Pathogen-specific cell-mediated immunity to guide the management of cytomegalovirus in solid organ transplantation: state of the art clinical review.

IF 3.9 3区 医学 Q2 IMMUNOLOGY
Expert Review of Clinical Immunology Pub Date : 2024-11-01 Epub Date: 2024-07-24 DOI:10.1080/1744666X.2024.2384060
Raymund R Razonable
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引用次数: 0

Abstract

Introduction: Cytomegalovirus (CMV) is a common opportunistic infection after solid organ transplantation, with significant impact on morbidity and long-term survival. Despite advances in diagnostics and therapeutics, the management of CMV remains very challenging.

Areas covered: This article reviews emerging data on the clinical utility of laboratory assays that quantify cell-mediated immune responses to CMV. Observational studies have consistently demonstrated that a deficiency in pathogen-specific cell-mediated immunity is correlated with a heightened risk of primary, reactivation or recurrent CMV after transplantation. A limited number of interventional studies have recently investigated cell-mediated immune assays in guiding the prevention and treatment of CMV infection after solid organ transplantation.

Expert opinion: The pathogenesis and outcome of CMV after solid organ transplantion reflect the interplay between viral replication and CMV-specific immune reconstitution. Research in CMV-specific cell-mediated immunity paved way for the development of several laboratory assays that may assist clinicians in predicting the risk of CMV after transplantation, individualize the approach to CMV disease prevention, guide the need and duration of treatment of CMV infection, and predict the risk of relapse after treatment. More interventional studies are needed to further solidify the role of cell-mediated immune assays in various clinical situations after transplantation.

病原体特异性细胞介导免疫指导实体器官移植中巨细胞病毒的管理:最新临床回顾。
简介:巨细胞病毒(CMV)是实体器官移植后常见的机会性感染:巨细胞病毒(CMV)是实体器官移植后常见的机会性感染,对发病率和长期生存有重大影响。尽管在诊断和治疗方面取得了进步,但巨细胞病毒的管理仍然极具挑战性:这篇文章回顾了量化 CMV 细胞介导免疫反应的实验室检测方法的临床实用性的新数据。观察性研究一致表明,病原体特异性细胞介导免疫的缺乏与移植后原发性、再激活或复发性 CMV 风险的增加相关。最近,少数干预性研究对细胞介导免疫测定进行了调查,以指导预防和治疗实体器官移植后的 CMV 感染:专家观点:CMV 在实体器官移植后的发病机制和结局反映了病毒复制与 CMV 特异性免疫重建之间的相互作用。对CMV特异性细胞介导免疫的研究为多种实验室检测方法的开发铺平了道路,这些检测方法可帮助临床医生预测移植后CMV感染的风险、个性化的CMV疾病预防方法、指导CMV感染治疗的必要性和持续时间,以及预测治疗后复发的风险。要进一步巩固细胞介导免疫测定在移植后各种临床情况中的作用,还需要更多的介入性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.60
自引率
2.30%
发文量
221
审稿时长
6-12 weeks
期刊介绍: Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.
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