title: IL-23 plasma level is strongly associated with CMV status and reactivation of CMV in renal transplant recipients.
abstract: Cytomegalovirus seropositivity is an independent risk factor for atherosclerosis in patients with ESRD. Donor CMV seropositivity is associated with higher graft loss. Dendritic cells, macrophages and Th17 lymphocytes are defined as producers of IL-23. IL-23 is thought to be involved in the promotion of Th17 cell polarization. Latent CMV-induced Th17 might be involved in the pathogenesis of CMV infection in patients with ESRD. We aimed to evaluate associations of Th17-dependent cytokines with ESRD, CMV status and post-transplant outcome in kidney transplantation.
  
  
  
  IL-21 plasma levels were similar in patients and healthy controls (p = 0.47), whereas IL-9 (p = 0.02) and IL-23 (p < 0.0001) levels were significantly higher in ESRD patients. CMV-seronegative (p = 0.002) and -seropositive (p < 0.001) patients had significantly higher IL-23 plasma levels than controls. CMV-seropositive patients showed excessively higher IL-23 (p < 0.001) plasma levels than CMV-seronegative patients. Patients with post-transplant CMV reactivation had higher IL-23 plasma levels than patients without CMV reactivation (p = 0.025).
  
  
  
  Our results indicate that latent CMV induces IL-23. IL-23 might be an inflammatory mediator of latent CMV infection in patients with ESRD and predisposes patients for post-transplant CMV reactivation.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany. mahmoud.sadeghi@med.uni-heidelberg.de.|Transplantation Immunology, University of Heidelberg, Heidelberg, Germany. mahmoud.sadeghi@med.uni-heidelberg.de.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Imad
authors.initials: I
authors.lastname: Lahdou
authors.affiliation: Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Opelz
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Zeier
authors.affiliation: Center for Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Schnitzler
authors.affiliation: Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Daniel
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000276:immunology*; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D005858:Germany; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D053759:Interleukin-23 / Q000097:blood*; D007378:Interleukins / Q000097:blood; D016030:Kidney Transplantation; D008264:Macrophages / Q000276:immunology*; D008297:Male; D051379:Mice; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*; D014184:Transplantation, Homologous; D014775:Virus Activation; D000098546:Interleukin-21
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D053759:Interleukin-23; D007378:Interleukins; D000098546:Interleukin-21
keywords: CMV; CMV-IgG; IL-23; Kidney transplantation; Th17