title: Autologous human cytomegalovirus-specific cytotoxic T cells as rescue therapy for ulcerative enteritis in primary immunodeficiency.
abstract: OBJECTIVE
  Patients affected by primary immunodeficiency usually undergo a wide range of infections, including reactivation of latent ones. Here we report two cases suffering from late-onset combined immunodeficiency in which ulcerative enteritis due to human Cytomegalovirus caused a life-threatening malabsorption syndrome.
  
  
  METHODS
  The assessment of the viral load was carried out on both blood and mucosal samples by quantitative real-time polymerase chain reaction assay. The generation of autologous virus-specific cytotoxic T cell lines was performed according to Good Manufacturing Practice protocol after peripheral blood mononuclear cells were collected through a single leukapheresis.
  
  
  RESULTS
  In both patients, the viral load resulted negligible in peripheral blood, but very high in mucosal specimens (range 1.064 - 1.031.692 copies/10(5) cells). After two rounds of antiviral therapy proved unsuccessful, the generation of virus-specific cytotoxic T cell lines was carried out despite severe lymphopenia, and their infusion resulted safe and durably effective in healing intestinal ulcerations and resetting the viral load.
  
  
  CONCLUSIONS
  Virus-specific cellular therapy was useful in reconstituting specific immunity and treating severe human Cytomegalovirus-related enteritis in patients with primary immunodeficiency.
authors.affiliation: Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation - University of Pavia, Pavia, Italy, rachele.ciccocioppo@unipv.it.
authors.forename: Rachele
authors.initials: R
authors.lastname: Ciccocioppo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Comoli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gallia
authors.forename: Sabrina
authors.initials: S
authors.lastname: Basso
authors.forename: Fausto
authors.initials: F
authors.lastname: Baldanti
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D002460:Cell Line; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D004751:Enteritis / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000276:immunology / Q000628:therapy*; D007413:Intestinal Mucosa / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D037182:T-Cell Antigen Receptor Specificity / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation*; D014182:Transplantation, Autologous; D014456:Ulcer / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D019562:Viral Load; D014775:Virus Activation