title: Allotype analysis to distinguish the origin of varicella-zoster virus immunoglobulin G after allogeneic stem cell transplantation.
abstract: Varicella-zoster virus (VZV) reactivation is a frequent complication after allogeneic hematopoietic stem cell transplantation (HSCT). Although previous studies have revealed that cellular immunity is important for suppressing reactivation, the role of humoral immunity against VZV has been poorly evaluated. We analyzed inherited polymorphisms in the immunoglobulin G (IgG) heavy chain constant regions of 50 HSCT recipient-donor pairs to distinguish donor-derived and recipient-derived antibodies. Twelve pairs were informative regarding the origin of IgG, since either the donors (n = 3) or recipients (n = 9) were homozygous null for the IgG1m(f) allotype. In these 9 homozygous-null recipients, allotype-specific IgG against VZV were measured by enzyme-linked immunosorbent assay and compared with measles-IgG. All 9 homozygous-null recipients were monitored for more than 1 year after HSCT, with (n = 4, localized zoster) or without (n = 5) clinical VZV disease. In 3 patients with VZV disease, donor-derived IgG against VZV was elevated between 500 to 700 days after HSCT after the episode of VZV disease. In 1 patient who suffered from VZV disease just before HSCT, donor-derived VZV IgG was elevated within 3 months after HSCT. On the other hand, 2 patients who received reduced-intensity conditioning (RIC) transplantation from an IgG1m(f) null donor maintained recipient-derived IgG against VZV for more than 1 year, whereas it was decreased within 3 months in 1 recipient who received conventional conditioning. In conclusion, the production of anti-VZV IgG by recipient plasma cells persists long after RIC. In patients without symptomatic VZV reactivation, donor-derived anti-VZV IgG did not reach titers comparable to those measured in healthy virus carriers.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Yukie
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Tomohito
authors.initials: T
authors.lastname: Machishima
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000235:genetics* / Q000276:immunology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006562:Herpes Zoster / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000097:blood / Q000235:genetics* / Q000276:immunology; D007129:Immunoglobulin Gm Allotypes / Q000097:blood / Q000235:genetics* / Q000276:immunology; D007143:Immunoglobulin Heavy Chains / Q000097:blood / Q000235:genetics* / Q000276:immunology; D008297:Male; D008457:Measles / Q000097:blood / Q000276:immunology; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011379:Prognosis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007129:Immunoglobulin Gm Allotypes; D007143:Immunoglobulin Heavy Chains; D019653:Myeloablative Agonists