Monitoring of intracellular adenosine triphosphate in CD4(+) T cells to predict the occurrence of cytomegalovirus disease in kidney transplant recipients
© 2016 Steunstichting ESOT..
The measurement of intracellular concentrations of adenosine triphosphate (iATP) in phytohemagglutinin-stimulated CD4(+) T cells constitutes a surrogate marker for post-transplant cell-mediated immunity (CMI). This assay has shown suboptimal accuracy for predicting infection after kidney transplantation (KT). We hypothesize that its predictive capacity depends on the specific contribution of the CMI to host-pathogen interactions. We assessed iATP levels in 100 KT recipients at baseline and months 1, 3, and 6 (363 measurements). No association was found between iATP at month 1 and the risk for overall or bacterial infection, although such association was evident for cytomegalovirus (CMV) disease (multivariate-adjusted hazard ratio [per 50-unit increment]: 0.83; P-value = 0.048). There were no significant differences in mean iATP between stable patients (319.4 ng/ml) and those developing overall (304.1 ng/ml) or bacterial infection (346.9 ng/ml) over the 45 days following monitoring. However, iATP was significantly lower in patients who developed CMV disease (223.5 ng/ml; P-values <0.002). The optimal cutoff (265 ng/ml) for predicting CMV disease in patients not receiving antiviral prophylaxis yielded sensitivity, specificity, positive, and negative predictive values of 85.7%, 68.3%, 15.2%, and 98.6%, respectively. In conclusion, a non-pathogen-specific monitoring of CMI by means of iATP informs the risk of CMV disease in KT recipients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Transplant international : official journal of the European Society for Organ Transplantation - 29(2016), 10 vom: 30. Okt., Seite 1094-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pérez-Jacoiste Asín, María Asunción [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 03.08.2017 Date Revised 17.08.2017 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/tri.12816 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM261910817 |
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| 520 | |a © 2016 Steunstichting ESOT. | ||
| 520 | |a The measurement of intracellular concentrations of adenosine triphosphate (iATP) in phytohemagglutinin-stimulated CD4(+) T cells constitutes a surrogate marker for post-transplant cell-mediated immunity (CMI). This assay has shown suboptimal accuracy for predicting infection after kidney transplantation (KT). We hypothesize that its predictive capacity depends on the specific contribution of the CMI to host-pathogen interactions. We assessed iATP levels in 100 KT recipients at baseline and months 1, 3, and 6 (363 measurements). No association was found between iATP at month 1 and the risk for overall or bacterial infection, although such association was evident for cytomegalovirus (CMV) disease (multivariate-adjusted hazard ratio [per 50-unit increment]: 0.83; P-value = 0.048). There were no significant differences in mean iATP between stable patients (319.4 ng/ml) and those developing overall (304.1 ng/ml) or bacterial infection (346.9 ng/ml) over the 45 days following monitoring. However, iATP was significantly lower in patients who developed CMV disease (223.5 ng/ml; P-values <0.002). The optimal cutoff (265 ng/ml) for predicting CMV disease in patients not receiving antiviral prophylaxis yielded sensitivity, specificity, positive, and negative predictive values of 85.7%, 68.3%, 15.2%, and 98.6%, respectively. In conclusion, a non-pathogen-specific monitoring of CMI by means of iATP informs the risk of CMV disease in KT recipients | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a predictive value | |
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| 700 | 1 | |a Fernández-Ruiz, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a López-Medrano, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Aquilino, Carolina |e verfasserin |4 aut | |
| 700 | 1 | |a González, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Ruiz-Merlo, Tamara |e verfasserin |4 aut | |
| 700 | 1 | |a Gutiérrez, Eduardo |e verfasserin |4 aut | |
| 700 | 1 | |a San Juan, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Paz-Artal, Estela |e verfasserin |4 aut | |
| 700 | 1 | |a Andrés, Amado |e verfasserin |4 aut | |
| 700 | 1 | |a Aguado, José Maria |e verfasserin |4 aut | |
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