Effector-Memory γδ T Lymphocytes Predict CMV Disease After the Withdrawal of Prophylaxis in Kidney Transplant Recipients

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Bibliographic Details
Title: Effector-Memory γδ T Lymphocytes Predict CMV Disease After the Withdrawal of Prophylaxis in Kidney Transplant Recipients
Authors: Yoann Abadie, Jonathan Visentin, Elodie Wojciechowski, Manon Charrier, Julie Déchanet-Merville, Isabelle Garrigue, Patrick Blanco, Pierre Merville, Hannah Kaminski, Lionel Couzi
Source: Transpl Int
Transplant International, Vol 38 (2025)
Publisher Information: Frontiers Media SA, 2025.
Publication Year: 2025
Subject Terms: immunology, RC581-951, immunomonitoring, CMV, Specialties of internal medicine, prophylaxis, Health Archive, infection
Description: Evaluation of CMV-specific cell-mediated immunity (CMI) has improved strategies to prevent post-transplant CMV disease. This study assessed the association between CMV disease and absolute count of TEMRA γδ T cells at the end of universal prophylaxis in kidney transplant recipients (KTR). We retrospectively analyzed 262 R⁺ and 82 D⁺/R⁻ KTRs who received antiviral prophylaxis and had TEMRA γδ T cells quantified at the end of prophylaxis. The primary endpoint was CMV disease within two years post-transplant. Post-prophylaxis CMV disease occurred in 43/344 (12.5%) patients. A threshold of 4.65/mm³ for TEMRA γδ T-cell count was identified by ROC analysis; higher counts were associated with reduced CMV disease incidence. While no significant association was found in the overall cohort, in R⁺ patients, a count >4.65/mm³ was associated with a 97.7% positive predictive value for protection against CMV disease. Multivariate analysis confirmed its independent association with disease-free survival [HR: 0.27 (95% CI: 0.09–0.85), p = 0.0252]. Measuring TEMRA γδ T-cell counts at the end of prophylaxis may serve as a useful, accessible immune marker to guide CMV prevention strategies in R⁺ kidney transplant recipients.
Document Type: Article
Other literature type
ISSN: 1432-2277
DOI: 10.3389/ti.2025.14339
Access URL: https://doaj.org/article/6823bffb4ea548a3945c12996ade9b71
Rights: CC BY
Accession Number: edsair.doi.dedup.....7e6bd5b912cb774c3f4e721a60d0f6dc
Database: OpenAIRE
Description
Abstract:Evaluation of CMV-specific cell-mediated immunity (CMI) has improved strategies to prevent post-transplant CMV disease. This study assessed the association between CMV disease and absolute count of TEMRA γδ T cells at the end of universal prophylaxis in kidney transplant recipients (KTR). We retrospectively analyzed 262 R⁺ and 82 D⁺/R⁻ KTRs who received antiviral prophylaxis and had TEMRA γδ T cells quantified at the end of prophylaxis. The primary endpoint was CMV disease within two years post-transplant. Post-prophylaxis CMV disease occurred in 43/344 (12.5%) patients. A threshold of 4.65/mm³ for TEMRA γδ T-cell count was identified by ROC analysis; higher counts were associated with reduced CMV disease incidence. While no significant association was found in the overall cohort, in R⁺ patients, a count >4.65/mm³ was associated with a 97.7% positive predictive value for protection against CMV disease. Multivariate analysis confirmed its independent association with disease-free survival [HR: 0.27 (95% CI: 0.09–0.85), p = 0.0252]. Measuring TEMRA γδ T-cell counts at the end of prophylaxis may serve as a useful, accessible immune marker to guide CMV prevention strategies in R⁺ kidney transplant recipients.
ISSN:14322277
DOI:10.3389/ti.2025.14339