Circulatory follicular helper T lymphocytes associate with lower incidence of CMV infection in kidney transplant recipients

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Suárez Fernández, Patricia and Utrero Rico, Alberto and Sandonis, Virginia and García Ríos, Estéfani and Arroyo Sánchez, Daniel and Fernández Ruiz, Mario and Andrés, Amado de and Polanco, Natalia and González Cuadrado, Cecilia and Almendro Vazquez, Patricia and Pérez Romero, Pilar and Aguado, José María and Paz Artal, Estela and Laguna Goya, Rocío (2021) Circulatory follicular helper T lymphocytes associate with lower incidence of CMV infection in kidney transplant recipients. American Journal of Transplantation, 21 (12). pp. 3946-3957. ISSN 1600-6135

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Official URL: https://doi.org/10.1111/ajt.16725




Abstract

Primary infection and/or reactivation of cytomegalovirus (CMV) in kidney transplant recipients (KTR) favor rejection and mortality. T follicular helper cells (TFH) could contribute to protection against CMV. Circulatory TFH (cTFH) were studied pretransplant and early posttransplant in 90 CMV seropositive KTR not receiving antithymocyte globulin or antiviral prophylaxis, followed-up for 1 year. Patients who presented CMV infection had significantly lower cTFH and activated cTFH pretransplant and early posttransplant. Pretransplant activated cTFH were also lower within patients who developed CMV disease. Pre- and 14 days posttransplant activated cTFH were an independent protective factor for CMV infection (HR 0.41, p = .01; and 0.52, p = .02, respectively). KTR with low cTFH 7 days posttransplant (<11.9%) had lower CMV infection-free survival than patients with high cTFH (28.2% vs. 67.6%, p = .002). cTFH were associated with CMV-specific neutralizing antibodies (Nabs). In addition, IL-21 increased interferon-γ secretion by CMV-specific CD8+ T cells in healthy controls. Thus, we show an association between cTFH and lower incidence of CMV infection, probably through their cooperation in CMV-specific Nab production and IL-21-mediated enhancement of CD8+ T cell activity. Moreover, monitoring cTFH pre- and early posttransplant could improve CMV risk stratification and help select KTR catalogued at low/intermediate risk who could benefit from prophylaxis.


Item Type:Article
Additional Information:

CRUE-CSIC (Acuerdos Transformativos 2021)

Uncontrolled Keywords:basic (laboratory) research, science, flow cytometry, immunobiology, infection and infectious agents- viral, Cytomegalovirus (CMV), infectious disease, kidney transplantation, nephrology, translational research, science
Subjects:Medical sciences > Medicine > Immunology
Medical sciences > Medicine > Nephrology and Urology
ID Code:70569
Deposited On:17 Feb 2022 15:59
Last Modified:18 Feb 2022 11:38

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