%0 Journal Article %1 Snyder2011 %A Snyder, L. D. %A Medinas, R. %A Chan, C. %A Sparks, S. %A Davis, W. A. %A Palmer, S. M. %A Weinhold, K. J. %D 2011 %J Am J Transplant %K cmv transplantation prophylaxis virus %N 3 %P 553--560 %R 10.1111/j.1600-6143.2010.03405.x %T Polyfunctional cytomegalovirus-specific immunity in lung transplant recipients receiving valganciclovir prophylaxis. %U http://dx.doi.org/10.1111/j.1600-6143.2010.03405.x %V 11 %X Cytomegalovirus (CMV) is a common opportunistic infection after lung transplant. Despite effective antiviral medications to treat CMV, invasive CMV disease contributes to lung allograft dysfunction and worse survival. Efforts to prevent CMV have led to the use of valganciclovir prophylaxis for increasingly longer periods after transplant. A pivotal concern with long-term antiviral prophylaxis is that it may prevent or delay the development of CMV-specific immunity and increase the subsequent risk of late onset disease. To address this issue, we conducted a pilot study to determine if CMV-specific immunity was detectable in lung transplant recipients at risk for CMV while on antiviral prophylaxis. Utilizing polychromatic flow cytometry panels, CMV-specific immunity was determined by peripheral blood CD4 and CD8 T cell expression of cytokines in response to the HLA restricted CMV peptides pp65 and IE-1. We determined CMV seropositive lung transplant recipients on valganciclovir for a median of 6 months from transplant have a detectable polyfunctional CMV-specific T cell response which is comparable to seropositive recipients not on antiviral medications and to healthy seropositive nontransplant controls. Thus, valganciclovir prophylaxis does not appear to impair the development of CMV-specific immunity in lung transplantation.

@article{Snyder2011, abstract = {Cytomegalovirus (CMV) is a common opportunistic infection after lung transplant. Despite effective antiviral medications to treat CMV, invasive CMV disease contributes to lung allograft dysfunction and worse survival. Efforts to prevent CMV have led to the use of valganciclovir prophylaxis for increasingly longer periods after transplant. A pivotal concern with long-term antiviral prophylaxis is that it may prevent or delay the development of CMV-specific immunity and increase the subsequent risk of late onset disease. To address this issue, we conducted a pilot study to determine if CMV-specific immunity was detectable in lung transplant recipients at risk for CMV while on antiviral prophylaxis. Utilizing polychromatic flow cytometry panels, CMV-specific immunity was determined by peripheral blood CD4 and CD8 T cell expression of cytokines in response to the HLA restricted CMV peptides pp65 and IE-1. We determined CMV seropositive lung transplant recipients on valganciclovir for a median of 6 months from transplant have a detectable polyfunctional CMV-specific T cell response which is comparable to seropositive recipients not on antiviral medications and to healthy seropositive nontransplant controls. Thus, valganciclovir prophylaxis does not appear to impair the development of CMV-specific immunity in lung transplantation.}, added-at = {2012-06-20T02:20:25.000+0200}, author = {Snyder, L. D. and Medinas, R. and Chan, C. and Sparks, S. and Davis, W. A. and Palmer, S. M. and Weinhold, K. J.}, biburl = {https://www.bibsonomy.org/bibtex/2e9b06286177308f66f3aa46281c3bcc4/aorchid}, description = {They found no differences between CD4 and CD8 responses in CMV+ LTR on or off valgcv and compared to healthy controls. Those that were CMV- and never had primary infection never developed positive Tc responses.}, doi = {10.1111/j.1600-6143.2010.03405.x}, file = {polyfxn tc responses:ID_General/TransplantClinical/AmJTransplant.11.553.pdf:PDF}, groups = {public}, institution = { Bioinformatics, Duke University, Durham, NC. laurie.snyder@duke.edu}, interhash = {9ae42f711f354fce57a2398466c24eb9}, intrahash = {e9b06286177308f66f3aa46281c3bcc4}, journal = {Am J Transplant}, keywords = {cmv transplantation prophylaxis virus}, language = {eng}, medline-pst = {ppublish}, month = Mar, number = 3, pages = {553--560}, pmid = {21219584}, timestamp = {2012-06-20T02:20:25.000+0200}, title = {Polyfunctional cytomegalovirus-specific immunity in lung transplant recipients receiving valganciclovir prophylaxis.}, url = {http://dx.doi.org/10.1111/j.1600-6143.2010.03405.x}, username = {aorchid}, volume = 11, year = 2011 }