title: Immune response to CMV in solid organ transplant recipients: current concepts and future directions.
abstract: Despite advances in immunosuppression and antiviral therapy, CMV continues to be a significant opportunistic pathogen adversely affecting the outcome of solid organ transplantation (SOT) recipients. While a significant proportion of CMV disease is caused by reactivation of latent virus, the risk is highest among CMV donor+ and recipient- SOT patients. CMV is responsible for both direct (e.g., pneumonitis, colitis) and indirect (e.g., rejection, atherosclerosis) morbidity and mortality. Healthy CMV-seropositive individuals have a high frequency of CMV-specific CD4(+) and CD8(+) T cells that provide immune protection by limiting CMV reactivation and replication. Changes to the innate and adaptive immune system from immunosuppressive therapy following SOT contribute to CMV disease pathogenesis. CMV disease after SOT is associated with poorer outcomes, thus novel strategies to prevent it are an area of active research. In this article, we review the current state of knowledge on the immune response to CMV following SOT.
authors.affiliation: Division of Infectious Diseases, Akron General Medical Center, 224 W. Exchange Street, Akron, OH 44302, USA. rwatkins@agmc.org
authors.forename: Richard R
authors.initials: RR
authors.lastname: Watkins
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Lemonovich
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D012307:Risk Factors; D019737:Transplants / Q000009:adverse effects*; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014765:Viral Vaccines