title: The effect of single and combined activating killer immunoglobulin-like receptor genotypes on cytomegalovirus infection and immunity after hematopoietic cell transplantation.
abstract: It has been shown that activating killer Ig-like receptor (aKIR) genes are important for control of cytomegalovirus (CMV) reactivation after hematopoietic cell transplantation (HCT). To date, using the broad classification of KIR haplotypes A and B, the precise role of individual KIR genes in the control of infection cannot be discerned. To address this, a consecutive case series of 211 non-T cell-depleted HCT patients all at risk for CMV were monitored biweekly for CMV DNA in plasma by quantitative polymerase chain reaction (Q-PCR) and at intervals for CMV-specific T cell immunity. Comparing patients with CMV reactivation (n = 152) to those with no reactivation (n = 59), the presence of specific aKIR haplotypes in the donor, but not in the recipient, were associated with protection from CMV reactivation and control of peak plasma CMV DNA (P < .001). A donor aKIR profile, predictive for low risk of CMV reactivation, contained either aKIR2DS2 and aKIR2DS4 or had >/=5 aKIR genes. Neither donor nor recipient inhibitory KIR (iKIR) played a role in a protective effect. CD4(+)- and CD8(+)-specific CMV immunity did not explain reduced CMV infection. The initial control of CMV infection after HCT is managed by aKIR functions, and donor aKIR haplotypes deserve further evaluation in donor selection for optimized HCT outcome.
authors.affiliation: CMV Laboratory in the Department of Virology, City of Hope, Duarte, California, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Zaia
authors.forename: Joel Y
authors.initials: JY
authors.lastname: Sun
authors.forename: Ghislaine M
authors.initials: GM
authors.lastname: Gallez-Hawkins
authors.forename: Lia
authors.initials: L
authors.lastname: Thao
authors.forename: Arisa
authors.initials: A
authors.lastname: Oki
authors.forename: Simon F
authors.initials: SF
authors.lastname: Lacey
authors.forename: Andrew
authors.initials: A
authors.lastname: Dagis
authors.forename: Joycelynne
authors.initials: J
authors.lastname: Palmer
authors.forename: Don J
authors.initials: DJ
authors.lastname: Diamond
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
authors.forename: David
authors.initials: D
authors.lastname: Senitzer
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000235:genetics* / Q000276:immunology*; D004279:DNA, Viral / Q000276:immunology; D005260:Female; D005838:Genotype; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007109:Immunity / Q000235:genetics / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054340:Receptors, KIR / Q000235:genetics* / Q000276:immunology*; D014019:Tissue Donors; D014775:Virus Activation
chemical_list: D004279:DNA, Viral; D054340:Receptors, KIR