Clinical utility of immune function based on IFN-γ monitoring of lymphocyte subsets for parvovirus B19 infection in renal recipients

Qian-Qian Zhang; Wei-Jie Zhang; Feng Wang; Song Chen; Sheng Chang

doi:10.1016/j.meegid.2022.105307

Clinical utility of immune function based on IFN-γ monitoring of lymphocyte subsets for parvovirus B19 infection in renal recipients

Infect Genet Evol. 2022 Sep:103:105307. doi: 10.1016/j.meegid.2022.105307. Epub 2022 Jun 20.

Authors

Qian-Qian Zhang¹, Wei-Jie Zhang¹, Feng Wang², Song Chen¹, Sheng Chang³

Affiliations

¹ Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Organ Transplantation, Ministry of Education NHC Key Laboratory of Organ Transplantation Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China.
² Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Organ Transplantation, Ministry of Education NHC Key Laboratory of Organ Transplantation Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China. Electronic address: changsheng@hust.edu.cn.

PMID: 35738549
DOI: 10.1016/j.meegid.2022.105307

Abstract

Background: There should be a heightened index of suspicion for Parvovirus B19 (PVB19)-related anemia in organ transplant recipients. Thus far, there is no consensus or recommendation for clinical routine monitoring methods of PVB19 recipients to allow tailoring of immunosuppression.

Methods: We conducted a retrospective study to evaluate the utility of the function (represented by the abilities to secrete IFN-γ) and numbers of lymphocyte subsets in monitoring PVB19 infections in renal recipients posttransplant. The enrolled 109 patients were split into 2 groups according to whether the recipients had an occurrence of PVB19 infection: 37 (33.94%) recipients developed PVB19 infection and 72 (66.06%) immune-stable recipients.

Results: The PVB19 infected group had significantly lower absolute counts and functions of different lymphocyte subsets compared with immune-stable recipients. We showed that the frequencies of IFN-γ + CD4 + T cells, IFN-γ + CD8 + T cells, and IFN-γ + NK cells increased markedly after treatment when compared to the occurrence in patients with timepoint before therapy, especially the percentages of IFN-γ + CD4 + T cells were significantly higher. Receiver operating characteristic (ROC) analysis showed that the optimal infection indicator was IFN-γ + NK cells frequency, with an auROC curve of 0.925. Concomitantly, Cox regression analysis indicated that the post-therapy increasing level of IFN-γ secreting function was significantly predictive of recurrent infections (P < 0.001).

Conclusions: We recommend prospective risk stratification for the high-risk population at risk of early-onset PVB19 infection and its recurrence involves screening strategies of immune-based surveillance with the sensitive IFN-γ + secreting monitoring for antiviral prophylaxis and preemptive therapy goal. Clinical Trial Notation: clinical trial registration number: chiCTR-ROC-17010756.

Keywords: IFN-γ secretion assay; Immune monitoring; Individualized therapy; Intracellular cytokine secretion; Kidney transplantation; PVB19.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Erythema Infectiosum* / immunology
Humans
Interferon-gamma* / analysis
Kidney Transplantation* / adverse effects
Lymphocyte Subsets / immunology
Parvovirus B19, Human* / immunology
Retrospective Studies
Transplant Recipients

Substances

Interferon-gamma