The value of polymerase chain reaction for the diagnosis of viral respiratory tract infections in lung transplant recipients

Weinberg, Adriana; Zamora, Martin R.; Li, Shaobing; Torres, Fernando; Hodges, Tony

doi:10.1016/s1386-6532(02)00006-9

Cited by 75 publications

(60 citation statements)

References 13 publications

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“…Previous studies have captured recipients with viral infections retrospectively and therefore may have underestimated the true incidence of viral infection (7,34). Prospective protocols to track viral symptoms and identify virus with polymerase chain reaction-based assays have demonstrated a much higher incidence of respiratory viral infection (0.66-1.56 infections per patient-year of follow-up) (35)(36)(37). Likewise, the detection of viral genomes in human cardiac and renal allografts has been increased using polymerase chain reaction-based technology, and the detection of viral genomes in these allografts is also associated with chronic allograft dysfunction (38)(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

IL-12 p80 Is an Innate Epithelial Cell Effector That Mediates Chronic Allograft Dysfunction

Mikols

Yan

Norris

et al. 2006

Am J Respir Crit Care Med

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Rationale: Bronchiolitis obliterans syndrome is the leading cause of chronic lung allograft dysfunction. We have demonstrated that respiratory viral infection is a bronchiolitis obliterans syndrome risk factor and virus-dependent injury induces expression of innate airway epithelial genes belonging to the interleukin (IL)-12 family. Thus, we hypothesized that epithelial cell IL-12 family members could mediate lung allograft dysfunction. Objectives: We used mouse and human allograft specimens to evaluate the role of epithelial cell IL-12 family members in allograft dysfunction associated with and without viral infection. Methods: Murine and human IL-12 family members were characterized and manipulated in allografts and then correlated with epithelial cell injury, immune cell accumulation, and collagen deposition. Results: In a mouse model of lung transplantation, concurrent viral infection and allogeneic transplantation increased epithelial injury and this was followed by exaggerated accumulation of macrophages and collagen deposition. This virus-driven allograft dysfunction was associated with an epithelial innate response manifested by a synergistic increase in the production of the macrophage chemoattractant IL-12 p80 (p80), but not IL-12 or IL-23. Blockade or overexpression of donor epithelial p80 resulted in a corresponding abrogation or enhancement of macrophage accumulation and allograft dysfunction. We extended these findings to human recipients with viral infection and transplant bronchitis and again observed excessive epithelial p80 expression that correlated with increased macrophage accumulation. Conclusions: These experiments support a role for an enhanced epithelial innate response as a central process in allograft dysfunction and identify the macrophage chemoattractant p80 as an innate epithelial effector of disease progression.

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Section: Discussionmentioning

confidence: 99%

IL-12 p80 Is an Innate Epithelial Cell Effector That Mediates Chronic Allograft Dysfunction

Mikols

Yan

Norris

et al. 2006

Am J Respir Crit Care Med

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“…34 Some epidemiologic studies have suggested an association between respiratory viral infection and the development of bronchiolitis obliterans syndrome (BOS). [35][36][37][38][39][40] These studies yielded mixed results and the association between respiratory virus infection and BOS remains unclear. 41,42 The recent availability of molecular diagnostics, including PCR and multiplex gene techniques for the recovery of many viruses simultaneously from a single specimen, increased the recovery of pathogens in respiratory infections that previously were considered to be of undetermined etiology.…”

Section: Respiratory Viral Infectionsmentioning

confidence: 99%

A 2010 working formulation for the standardization of definitions of infections in cardiothoracic transplant recipients

Husain

Mooney

Danziger‐Isakov

et al. 2011

The Journal of Heart and Lung Transplantation

187

171

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“…Present methods of diagnosing viral respiratory infections include tissue culture isolation (TC); rapid shell vial detection (SV); direct antigen detection using enzyme, fluorescence, optical, or chromatographic immunoassays; and PCR (10,14). The rapid influenza immunoassays (RIIA) provide a result in 15 to 30 min.…”

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confidence: 99%

Evaluation of Three Immunoassay Kits for Rapid Detection of Influenza Virus A and B

Weinberg

Walker

2005

Clin Vaccine Immunol

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Influenza causes high morbidity and mortality in very young and elderly individuals, which can be controlled with antivirals and/or vaccines. The success of therapeutic measures is predicated on the rapid and precise diagnosis of the infection. We compared three rapid influenza immunoassay (RIIA) kits for the diagnosis of influenza virus A and B using 178 respiratory specimens submitted for routine testing. BD Directigen Flu A؉B (Directigen), Directigen EZ Flu A؉B (EZ), and NOW Flu A NOW Flu B (NOW; Binax) tests had comparable combined influenza virus A and B specificities, varying from 94 to 98%. In contrast, the sensitivity of EZ was significantly lower (39%) than that of NOW (76%) and marginally lower than that of Directigen (56%). The differences in sensitivity were most evident in patients who were >9 years old (Directigen, 53%; EZ, 32%; and NOW, 69%). Among specimens, bronchoalveolar lavage fluids yielded the most discrepant results, with sensitivities varying from 0 (EZ) to 100% (NOW), followed by nasopharyngeal swabs (sensitivities of 27 to 100%) and nasal washes (50 to 81%). The Directigen kit format allowed for faster completion but more cumbersome performance and more difficult interpretation compared with the other two kits. Overall, NOW provided the most accurate diagnoses and had user-friendly technical characteristics. However, the low overall sensitivity of the RIIAs indicates that these can be used as screening tools only.

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The value of polymerase chain reaction for the diagnosis of viral respiratory tract infections in lung transplant recipients

Cited by 75 publications

References 13 publications

IL-12 p80 Is an Innate Epithelial Cell Effector That Mediates Chronic Allograft Dysfunction

IL-12 p80 Is an Innate Epithelial Cell Effector That Mediates Chronic Allograft Dysfunction

A 2010 working formulation for the standardization of definitions of infections in cardiothoracic transplant recipients

Evaluation of Three Immunoassay Kits for Rapid Detection of Influenza Virus A and B

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