Comparison of Humoral and Cellular CMV Immunity in Patients Awaiting Kidney Transplantation
Monika Lindemann,
Benjamin Wilde,
Justa Friebus-Kardash,
Anja Gäckler,
Oliver Witzke,
Ulf Dittmer,
Peter A. Horn,
Andreas Kribben,
Nils Mülling,
Ute Eisenberger
Affiliations
Monika Lindemann
Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Benjamin Wilde
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Justa Friebus-Kardash
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Anja Gäckler
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Oliver Witzke
West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany
Ulf Dittmer
Institute for Virology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany
Peter A. Horn
Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Andreas Kribben
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Nils Mülling
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Ute Eisenberger
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
Chronic kidney disease may alter antiviral T cell immunity. In the current study, we assessed in 63 patients prior to kidney transplantation how humoral and cellular immunity against cytomegalovirus (CMV) correlated using an interferon (IFN)-γ ELISpot (T-Track® CMV, Mikrogen, Neuried, Germany). The cohort comprised 24 patients with negative and 39 with positive CMV IgG. Whereas none of the patients with negative CMV IgG showed detectable responses to the T-Track® CMV, 26 out of 39 patients with positive CMV IgG had positive ELISpot responses. The median response to CMV pp65 in the CMV seronegative group was 0 spot forming units (SFU) per 200,000 PBMC (range 0–1) and in the seropositive group 43 SFU (range 0–750). Thus, 13 out of 39 patients with positive CMV serostatus (33%) had undetectable T cell immunity and may be at an increased risk of CMV reactivation. CMV pp65-specific ELISpot responses were 29.3-fold higher in seropositive patients with vs. without dialysis and 5.6-fold higher in patients with vs. without immunosuppressive therapy, but patients with dialysis and immunosuppressive therapy showed, as expected, lower responses to phytohemagglutinin, the positive control. This finding may be caused by (subclinical) CMV-DNAemia and a “booster” of CMV-specific T cells.
