Background Immunological ageing of the T cell compartment is related to a decreased T cell immunity. Cytomegalovirus (CMV) infection in healthy individuals has been associated with an ageing effect on the T cell compartment and contributes to the immunedeficiency of the elderly. In this study, we investigated the effect of a primary CMV infection on T cell ageing in CMV- kidney transplant (KTx) recipients, who received a kidney from a CMV+ donor.
Methods The T cell receptor excision circle (TREC) content and % CD31+ naÏve T cells were measured as markers for thymic output. The relative telomere length (RTL) was determined as a measure for proliferative history and immunophenotyping was used to establish the differentiation status of circulating T cells. CMV- KTx recipients receiving a kidney from a CMV+ donor (D+/R-, n=31) were compared to those receiving one from a CMV- donor (D-/R-, n=47) matching for age and immunosuppressive medication. Patients were followed prior to and at 3, 6 and 12 months post transplantation. All patients received valganciclovir during the first 6 months after transplantation.
Results At 6 months, 30% of the D+/R- KTx recipients had detectable anti-CMV IgG titers and 100% at 12 months. Four recipients developed CMV disease and were excluded from analysis. Primary CMV infection did not affect the TREC content, % CD31+ naÏve T cells and RTL of CD4 and CD8 T cells. Twelve months following KTx, absolute numbers of CD8+ memory T cells were increased (p<0.05) mainly as a result of a significant increase in terminally differentiated EMRA CD8+ T cells (p=0.03). A significant increase in the % of memory CD4+ as well as CD8+ T cells lacking CD28 expression was noticed for the D+/R- KTx recipients when comparing percentages pre to 12 months following KTx, i.e. 5.68% vs. 19.83% (p<0.05) and 32.71% vs. 60.45% (p<0.01), respectively. This increase in number of differentiated T cells was not detected in the D-/R- KTx recipients.
Conclusion Primary CMV infection in D+/R- KTx recipients does not affect thymic output or telomere length and therefore does not induce generalized immunological T cell ageing. However, CMV infection substantially increases the number of terminally differentiated CD8 and to a lesser extent CD4 T cells.
(This study was financially supported by the Dutch Kidney Foundation (KSPB.10.12)).
To cite this abstract in AMA style:Meijers R, Litjens N, Wit Ede, Langerak A, Baan C, Weimar W, Betjes M. Primary Cytomegalovirus Infection Has a Limited Effect on the Immunological Age of Kidney Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/primary-cytomegalovirus-infection-has-a-limited-effect-on-the-immunological-age-of-kidney-transplant-recipients/. Accessed October 27, 2020.
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