Cytomegalovirus HLA antigen load as a new potential predictive factor after haploidentical stem cell transplantation

IF 3.2 4区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Current Research in Translational Medicine Pub Date : 2025-05-14 DOI:10.1016/j.retram.2025.103518

Antonio Milano , Jacopo Mariotti , Pietro Crivello , Giulia Di Maggio , Giorgia Cornacchini , Giuliana Lando , Silvano Rossini , Marialuisa Lavitrano , Stefania Bramanti , Roberto Crocchiolo

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Abstract

Among the complications occurring after allogeneic hematopoietic stem cell transplantation (HSCT), infection by human Cytomegalovirus (CMV) represents one of the most relevant in terms of morbidity/mortality and specific management is required by either monitoring viral load and administer anti-CMV therapies. Due to the physiological role of the Human Leucocyte Antigen (HLA) system in presenting foreign antigens to the adaptive immune system to enhance viral clearance, we measured here the HLA antigen load for two immunodominant CMV peptides and correlate with transplant outcome in 238 consecutive adult patients undergoing haploidentical HSCT at a single center.

Interestingly, a higher class I antigen load (i.e. above the median) for protein IE1 correlated with an inferior absolute incidence of CMV infection; moreover, a statistically significant correlation with lower non-relapse mortality and higher overall survival was observed (HR: 0.32, 0.12–0.84, p = 0.02; 0.34 (0.17–0.69, p = 0.003; respectively), with a protective effect in patients with high antigen load values.

Despite additional research is needed, our exploratory data support the role of the HLA polymorphism on CMV infection and survival after HSCT. The introduction of CMV antigen load as a new potential predictive factor might contribute to further define the post-transplant risk on an individualised basis.

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巨细胞病毒HLA抗原载量作为单倍体干细胞移植后新的潜在预测因子

在同种异体造血干细胞移植（HSCT）后发生的并发症中，人巨细胞病毒（CMV）感染是发病率/死亡率最相关的并发症之一，需要通过监测病毒载量和给予抗巨细胞病毒治疗来进行特异性管理。由于人类白细胞抗原（HLA）系统在将外来抗原呈递到适应性免疫系统以增强病毒清除方面的生理作用，我们在此测量了两种免疫优势CMV肽的HLA抗原负荷，并在单个中心测量了238例连续接受单倍体同种HSCT的成人患者的移植结果。有趣的是，IE1蛋白较高的I类抗原载量（即高于中位数）与CMV感染的绝对发生率较低相关；此外，与较低的非复发死亡率和较高的总生存率有统计学意义的相关性(HR: 0.32, 0.12-0.84, p = 0.02；0.34 (0.17-0.69, p = 0.003；)，对抗原负荷值高的患者有保护作用。尽管还需要进一步的研究，我们的探索性数据支持HLA多态性在巨细胞病毒感染和移植后生存中的作用。引入巨细胞病毒抗原负荷作为一个新的潜在预测因素可能有助于进一步确定个体化移植后风险。

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

Current Research in Translational Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology

CiteScore

7.00

自引率

4.90%

发文量

审稿时长

45 days

期刊介绍： Current Research in Translational Medicine is a peer-reviewed journal, publishing worldwide clinical and basic research in the field of hematology, immunology, infectiology, hematopoietic cell transplantation, and cellular and gene therapy. The journal considers for publication English-language editorials, original articles, reviews, and short reports including case-reports. Contributions are intended to draw attention to experimental medicine and translational research. Current Research in Translational Medicine periodically publishes thematic issues and is indexed in all major international databases (2017 Impact Factor is 1.9). Core areas covered in Current Research in Translational Medicine are: Hematology, Immunology, Infectiology, Hematopoietic, Cell Transplantation, Cellular and Gene Therapy.