title: Potential Immunomodulatory Role of Specific Anticytomegalovirus Intravenous Immunoglobulin in Heart Recipients.
abstract: BACKGROUND
  Specific anticytomegalovirus (anti-CMV) intravenous immunoglobulin (IVIG) has the potential to influence the immune response, but its complex mode of action has not been well evaluated.
  
  
  METHODS
  An immunologic study of 6 CMV-seronegative heart transplant patients receiving anti-CMV prophylaxis with the use of ganciclovir and CMV-IVIG (150 mg/kg within 24 hours after transplantation and 100 mg/kg on days 2, 7, 14, 22, 35, 56, and 77 after transplantation) was performed in a single center. Lymphocyte subsets were evaluated by means of 4-color flow cytometry at the time of inclusion in the waiting list and at 3 months after transplantation.
  
  
  RESULTS
  High-risk heart recipients receiving CMV-IVIG showed a clear reduction in the frequency of activated CD4+CD38+DR+ T-helper cells at 3 months after transplantation compared with a group of 27 untreated control subjects who received only anti-CMV prophylaxis with the use of ganciclovir. In this study, an increase of CD19+CD27-IgM+IgD+ naïve B cells was also observed in seronegative recipients after prophylaxis with the use of CMV-IVIG but not in control subjects. None of the CMV-IVIG-treated recipients developed acute cellular rejection during the 1st 6 months after transplantation.
  
  
  CONCLUSIONS
  The immune modulation of activated CD4+ lymphocyte and of naïve B-cell subsets after CMV-IVIG use should be further evaluated in future prospective studies with higher numbers of patients.
authors.affiliation: Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. Electronic address: javier.carbone@salud.madrid.org.
authors.forename: J
authors.initials: J
authors.lastname: Carbone
authors.affiliation: Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gallego
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Fernandez Yañez
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Sousa
authors.affiliation: Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Sarmiento
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D016027:Heart Transplantation; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; C045781:cytomegalovirus-specific hyperimmune globulin; D015774:Ganciclovir