title: Immune function assay (immunknow) drop over first 6 months after renal transplant: a predictor of opportunistic viral infections?
abstract: BACKGROUND
  The Immuknow assay (IKA; Cylex) is a T-cell immune function assay that evaluates immunoreactivity in immunocompromised patients. The aim of this study was to analyze IKA values in a cohort of kidney transplantation (KT) recipients to investigate correlations between single-time point low IKA values and their trend over time with cytomegalovirus (CMV) or BK virus (BKV) reactivation.
  
  
  METHODS
  A total of 118 adult patients receiving deceased-donor KT were enrolled (55.6±11.9 years old; 79 [66.9%] male). IKA CMV and BKV viremia determinations and were performed at months 1, 3, and 6 after surgery.
  
  
  RESULTS
  Overall, 272 IKA determinations were performed: IKA values significantly decreased from month 1 (422±184 ng/mL) to month 3 (330±159 ng/mL; P<.001) and from month 3 to month 6 (300±128 ng/mL; P=.030). IKA values did not correlate with renal function or viral reactivation at any time. However, patients with either CMV or BKV viremia had a trend to higher IKA values at month 1 and lower IKA values at month 6, even if the difference did not reach a statistical significance (P=.115).
  
  
  CONCLUSIONS
  Our study suggests that presence of low immunologic reactivity (IKA<225 ng/mL) is not associated with an increased risk of CMV and BKV reactivation over the 1st 6 months after KT. However, a trend to a more pronounced drop in IKA values over time was observed in patients with viral reactivation. These preliminary results suggests that drop in IKA values within the 1st post-KT months, unlike single-time point immune function assay, may predict the risk of opportunistic viral infections.
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy. Electronic address: marco.quaglia@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Quaglia
authors.affiliation: Medical Statistics and Cancer Epidemiology Unit, "A. Avogadro" University, Novara, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Cena
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Fenoglio
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Musetti
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Cagna
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Radin
authors.affiliation: Transplantation Immunology Service, "San Giovanni Battista" University Hospital, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Roggero
authors.affiliation: Transplantation Immunology Service, "San Giovanni Battista" University Hospital, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
authors.affiliation: Medical Statistics and Cancer Epidemiology Unit, "A. Avogadro" University, Novara, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Magnani
authors.affiliation: Nephrology and Transplant Unit, Department of Translational Medicine, "Maggiore della Carità" University Hospital and Interdisciplinary Research Center Autoimmune Disease (IRCAD), "A. Avogadro" University, Novara, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Stratta
mesh_terms: D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D027601:Polyomavirus Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D011183:Postoperative Complications; D014766:Viremia / Q000175:diagnosis; D014775:Virus Activation