title: Primary Cytomegalovirus Infection Significantly Impacts Circulating T Cells in Kidney Transplant Recipients.
abstract: Cytomegalovirus (CMV) infection profoundly affects the T cell compartment and is associated with alterations in T cell aging parameters and generation of cytotoxic CD4(+) CD28null T cells. Hence, the effect of a primary CMV infection post-kidney transplantation (KT) on the peripheral T cell compartment was examined. As aging parameters, we determined the T cell differentiation status, T cell receptor excision circle (TREC) content, CD31(+) naïve T cell numbers and relative telomere length (RTL) pre-KT and 12 months post-KT. CMV-seronegative KT recipients, receiving a kidney from a CMV-seropositive donor (D+/R-) were compared to D+/R+ KT recipients. Eleven out of the 22 D+/R- KT recipients had CMV viremia post-KT. They developed CMV-specific CD4(+) and CD8(+) T cells and their T cell compartment shifted towards a more differentiated memory phenotype with expansion of CD4(+) CD28null and CD8(+) CD28null cells. One year post-KT, the CD8(+) T cell count was almost doubled compared to nonviremic D+/R- and D+/R+ KT recipients. In addition, the RTL of the CD8(+) T cell was significantly lower and both the TREC content and CD31(+) naïve T cell numbers significantly decreased. Moreover, primary CMV infection was associated with a negative impact on glomerular filtration rate. In conclusion, primary CMV infection has a substantial impact on the number and phenotype of peripheral T cells and may negatively affect renal allograft function.
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: R W J
authors.initials: RW
authors.lastname: Meijers
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: N H R
authors.initials: NH
authors.lastname: Litjens
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: D A
authors.initials: DA
authors.lastname: Hesselink
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Langerak
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: C C
authors.initials: CC
authors.lastname: Baan
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: M G H
authors.initials: MG
authors.lastname: Betjes
mesh_terms: D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000276:immunology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery* / Q000821:virology; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology*; D014181:Transplantation Immunology; D014779:Virus Replication / Q000276:immunology
keywords: T cell biology; basic (laboratory) research/science; immunobiology; infection and infectious agents; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; kidney transplantation: living donor; thymus/thymic biology; viral: Cytomegalovirus(CMV)