Cytomegalovirus infection is associated with thymic dysfunction and chronic graft-versus-host disease after pediatric hematopoietic stem cell transplantation

Copyright © 2024. Published by Elsevier Inc.

Bibliographische Detailangaben
Veröffentlicht in:Clinical immunology (Orlando, Fla.). - 1999. - 265(2024) vom: 21. Juli, Seite 110302
1. Verfasser: Kielsen, Katrine (VerfasserIn)
Weitere Verfasser: Møller, Dina Leth, Pedersen, Anders Elm, Nielsen, Claus Henrik, Ifversen, Marianne, Ryder, Lars Peter, Müller, Klaus
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:Clinical immunology (Orlando, Fla.)
Schlagworte:Journal Article CMV infection Chronic graft-versus-host disease Hematopoietic stem cell transplantation Regulatory T cells Thymic function
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245 1 0 |a Cytomegalovirus infection is associated with thymic dysfunction and chronic graft-versus-host disease after pediatric hematopoietic stem cell transplantation 
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520 |a Pediatric hematopoietic stem cell transplantation (HSCT) is challenged by chronic graft-versus-host disease (cGvHD) significantly affecting survival and long-term morbidity, but underlying mechanisms including the impact of post-HSCT CMV infection are sparsely studied. We first investigated the impact of CMV infection for development of cGvHD in 322 children undergoing standard myeloablative HSCT between 2000 and 2018. Clinically significant CMV infection (n = 61) was an independent risk factor for chronic GvHD in a multivariable Cox regression analysis (HR = 2.17, 95% CI = 1.18-3.97, P = 0.013). We next explored the underlying mechanisms in a subcohort of 39 children. CMV infection was followed by reduced concentration of recent thymic emigrants (17.5 vs. 51.9 × 106/L, P = 0.048) and naïve CD4+ and CD8+ T cells at 6 months post-HSCT (all P < 0.05). Furthermore, CD25highFOXP3+ Tregs tended to be lower in patients with CMV infection (2.9 vs. 9.6 × 106/L, P = 0.055), including Tregs expressing the naivety markers CD45RA and Helios. CD8+ T-cell numbers rose after CMV infection and was dominated by exhausted PD1-expressing cells (66% vs. 39%, P = 0.023). These findings indicate that post-HSCT CMV infection is a main risk factor for development of chronic GvHD after pediatric HSCT and suggest that this effect is caused by reduced thymic function with a persistently impaired production of naïve and regulatory T cells in combination with increased peripheral T-cell exhaustion 
650 4 |a Journal Article 
650 4 |a CMV infection 
650 4 |a Chronic graft-versus-host disease 
650 4 |a Hematopoietic stem cell transplantation 
650 4 |a Regulatory T cells 
650 4 |a Thymic function 
700 1 |a Møller, Dina Leth  |e verfasserin  |4 aut 
700 1 |a Pedersen, Anders Elm  |e verfasserin  |4 aut 
700 1 |a Nielsen, Claus Henrik  |e verfasserin  |4 aut 
700 1 |a Ifversen, Marianne  |e verfasserin  |4 aut 
700 1 |a Ryder, Lars Peter  |e verfasserin  |4 aut 
700 1 |a Müller, Klaus  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t Clinical immunology (Orlando, Fla.)  |d 1999  |g 265(2024) vom: 21. Juli, Seite 110302  |w (DE-627)NLM098196855  |x 1521-7035  |7 nnns 
773 1 8 |g volume:265  |g year:2024  |g day:21  |g month:07  |g pages:110302 
856 4 0 |u http://dx.doi.org/10.1016/j.clim.2024.110302  |3 Volltext 
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