Publikation

KIR-associated protection from CMV replication requires pre-existing immunity: a prospective study in solid organ transplant recipients

Wissenschaftlicher Artikel/Review - 10.07.2014

Bereiche
PubMed
DOI

Zitation
Gonzalez A, Hess C, Stern M, Meylan P, Manuel O, Villard J, Berger C, Mueller N, Boggian K, van Delden C, Garzoni C, Hirsch H, Schmitter K. KIR-associated protection from CMV replication requires pre-existing immunity: a prospective study in solid organ transplant recipients. Genes Immun 2014; 15:495-9.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Genes Immun 2014; 15
Veröffentlichungsdatum
10.07.2014
eISSN (Online)
1476-5470
Seiten
495-9
Kurzbeschreibung/Zielsetzung

Previous studies have associated activating Killer cell Immunoglobulin-like Receptor (KIR) genes with protection from cytomegalovirus (CMV) replication after organ transplantation. Whether KIR-associated protection is operating in the context of primary infection, re-activation, or both, remains unknown. Here we correlated KIR genotype and CMV serostatus at the time of transplantation with rates of CMV viremia in 517 heart (n=57), kidney (n=223), liver (n=165) or lung (n=72) allograft recipients reported to the Swiss Transplant Cohort Study. Across the entire cohort we found B haplotypes-which in contrast to A haplotypes may contain multiple activating KIR genes-to be protective in the most immunosuppressed patients (receiving anti-thymocyte globulin induction and intensive maintenance immunosuppression) (hazard ratio after adjustment for covariates 0.46, 95% confidence interval 0.29-0.75, P=0.002). Notably, a significant protection was detected only in recipients who were CMV-seropositive at the time of transplantation (HR 0.45, 95% CI 0.26-0.77, P=0.004), but not in CMV seronegative recipients (HR 0.59, 95% CI 0.22-1.53, P=0.28). These data indicate a prominent role for KIR-and presumably natural killer (NK) cells-in the control of CMV replication in CMV seropositive organ transplant recipients treated with intense immunosuppression.