title: Increased proportion of perforin-expressing CD8+T-cells indicates control of herpesvirus reactivation in children after stem cell transplantation.
abstract: Hematopoietic stem cell transplantation (HSCT) is frequently complicated by viral reactivations. Early diagnosis of viral reactivations and preemptive therapy relies on frequent viralload monitoring. An easy marker of effective cytotoxicity in lymphopenia is lacking and therefore we studied perforin-expression in CD8+T-cells in children following HSCT. Prospectively, we weekly monitored viral loads and perforin-expression of CD8+T-cells in whole blood by FACS, until 4months after HSCT in children. 27 patients were included (median age 4,3, range 0.3-20,1years) of whom 19 developed viral reactivations. These patients showed higher percentages of perforin-expressing CD8+T-cells (17,2%, range 0-63%) than those without (6,8%; range 0-16%) (p=0.001). The increased percentage of perforin-expressing CD8+T-cells coincided with a decrease in viral load with a median interval between maximum viral load and maximum level of perforin-expression of 0,4weeks (range 0.1-7.1). We conclude that perforin-expression in CD8+T-cells may be a marker for effective antiviral T-cell reconstitution early after HSCT in children.
authors.affiliation: Dept. of Immunology, Hematology and BMT, University Medical Center Utrecht, Lundlaan 6, 3584 CX, Utrecht, the Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: de Pagter
authors.forename: J J
authors.initials: JJ
authors.lastname: Boelens
authors.forename: R
authors.initials: R
authors.lastname: Jacobi
authors.forename: R
authors.initials: R
authors.lastname: Schuurman
authors.forename: N M
authors.initials: NM
authors.lastname: Nanlohy
authors.forename: E A M
authors.initials: EA
authors.lastname: Sanders
authors.forename: D
authors.initials: D
authors.lastname: van Baarle
mesh_terms: D000293:Adolescent; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000276:immunology / Q000502:physiology*; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D054353:Perforin / Q000096:biosynthesis* / Q000097:blood*; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000097:blood / Q000276:immunology* / Q000821:virology; D018709:Statistics, Nonparametric; D014775:Virus Activation; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D054353:Perforin