxic T lymphocytes and leflunomide successfully control refractory cytomegalovirus infections and disease of multiple sites after allogeneic-hematopoietic stem cell transplantation: A case report

Ocular Infection of HCMV: Immunology, Pathogenesis, and Interventions

Contact Info

Product

Resources

About