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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1445553

Discordance between humoral and cellular immune responses to cytomegalovirus infection in CMV seropositive patients awaiting lung transplantation

Provisionally accepted
Meritxell Boada-Pérez Meritxell Boada-Pérez 1,2Cristina Berastegui Cristina Berastegui 3,4Marta Erro Marta Erro 5Piedad Usetti Piedad Usetti 5Elena Crespo Elena Crespo 6,7Laura Donadeu Casassas Laura Donadeu Casassas 6,7Oriol Bestard Oriol Bestard 6,7,8Gabriel Anguera Gabriel Anguera 9Amparo Solé Amparo Solé 9Ricardo Ponz Mir Ricardo Ponz Mir 10Brian Molloy Brian Molloy 10Eva Revilla-López Eva Revilla-López 1,3Victor Monforte Victor Monforte 3,4*Susana Gómez-Ollés Susana Gómez-Ollés 2,4
  • 1 Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Balearic Islands, Spain
  • 2 Department of Pulmonology, Vall d'Hebron Research Institute (VHIR), Barcelona, Balearic Islands, Spain
  • 3 Lung Transplant Unit, Pulmonology Department, Vall d'Hebron University Hospital, Barcelona, Balearic Islands, Spain
  • 4 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
  • 5 Department of Pulmonary Medicine, Puerta de Hierro Majadahonda University Hospital, Majadahonda, Madrid, Spain
  • 6 Laboratory of Nephrology and Transplantation, Vall d'Hebron Research Institute, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Balearic Islands, Spain
  • 7 Vall d'Hebron for Solid Organ Transplantation Research Group, Vall d'Hebron Research Institute, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Balearic Islands, Spain
  • 8 Kidney Transplant Unit, Nephrology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
  • 9 Lung Transplant Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
  • 10 Medical Affairs Department, MSD, Madrid, Asturias, Spain

The final, formatted version of the article will be published soon.

    Introduction: Risk stratification for CMV infection in lung transplantation (LT) currently relies on determining donor and recipient CMV IgG before transplantation. However, it has been observed that some patients who test positive for CMV-specific humoral response before kidney transplantation (KT) exhibit a weak or absent CMV-specific cellular response. The significance of this observation in LT is still unknown.Methods: This prospective, multicenter, observational study evaluated the agreement between CMV IgG serology and specific cell-mediated response (specific T cell Enzyme-Linked ImmunoSpot Assay, ELISPOT, against CMV pp65 and IE-1 antigens) in 121 patients on the waiting list for LT.Results: One hundred and four (86%) patients were seropositive for CMV. Discordant humoral and cellular immunologic responses were observed, 29% of seropositive patients had a weak ELISPOT response to IE-1 and 39% to pp65. In 22% of seropositive patients, there was a weak or no response to both antigens. All seronegative patients did not respond to either antigen.Conclusions: Therefore, over 20% of CMV seropositive LT candidates showed weak CMV-specific cellular immune responses despite detectable serological memory against CMV. This may be important in assessing the risk of developing a CMV infection after transplantation.

    Keywords: Elispot, Infection risk, immunocompromised, Pre-transplant, Serology, CMVcell mediated immunity, Humoral Immune Response

    Received: 07 Jun 2024; Accepted: 30 Dec 2024.

    Copyright: © 2024 Boada-Pérez, Berastegui, Erro, Usetti, Crespo, Donadeu Casassas, Bestard, Anguera, Solé, Ponz Mir, Molloy, Revilla-López, Monforte and Gómez-Ollés. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Victor Monforte, Lung Transplant Unit, Pulmonology Department, Vall d'Hebron University Hospital, Barcelona, Balearic Islands, Spain

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