Different profiles of cytomegalovirus RNA transcripts and anti-cytomegalovirus IgM antibodies in renal transplant recipients.
BACKGROUND
A difference in anti-cytomegalovirus IgM antibody profile has been found between sera from acutely cytomegalovirus (CMV)-infected patients and sera from CMV-infected patients with subclinical infection.


OBJECTIVE
The aim of this study is to investigate whether such different IgM antibody responses are correlated with differences in the expression of CMV immediate early and late mRNAs.


METHODS
We have investigated the anti-CMV IgM response in 46 renal transplant recipients by employing two commercially available IgM kits (AxSYM and IMX) as well as two novel enzyme-linked immunosorbent assays (ELISAs), which were developed using recombinant ppUL32 (pp150) and pUL80a (p38), respectively. The results were compared with four direct CMV diagnostic tests: pp65 antigenemia, viral culture and nucleic acid sequence-based amplification (NASBA), detecting either CMV immediate early 1 (IE1) mRNA (IE1-NASBA), or CMV pp67 (late) mRNA (pp67-NASBA).


RESULTS
Analysis of all CMV-infected recipients (n=28) showed that in 16 recipients (group I) more than one direct test became positive after transplantation, while in the other 12 recipients (group II), IE1-NASBA was the only direct test to become positive. In group I, 100, 81, 100 and 50% of the recipients were IgM-positive with AxSYM, IMX, p38 and pp150, respectively. In group II, 100, 83, 17 and 83% of the recipients were IgM-positive with AxSYM, IMX, p38 and pp150, respectively.


CONCLUSIONS
Our data indicate that the IgM-response against p38 and pp150 differs significantly (P<0.01) between group I recipients with productive CMV infection, and group II recipients with a non-productive CMV infection which may be of diagnostic and prognostic relevance.
Goossens
V J
VJ
Department of Medical Microbiology, University Hospital Maastricht, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. vvgo@lmib.azm.nl
Vink
C
C
Mullers
W
W
Middeldorp
J M
JM
Bruggeman
C A
CA
D000914:Antibodies, Viral / Q000097:blood*; D002352:Carrier Proteins; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000821:virology*; D006801:Humans; D017874:Immediate-Early Proteins / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood*; D016030:Kidney Transplantation; D010750:Phosphoproteins / Q000235:genetics; D011183:Postoperative Complications; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000097:blood*; D014764:Viral Proteins; D048051:p38 Mitogen-Activated Protein Kinases
D000914:Antibodies, Viral; D002352:Carrier Proteins; C088645:IE1 protein, cytomegalovirus; D017874:Immediate-Early Proteins; D007075:Immunoglobulin M; D010750:Phosphoproteins; D012333:RNA, Messenger; D012367:RNA, Viral; D014764:Viral Proteins; D048051:p38 Mitogen-Activated Protein Kinases