title: Evaluation of Epstein-Barr virus-specific immunologic response in solid organ transplant recipients with an enzyme-linked ImmunoSpot assay.
abstract: Epstein-Barr virus (EBV) is a γ-herpes virus, responsible for infectious mononucleosis in immunocompetent hosts. Cellular immunity appears rapidly during EBV primary infection, keeping it silent despite long-life persistence in B lymphocytes. Defects of the EBV-specific cellular immunity are supposed to be the basis of post-transplantation lymphoproliferative disorders, promoted by high levels of immunosuppression. We retrospectively reviewed 197 solid organ transplant recipients to investigate EBV-specific lymphocyte responsiveness using Enzyme-linked ImmunoSpot assay (EliSpot), which assesses the EBV-specific interferon (IFN)-γ producing peripheral blood mononuclear cells, and kinetics of EBV infection/reactivation post-transplantation using quantitative real-time polymerase chain reaction (PCR) on whole blood. Overall, 102 of the 197 patients (51.8%) showed EBV responsiveness at the EBV-EliSpot assay: 68 (66.6%) showed a persistently positive EBV response in 3 or more determinations and 34 (33.3%) had transient episodes of nonresponsiveness. Ninety-five (48.2%) patients were persistently EBV nonresponders. EBV-DNAemia data were available for 58 patients: 27.6% presented at least one episode of EBV-DNA occurrence. No differences were found in EBV-EliSpot response stratification between the groups of patients who experienced episodes of EBV reactivation and those without EBV-DNAemia. However, EBV DNAemia peak values tended to be higher in the first year post-transplantation in the group of patients with a persistent positive EBV-specific immune response. EBV viral load quantitation in blood and EliSpot EBV-specific immune response determination may represent a powerful tool for monitoring solid organ transplant recipients, guiding immunosuppression modulation in patients with active EBV replication.
authors.affiliation: S.C. Virologia U., Città della Salute e della Scienza di Torino Hospital, Torino, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rittà
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: F
authors.initials: F
authors.lastname: Sinesi
authors.forename: F
authors.initials: F
authors.lastname: Sidoti
authors.forename: A
authors.initials: A
authors.lastname: Di Nauta
authors.forename: S
authors.initials: S
authors.lastname: Mantovani
authors.forename: A
authors.initials: A
authors.lastname: Piceghello
authors.forename: S
authors.initials: S
authors.lastname: Simeone
authors.forename: D
authors.initials: D
authors.lastname: Ricci
authors.forename: M
authors.initials: M
authors.lastname: Boffini
authors.forename: P
authors.initials: P
authors.lastname: Solidoro
authors.forename: S
authors.initials: S
authors.lastname: Baldi
authors.forename: G P
authors.initials: GP
authors.lastname: Segoloni
authors.forename: R
authors.initials: R
authors.lastname: Cavallo
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D008297:Male; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies