Comparison of intracellular cytokine staining versus an ELISA-based assay to assess CMV-specific cell-mediated immunity in high-risk kidney transplant recipients

© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC..

The best method for monitoring cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) among high-risk kidney transplant (KT) recipients remains uncertain. We assessed CMV-CMI by intracellular cytokine staining (ICS) by flow cytometry and a commercial interferon (IFN)-γ release assay (QuantiFERON®-CMV [QTF-CMV]) at posttransplant months 3, 4, and 5 in 53 CMV-seropositive KT recipients that had received induction therapy with antithymocyte globulin (ATG) and a 3-month course of valganciclovir prophylaxis. The discriminative capacity (areas under receiver operating characteristics curve [auROCs]) and diagnostic accuracy to predict immune protection against CMV infection from the discontinuation of prophylaxis to month 12 were compared between both methods. There was significant although moderate correlations between CMV-specific IFN-γ-producing CD8+ T-cell counts enumerated by ICS and IFN-γ levels by QTF-CMV at months 3 (rho: 0.493; p = 0.005) and 4 (rho: 0.440; p = 0.077). The auROCs for CMV-specific CD4+ and CD8+ T-cells by ICS were nonsignificantly higher than that of QTF-CMV (0.696 and 0.733 vs. 0.678; p = 0.900 and 0.692, respectively). The optimal cut-off of ≥0.395 CMV-specific CD8+ T-cells yielded a sensitivity of 86.4%, specificity of 54.6%, positive predictive value of 79.2% and negative predictive value of 66.7% to predict protection. The corresponding estimates for QTF-CMV (IFN-γ levels ≥0.2 IU/mL) were 78.9%, 37.5%, 75.0%, and 42.9%, respectively. The enumeration of CMV-specific IFN-γ-producing CD8+ T-cells at the time of cessation of prophylaxis performed slightly better than the QTF-CMV assay to predict immune protection in seropositive KT recipients previously treated with ATG.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:95

Enthalten in:

Journal of medical virology - 95(2023), 4 vom: 01. Apr., Seite e28733

Sprache:

Englisch

Beteiligte Personen:

Fernández-Ruiz, Mario [VerfasserIn]
Redondo, Natalia [VerfasserIn]
Parra, Patricia [VerfasserIn]
Ruiz-Merlo, Tamara [VerfasserIn]
Rodríguez-Goncer, Isabel [VerfasserIn]
Polanco, Natalia [VerfasserIn]
González, Esther [VerfasserIn]
López-Medrano, Francisco [VerfasserIn]
San Juan, Rafael [VerfasserIn]
Navarro, David [VerfasserIn]
Andrés, Amado [VerfasserIn]
Aguado, José María [VerfasserIn]

Links:

Volltext

Themen:

Cell-mediated immunity
Cytokines
Cytomegalovirus
Immune monitoring
Intracellular cytokine staining
Journal Article
Kidney transplantation
QuantiFERON-CMV
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 17.05.2023

Date Revised 22.06.2023

published: Print

Citation Status MEDLINE

doi:

10.1002/jmv.28733

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM356885364