Immune monitoring of prevalent kidney transplant recipients using Torque Teno Virus : Protocol for a single-centre prospective cohort study
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
INTRODUCTION: Kidney transplant recipients (KTRs) suffer from immunosuppression-related adverse events (iRAEs), such as infections and malignancy from chronic immunosuppression, but are also at risk of graft loss from rejection with underimmunosuppression. Biomarkers that predict both iRAEs and rejection while allowing individualisation of immunosuppression exposure are lacking. Although plasma viral DNA levels of torque teno virus (TTV), a widely prevalent, non-pathogenic virus, have been shown to predict both iRAE and rejection in newly transplanted KTRs within the first year after transplant, its role for prevalent KTRs on stable immunosuppression is less clear.This study aims to determine the prognostic value of TTV levels for severe infections (defined as infections requiring hospitalisation) in prevalent KTRs on stable immunosuppression for at least 3 months and compare it against that of other commonly available biomarkers. The study also aims to explore the relationship between TTV levels and factors affecting the 'net state of immunosuppression' as well as other clinical outcomes.
METHODS AND ANALYSIS: This is a single-centre, prospective, observational cohort study of 172 KTRs on stable immunosuppression for more than 3 months. TTV levels will be measured using the TTV R-GENE kit upon recruitment when study subjects are admitted and when kidney allograft biopsies are performed. Subjects will be monitored for iRAEs and rejection for at least 12 months. The relationship between TTV load and clinical outcomes such as severe infections will be analysed and compared against that from other common biomarkers and previously published predictive scores.
ETHICS AND DISSEMINATION: The study was approved by the SingHealth Centralised Institutional Review Board (2023/2170). The results will be presented at conferences and submitted for publication in peer-reviewed journals.
TRIAL REGISTRATION NUMBER: NCT05836636.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
BMJ open - 13(2023), 9 vom: 19. Sept., Seite e076122 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ho, Quan Yao [VerfasserIn] |
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| Links: |
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| Themen: |
IMMUNOLOGY |
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| Anmerkungen: |
Date Completed 22.09.2023 Date Revised 22.09.2023 published: Electronic ClinicalTrials.gov: NCT05836636 Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2023-076122 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a INTRODUCTION: Kidney transplant recipients (KTRs) suffer from immunosuppression-related adverse events (iRAEs), such as infections and malignancy from chronic immunosuppression, but are also at risk of graft loss from rejection with underimmunosuppression. Biomarkers that predict both iRAEs and rejection while allowing individualisation of immunosuppression exposure are lacking. Although plasma viral DNA levels of torque teno virus (TTV), a widely prevalent, non-pathogenic virus, have been shown to predict both iRAE and rejection in newly transplanted KTRs within the first year after transplant, its role for prevalent KTRs on stable immunosuppression is less clear.This study aims to determine the prognostic value of TTV levels for severe infections (defined as infections requiring hospitalisation) in prevalent KTRs on stable immunosuppression for at least 3 months and compare it against that of other commonly available biomarkers. The study also aims to explore the relationship between TTV levels and factors affecting the 'net state of immunosuppression' as well as other clinical outcomes | ||
| 520 | |a METHODS AND ANALYSIS: This is a single-centre, prospective, observational cohort study of 172 KTRs on stable immunosuppression for more than 3 months. TTV levels will be measured using the TTV R-GENE kit upon recruitment when study subjects are admitted and when kidney allograft biopsies are performed. Subjects will be monitored for iRAEs and rejection for at least 12 months. The relationship between TTV load and clinical outcomes such as severe infections will be analysed and compared against that from other common biomarkers and previously published predictive scores | ||
| 520 | |a ETHICS AND DISSEMINATION: The study was approved by the SingHealth Centralised Institutional Review Board (2023/2170). The results will be presented at conferences and submitted for publication in peer-reviewed journals | ||
| 520 | |a TRIAL REGISTRATION NUMBER: NCT05836636 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a IMMUNOLOGY | |
| 650 | 4 | |a INFECTIOUS DISEASES | |
| 650 | 4 | |a Kidney & urinary tract disorders | |
| 650 | 4 | |a Renal transplantation | |
| 650 | 4 | |a Transplant medicine | |
| 700 | 1 | |a Lai, Chooi Mun Deborah |e verfasserin |4 aut | |
| 700 | 1 | |a Liew, Ian Tatt |e verfasserin |4 aut | |
| 700 | 1 | |a Oon, Lynette Lin Ean |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Kun Lee |e verfasserin |4 aut | |
| 700 | 1 | |a Chung, Shimin Jasmine |e verfasserin |4 aut | |
| 700 | 1 | |a Thangaraju, Sobhana |e verfasserin |4 aut | |
| 700 | 1 | |a Tien, Shan-Yeu Carolyn |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Chieh Suai |e verfasserin |4 aut | |
| 700 | 1 | |a Kee, Terence |e verfasserin |4 aut | |
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