title: Potential role of CC chemokine receptor 6 in prediction of late-onset cytomegalovirus infection following solid organ transplant.
abstract: CCR6 is a chemokine receptor involved in homing memory T cells, particularly Th17 cells, to sites of mucosal inflammation. Despite the critical role of memory T cells in long-term protective immunity against cytomegalovirus (CMV), a virus that reactivates at multiple mucosal sites, the ability of CCR6 or other Th17 marker expression to predict CMV reactivation following transplantation is not clear. Using 11-color flow cytometry, in this prospective single-center pilot study, we measured the expression of CCR6 and other markers of T-cell function in peripheral blood samples obtained from 21 SOT recipients at the time of discontinuation of anti-CMV prophylaxis. CMV viremia was monitored on a monthly basis after discontinuation of prophylaxis. Eleven patients (52%) developed CMV viremia during the six-month follow-up period. Late-onset CMV infection was preceded by an immune phenotype characterized by increased CCR6 expression on bulk CD4(+) T cells and a reduced number of circulating CMV IE-1-specific Th1 (CD4(+) IFN-γ(+)) cells. Among the markers evaluated, CCR6 was the best single predictor of late-onset CMV infection. Our results suggest that CCR6 expression at the time of discontinuation of antiviral prophylaxis might be a useful predictor of late-onset CMV reactivation and provide the basis for future larger prospective studies.
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Jose F
authors.initials: JF
authors.lastname: Camargo
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Medicine, University Health Network, Toronto, ON, Canada.|Department of Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.
authors.forename: Mariangela R
authors.initials: MR
authors.lastname: Resende
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zamel
authors.affiliation: Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Klement
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada.
authors.forename: Alyajahan
authors.initials: A
authors.lastname: Bhimji
authors.affiliation: Departments of Medicine and Immunology, University of Toronto, Toronto, ON, Canada.
authors.forename: Sanja
authors.initials: S
authors.lastname: Huibner
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Deepali
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Atul
authors.initials: A
authors.lastname: Humar
authors.affiliation: Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Igor
authors.initials: I
authors.lastname: Jurisica
authors.affiliation: Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Shaf
authors.initials: S
authors.lastname: Keshavjee
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada.|Departments of Medicine and Immunology, University of Toronto, Toronto, ON, Canada.
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
authors.affiliation: Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, ON, Canada.|Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D010865:Pilot Projects; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control; D011446:Prospective Studies; D054399:Receptors, CCR6 / Q000097:blood*; D014766:Viremia / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D054399:Receptors, CCR6
keywords: T cell biology; cytomegalovirus; infection; infectious disease; viral