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Palmer WH, Norman PJ. The impact of HLA polymorphism on herpesvirus infection and disease. Immunogenetics 2023; 75:231-247. [PMID: 36595060 PMCID: PMC10205880 DOI: 10.1007/s00251-022-01288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/24/2022] [Indexed: 01/04/2023]
Abstract
Human Leukocyte Antigens (HLA) are cell surface molecules, central in coordinating innate and adaptive immune responses, that are targets of strong diversifying natural selection by pathogens. Of these pathogens, human herpesviruses have a uniquely ancient relationship with our species, where coevolution likely has reciprocating impact on HLA and viral genomic diversity. Consistent with this notion, genetic variation at multiple HLA loci is strongly associated with modulating immunity to herpesvirus infection. Here, we synthesize published genetic associations of HLA with herpesvirus infection and disease, both from case/control and genome-wide association studies. We analyze genetic associations across the eight human herpesviruses and identify HLA alleles that are associated with diverse herpesvirus-related phenotypes. We find that whereas most HLA genetic associations are virus- or disease-specific, HLA-A*01 and HLA-A*02 allotypes may be more generally associated with immune susceptibility and control, respectively, across multiple herpesviruses. Connecting genetic association data with functional corroboration, we discuss mechanisms by which diverse HLA and cognate receptor allotypes direct variable immune responses during herpesvirus infection and pathogenesis. Together, this review examines the complexity of HLA-herpesvirus interactions driven by differential T cell and Natural Killer cell immune responses.
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Affiliation(s)
- William H. Palmer
- Department of Biomedical Informatics, University of Colorado, Aurora, CO USA
- Department of Immunology & Microbiology, University of Colorado, Aurora, CO USA
| | - Paul J. Norman
- Department of Biomedical Informatics, University of Colorado, Aurora, CO USA
- Department of Immunology & Microbiology, University of Colorado, Aurora, CO USA
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2
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Zuo W, Yu XX, Liu XF, Chang YJ, Wang Y, Zhang XH, Xu LP, Liu KY, Zhao XS, Huang XJ, Zhao XY. The Interaction of HLA-C1/KIR2DL2/L3 Promoted KIR2DL2/L3 Single-Positive/NKG2C-Positive Natural Killer Cell Reconstitution, Raising the Incidence of aGVHD after Hematopoietic Stem Cell Transplantation. Front Immunol 2022; 13:814334. [PMID: 35572602 PMCID: PMC9101514 DOI: 10.3389/fimmu.2022.814334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
NKG2C+ natural killer (NK) cell plays a vital role in CMV infection control after hematopoietic stem cell transplantation (HSCT). However, the modulation on NKG2C+ NK cell reconstitution is still unclear. NK cell education is affected by the interactions of HLA-I/killer immunoglobulin receptor (KIR). Our aim is to figure out which HLA-I/KIR interaction plays a dominant role in NKG2C+ NK education. Based on allogeneic haploidentical HSCT, we investigated the expansion and function of single KIR positive NKG2C+ NK cells via the interaction of KIR with both donor HLA and recipient HLA at days 30, 90, and 180 after HSCT. KIR2DL2/L3 single-positive/NKG2C+ cells were significantly expanded compared with KIR2DL1 or KIR3DL1 single-positive/NKG2C+ cells when donors and recipients were both HLA-C1/C1 or HLA-C1C1BW4 (p < 0.05), with higher NKp30 expression (p < 0.05). Moreover, the proportion of single KIR positive NK cells increased in both NKG2C+/NKG2A- NK cells and conventional NKG2C-/NKG2A- NK cells over time. We also observed that increased proportion of KIR2DL2/L3 single-positive/NKG2C+ NK cells correlated with higher incidence of acute graft-versus-host disease (aGVHD). Our study allows a better understanding of HLA-I/KIR interaction in the NKG2C+ NK cell education after HSCT.
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Abstract
Natural Killer (NK) cells are key effectors of the innate immune system which represent the first line of defense against viral infections. NK cell activation depends on the engagement of a complex receptor repertoire expressed on their surface, consisting of both activating and inhibitory receptors. Among the known NK cell receptors, the family of killer Ig-like receptors (KIRs) consists in activating/inhibitory receptors that interact with specific human leukocyte antigen (HLA) molecules expressed on target cells. In particular, the expression of peculiar KIRs have been reported to be associated to viral infection susceptibility. Interestingly, a significant association between the development and onset of different human pathologies, such as tumors, neurodegeneration and infertility, and a clonal KIRs expression on NK cells has been described in presence of viral infections, supporting the crucial role of KIRs in defining the effect of viral infections in different tissues and organs. This review aims to report the state of art about the role of KIRs receptors in NK cell activation and viral infection control.
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4
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Licensing Natural Killers for Antiviral Immunity. Pathogens 2021; 10:pathogens10070908. [PMID: 34358058 PMCID: PMC8308748 DOI: 10.3390/pathogens10070908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/25/2022] Open
Abstract
Immunoreceptor tyrosine-based inhibitory motif (ITIM)-bearing receptors (IRs) enable discrimination between self- and non-self molecules on the surface of host target cells. In this regard, they have a vital role in self-tolerance through binding and activating intracellular tyrosine phosphatases which can inhibit cellular activation. Yet, self-MHC class I (MHC I)-specific IRs are versatile in that they can also positively impact lymphocyte functionality, as exemplified by their role in natural killer (NK) cell education, often referred to as ’licensing‘. Recent discoveries using defined mouse models of cytomegalovirus (CMV) infection have revealed that select self-MHC I IRs can increase NK cell antiviral defenses as well, whereas other licensing IRs cannot, or instead impede virus-specific NK responses for reasons that remain poorly understood. This review highlights a role for self-MHC I ‘licensing’ IRs in antiviral immunity, especially in the context of CMV infection, their impact on virus-specific NK cells during acute infection, and their potential to affect viral pathogenesis and disease.
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Dębska-Zielkowska J, Moszkowska G, Zieliński M, Zielińska H, Dukat-Mazurek A, Trzonkowski P, Stefańska K. KIR Receptors as Key Regulators of NK Cells Activity in Health and Disease. Cells 2021; 10:1777. [PMID: 34359951 PMCID: PMC8303609 DOI: 10.3390/cells10071777] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Natural killer (NK) cells are part of the cellular immune response. They target mainly cancer and virally infected cells. To a high extent cytotoxic activity of NK cells is regulated inter alia by signals from killer immunoglobulin-like receptors (KIR). The major histocompatibility complex (MHC) class I molecules are important ligands for KIR receptors. Binding of ligands (such as MHC I) to the KIR receptors has the important role in solid organ or hematopoietic cell transplantation. Of note, the understanding of the relationship between KIR and MHC receptors may contribute to the improvement of transplant results. Donor-recipient matching, which also includes the KIR typing, may improve monitoring, individualize the treatment and allow for predicting possible effects after transplantation, such as the graft-versus-leukemia effect (GvL) or viral re-infection. There are also less evident implications of KIR/MHC matching, such as with pregnancy and cancer. In this review, we present the most relevant literature reports on the importance of the KIR/MHC relationship on NK cell activity and hematopoietic stem cell transplantation (HSCT)/solid organ transplantation (SOT) effects, the risk of allograft rejection, protection against post-transplant cytomegalovirus (CMV) infection, pregnancy complications, cancer and adoptive therapy with NK cells.
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Affiliation(s)
- Joanna Dębska-Zielkowska
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Grażyna Moszkowska
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Hanna Zielińska
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Anna Dukat-Mazurek
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdańsk, 80-210 Gdansk, Poland; (G.M.); (M.Z.); (H.Z.); (A.D.-M.); (P.T.)
| | - Katarzyna Stefańska
- Department of Obstetrics, Medical University of Gdańsk, 80-214 Gdansk, Poland;
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Yawata N, Shirane M, Woon K, Lim X, Tanaka H, Kawano YI, Yawata M, Chee SP, Siak J, Sonoda KH. Molecular Signatures of Natural Killer Cells in CMV-Associated Anterior Uveitis, A New Type of CMV-Induced Disease in Immunocompetent Individuals. Int J Mol Sci 2021; 22:ijms22073623. [PMID: 33807229 PMCID: PMC8037729 DOI: 10.3390/ijms22073623] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 12/16/2022] Open
Abstract
Cytomegalovirus (CMV) causes clinical issues primarily in immune-suppressed conditions. CMV-associated anterior uveitis (CMV-AU) is a notable new disease entity manifesting recurrent ocular inflammation in immunocompetent individuals. As patient demographics indicated contributions from genetic background and immunosenescence as possible underlying pathological mechanisms, we analyzed the immunogenetics of the cohort in conjunction with cell phenotypes to identify molecular signatures of CMV-AU. Among the immune cell types, natural killer (NK) cells are main responders against CMV. Therefore, we first characterized variants of polymorphic genes that encode differences in CMV-related human NK cell responses (Killer cell Immunoglobulin-like Receptors (KIR) and HLA class I) in 122 CMV-AU patients. The cases were then stratified according to their genetic features and NK cells were analyzed for human CMV-related markers (CD57, KLRG1, NKG2C) by flow cytometry. KIR3DL1 and HLA class I combinations encoding strong receptor–ligand interactions were present at substantially higher frequencies in CMV-AU. In these cases, NK cell profiling revealed expansion of the subset co-expressing CD57 and KLRG1, and together with KIR3DL1 and the CMV-recognizing NKG2C receptor. The findings imply that a mechanism of CMV-AU pathogenesis likely involves CMV-responding NK cells co-expressing CD57/KLRG1/NKG2C that develop on a genetic background of KIR3DL1/HLA-B allotypes encoding strong receptor–ligand interactions.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- CD57 Antigens/genetics
- CD57 Antigens/immunology
- Cohort Studies
- Cytomegalovirus/immunology
- Cytomegalovirus/pathogenicity
- Cytomegalovirus Infections/immunology
- Female
- Genes, MHC Class I/genetics
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Immunocompromised Host/immunology
- Immunocompromised Host/physiology
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Killer Cells, Natural/physiology
- Lectins, C-Type/genetics
- Lectins, C-Type/metabolism
- Male
- Middle Aged
- NK Cell Lectin-Like Receptor Subfamily C/genetics
- NK Cell Lectin-Like Receptor Subfamily C/immunology
- NK Cell Lectin-Like Receptor Subfamily C/metabolism
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Receptors, KIR/genetics
- Transplantation, Homologous/adverse effects
- Uveitis, Anterior/genetics
- Uveitis, Anterior/metabolism
- Uveitis, Anterior/virology
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Affiliation(s)
- Nobuyo Yawata
- Department of Ocular Pathology and Imaging Science, Kyushu University, Fukuoka 812-8582, Japan
- Singapore Eye Research Institute, Singapore 168751, Singapore; (K.W.); (X.L.); (S.-P.C.); (J.S.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence:
| | - Mariko Shirane
- Department of Ophthalmology, Kyushu University, Fukuoka 812-8582, Japan; (M.S.); (K.-H.S.)
| | - Kaing Woon
- Singapore Eye Research Institute, Singapore 168751, Singapore; (K.W.); (X.L.); (S.-P.C.); (J.S.)
| | - Xinru Lim
- Singapore Eye Research Institute, Singapore 168751, Singapore; (K.W.); (X.L.); (S.-P.C.); (J.S.)
| | | | - Yoh-Ichi Kawano
- Department of Ophthalmology, Fukuoka Dental College, Fukuoka 814-0193, Japan;
| | - Makoto Yawata
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research, A*STAR, Singapore 117609, Singapore;
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- National University Health System, Singapore 119228, Singapore
- Immunology Programme, Life Sciences Institute, National University of Singapore, Singapore 117456, Singapore
- NUSMED Immunology Translational Research Programme, National University of Singapore, Singapore 117456, Singapore
- International Research Center for Medical Sciences, Kumamoto University, Kumamoto 860-8555, Japan
| | - Soon-Phaik Chee
- Singapore Eye Research Institute, Singapore 168751, Singapore; (K.W.); (X.L.); (S.-P.C.); (J.S.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Ocular Inflammation and Immunology Department, Singapore National Eye Centre, Singapore 168751, Singapore
| | - Jay Siak
- Singapore Eye Research Institute, Singapore 168751, Singapore; (K.W.); (X.L.); (S.-P.C.); (J.S.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Ocular Inflammation and Immunology Department, Singapore National Eye Centre, Singapore 168751, Singapore
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Kyushu University, Fukuoka 812-8582, Japan; (M.S.); (K.-H.S.)
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Ferreira JM, Santos LDS, Oliveira SP, Dos Santos BRC, Dos Santos ACM, de Moura EL, de Souza EVM, de Lima Filho JL. Chikungunya Virus Infection Outcome: A Systematic Review of Host Genetics. Immunol Invest 2020; 50:58-79. [PMID: 32204641 DOI: 10.1080/08820139.2020.1733011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Chikungunya virus (CHIKV) is a global concern, inducing chikungunya fever and trigging an arthritogenic chronic phase beyond some severe forms. Outcomes of CHIKV infections in humans are dependent on genetic variations. Here, a systematic review was performed to show evidence of genetic variations on infection outcomes of patients. Methods: Searches were performed in Scopus, SciELO, MEDLINE/PubMed, Web of Science, OneFile (GALE), Periódicos CAPES and ScienceDirect Journals databases. The PICOS approach was used to assess the eligibility of records. A meta-analysis was also conducted to show an association between described alleles/genes and CHIKV infection outcome. Results: Reviews of genetic variants were conducted on genes: CD 209, OAS1, OAS2, OAS3, MIF, TLR-3, TLR-7, TLR-8, MYD-88, KIR, HLA-B; HLA-C; DRB1 and DQB1. Studies were performed on Gabon, Singapore, and India, including Indians, Malay, Gabonese and Chinese ethnicities and published between 2009-2017. The meta-analysis was performed with DRB1 *01; *03; *04; *07; *10; *11; *13; *14 and *15 and DQB1 *02; *03; *05 and *06 alleles with Indian population sample. Sampling power was >80% and a significant positive association between DRB1*14 and CHIKV infection was found (OR = 1.67, 95% CI = 1.04-2.67; p = .03). Conclusion: Majority of the studies were conducted in India. Meta-analysis suggests that DRB1*14 is related to the susceptibility of symptomatic CHIKV infection in Indian population. The literature about CHIKV infection and genetic variations is scarce. The precise role of genetic variation in CHIKV is not clear yet. Further studies are necessary to provide more concrete evidences.
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Affiliation(s)
- Jean Moisés Ferreira
- Laboratório de Imunopatologia Keizo Asami - LIKA, Centro de Biociências, Universidade Federal de Pernambuco (UFPE) , Recife, Pernambuco, Brazil
| | - Leandro Douglas Silva Santos
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - Susana Paiva Oliveira
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - Bárbara Rayssa Correia Dos Santos
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - Ana Caroline Melo Dos Santos
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - Edilson Leite de Moura
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - Elaine Virginia Martins de Souza
- Laboratório de Biologia Molecular E Expressão Gênica - LABMEG, Universidade Federal de Alagoas (UFAL) - Campus Arapiraca , Arapiraca, Alagoas, Brazil
| | - José Luiz de Lima Filho
- Laboratório de Imunopatologia Keizo Asami - LIKA, Centro de Biociências, Universidade Federal de Pernambuco (UFPE) , Recife, Pernambuco, Brazil
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Berry R, Watson GM, Jonjic S, Degli-Esposti MA, Rossjohn J. Modulation of innate and adaptive immunity by cytomegaloviruses. Nat Rev Immunol 2019; 20:113-127. [PMID: 31666730 DOI: 10.1038/s41577-019-0225-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 02/07/2023]
Abstract
The coordinated activities of innate and adaptive immunity are critical for effective protection against viruses. To counter this, some viruses have evolved sophisticated strategies to circumvent immune cell recognition. In particular, cytomegaloviruses encode large arsenals of molecules that seek to subvert T cell and natural killer cell function via a remarkable array of mechanisms. Consequently, these 'immunoevasins' play a fundamental role in shaping the nature of the immune system by driving the evolution of new immune receptors and recognition mechanisms. Here, we review the diverse strategies adopted by cytomegaloviruses to target immune pathways and outline the host's response.
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Affiliation(s)
- Richard Berry
- Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia. .,Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia. .,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia.
| | - Gabrielle M Watson
- Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia
| | - Stipan Jonjic
- Department of Histology and Embryology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Mariapia A Degli-Esposti
- Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia
| | - Jamie Rossjohn
- Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia.,Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
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9
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Killer Immunoglobulin-Like Receptor 2DS2 (KIR2DS2), KIR2DL2-HLA-C1, and KIR2DL3 as Genetic Markers for Stratifying the Risk of Cytomegalovirus Infection in Kidney Transplant Recipients. Int J Mol Sci 2019; 20:ijms20030546. [PMID: 30696053 PMCID: PMC6387393 DOI: 10.3390/ijms20030546] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/10/2019] [Accepted: 01/24/2019] [Indexed: 12/13/2022] Open
Abstract
Infection with cytomegalovirus (CMV) remains a major problem in kidney transplant recipients, resulting in serious infectious complications and occasionally mortality. Accumulating evidence indicates that natural killer cell immunoglobulin-like receptors (KIRs) and their ligands affect the susceptibility to various diseases, including viral infections (e.g., CMV infection). We investigated whether KIR genes and their ligands affect the occurrence of CMV infection in a group of 138 kidney transplant recipients who were observed for 720 days posttransplantation. We typed the recipients for the presence of KIR genes (human leukocyte antigen C1 [HLA-C1], HLA-C2, HLA-A, HLA-B, and HLA-DR1) by polymerase chain reaction with sequence-specific primers. The multivariate analysis revealed that the lack of KIR2DS2 (p = 0.035), the presence of KIR2DL3 (p = 0.075), and the presence of KIR2DL2–HLA-C1 (p = 0.044) were risk factors for posttransplant CMV infection. We also found that a lower estimated glomerular filtration rate (p = 0.036), an earlier time of antiviral prophylaxis initiation (p = 0.025), lymphocytopenia (p = 0.012), and pretransplant serostatus (donor-positive/recipient-negative; p = 0.042) were independent risk factors for posttransplant CMV infection. In conclusion, our findings confirm that the KIR/HLA genotype plays a significant role in anti-CMV immunity and suggest the contribution of both environmental and genetic factors to the incidence of CMV infection after kidney transplantation.
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10
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The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation. Transplantation 2019; 102:900-931. [PMID: 29596116 DOI: 10.1097/tp.0000000000002191] [Citation(s) in RCA: 691] [Impact Index Per Article: 138.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite recent advances, cytomegalovirus (CMV) infections remain one of the most common complications affecting solid organ transplant recipients, conveying higher risks of complications, graft loss, morbidity, and mortality. Research in the field and development of prior consensus guidelines supported by The Transplantation Society has allowed a more standardized approach to CMV management. An international multidisciplinary panel of experts was convened to expand and revise evidence and expert opinion-based consensus guidelines on CMV management including prevention, treatment, diagnostics, immunology, drug resistance, and pediatric issues. Highlights include advances in molecular and immunologic diagnostics, improved understanding of diagnostic thresholds, optimized methods of prevention, advances in the use of novel antiviral therapies and certain immunosuppressive agents, and more savvy approaches to treatment resistant/refractory disease. The following report summarizes the updated recommendations.
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11
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Jorga K, Reigner B, Chavanne C, Alvaro G, Frey N. Pediatric Dosing of Ganciclovir and Valganciclovir: How Model-Based Simulations Can Prevent Underexposure and Potential Treatment Failure. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2018; 8:167-176. [PMID: 30354026 PMCID: PMC6430157 DOI: 10.1002/psp4.12363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022]
Abstract
Intravenous ganciclovir and oral valganciclovir are effective in the prevention and treatment of pediatric cytomegalovirus (CMV) infection but various dosing regimens are used in medical practice. Population pharmacokinetic (PopPK) model-based simulations were used to propose a new ganciclovir pediatric dosing algorithm for regulatory review and to evaluate the approved valganciclovir pediatric dosing algorithm against published dosing recommendations derived from quantitative approaches. Oral valganciclovir (mg = 7 × body surface area (BSA) × creatinine clearance according to the Schwarz formula (CrCLS) daily) and i.v. ganciclovir (mg = 3 × BSA × CrCLS daily) are effective in reaching ganciclovir target exposure for the prevention of CMV (area under the concentration-time curve (AUC)0-24 40-60 μg ∙ hour/mL) in most pediatric patients across the full pediatric age range. In contrast, ganciclovir and valganciclovir dosing based on body weight, as commonly used in medical practice, leads to underexposure, particularly in younger pediatric patients. This example shows that model-based dosing algorithms built on clinical pharmacology and implemented using good modeling practice can prevent underexposure and reduce the risk of treatment failure in pediatric patients.
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Affiliation(s)
- Karin Jorga
- KarinJorga Life Science Consulting GmbH, Basel, Switzerland
| | - Bruno Reigner
- Pharma Research & Development, Pharmaceutical Sciences-Clinical Pharmacology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Clarisse Chavanne
- Pharma Research & Development, Pharmaceutical Sciences-Clinical Pharmacology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Giuseppe Alvaro
- Safety Risk Management, Established Products, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Nicolas Frey
- Pharma Research & Development, Pharmaceutical Sciences-Clinical Pharmacology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
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12
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Bigley AB, Agha NH, Baker FL, Spielmann G, Kunz HE, Mylabathula PL, Rooney BV, Laughlin MS, Mehta SK, Pierson DL, Crucian BE, Simpson RJ. NK cell function is impaired during long-duration spaceflight. J Appl Physiol (1985) 2018; 126:842-853. [PMID: 30382809 DOI: 10.1152/japplphysiol.00761.2018] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Maintaining astronaut health during space travel is paramount for further human exploration of the solar system beyond Earth's orbit. Of concern are potential dysregulations in immunity, which could increase the likelihood of cancer and latent viral reactivation. Natural killer (NK) cells are critical effectors of the innate immune system, and their function and phenotype are important to immunosurveillance of nascent tumors and latent viral infections. We compared changes in NK cell phenotype and function in eight crew members who completed an ~6-mo mission to the International Space Station (ISS) with healthy controls who remained on Earth. Assessments were made before (180 and 60 days before launch), during [flight day + 90 days (FD+90) and 1 day before return (R-1)], and after the mission (at R+0, R+18, R+33, and R+66). These samples, plus an additional in-flight sample (FD+180), were collected from a crew member who spent 340 days (~1 yr) on the ISS. NK cell cytotoxic activity (NKCA) against K562 leukemia targets in vitro was reduced by ~50% at FD+90 in ISS crew but not controls. This decrease was more pronounced in "rookie" compared with "veteran" crew members. The ~1-yr mission crew member did not show declines in NKCA against K562 until late in the mission (R-1 and R+0). NK cell numbers, expression of activating and inhibitory receptors, target cell binding, and expression and degranulation of perforin and granzyme B were unaltered with spaceflight. Similarly, when we exposed an immortalized NK cell line (NK-92) to sera collected at different mission time points (before, during, and after flight), there was no effect on NKCA. This is the first study to report impaired NK cell function during long-duration space travel. Countermeasures may be needed to mitigate immune system impairment in exploration class mission crew during long-duration spaceflight missions. NEW & NOTEWORTHY Immune system impairment may inhibit future human space exploration missions to Mars. Natural killer (NK) cells are key components of immunity and vital for tumor surveillance and the prevention of latent virus reactivation. We report that NK cell function is impaired in astronauts during an ~6-mo orbital space mission compared with preflight levels and ground-based controls. Declines in NK cell function were more marked in first-time "rookie" fliers. Countermeasures are needed to preserve NK cell-mediated immunity during spaceflight.
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Affiliation(s)
- Austin B Bigley
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Nadia H Agha
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Forrest L Baker
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona
| | - Guillaume Spielmann
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,School of Kinesiology, Louisiana State University , Baton Rouge, Louisiana
| | - Hawley E Kunz
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Preteesh L Mylabathula
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona
| | - Bridgette V Rooney
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Mitzi S Laughlin
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Satish K Mehta
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Duane L Pierson
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Brian E Crucian
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Richard J Simpson
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona.,Department of Immunobiology, The University of Arizona , Tucson, Arizona
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13
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Abstract
Natural killer (NK) cells play an important role in the host response against viral infections and cancer development. They are able to kill virus-infected and tumor cells, and they produce different important cytokines that stimulate the antiviral and antitumor adaptive immune response, particularly interferon gamma. NK cells are of particular importance in herpesvirus infections, which is illustrated by systemic and life-threatening herpesvirus disease symptoms in patients with deficiencies in NK cell activity and by the myriad of reports describing herpesvirus NK cell evasion strategies. The latter is particularly obvious for cytomegaloviruses, but increasing evidence indicates that most, if not all, members of the herpesvirus family suppress NK cell activity to some extent. This review discusses the different NK cell evasion strategies described for herpesviruses and how this knowledge may translate to clinical applications.
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14
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Shaffer BC, Hsu KC. How important is NK alloreactivity and KIR in allogeneic transplantation? Best Pract Res Clin Haematol 2016; 29:351-358. [PMID: 27890259 DOI: 10.1016/j.beha.2016.10.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Relapse of acute myelogenous leukemia (AML) after allogeneic hematopoietic cell transplantation (allo HCT) is a major cause of death in transplant recipients. Efforts to control relapse by promoting donor T-cell alloreactivity, such as withdrawal of immune suppression or donor lymphocyte infusions, are limited by the propensity to induce graft versus host disease (GVHD) and by inadequate efficacy. Therefore, options for AML patients who have relapsed AML after allo HCT are few and outcomes are poor. Similar to T-cells, natural killer (NK) cells have potent anti-leukemia effector capacity, and yet unlike T-cells, NK cells do not mediate GVHD. Furthermore, their function does not require matching of human leukocyte antigens (HLA) between donor and recipient. Maximizing donor NK alloreactivity thus holds the exciting possibility to induce the graft versus leukemia (GVL) effect without engendering GVHD. Among the array of activating and inhibitory NK cell surface receptors, the killer Ig-like receptors (KIR) play a central role in modulating NK effector function. Here we will review how KIR mediates donor alloreactivity, discuss the role of KIR gene and allele typing to optimize allo HCT donor selection, and discuss how KIR may aid adoptive NK and other cell therapies.
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Affiliation(s)
- Brian C Shaffer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Katharine C Hsu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Immunology Program, Sloan Kettering Institute, New York, NY, United States; Department of Medicine, Weill Cornell Medical College, New York, NY, United States.
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15
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Bigley AB, Rezvani K, Shah N, Sekine T, Balneger N, Pistillo M, Agha N, Kunz H, O'Connor DP, Bollard CM, Simpson RJ. Latent cytomegalovirus infection enhances anti-tumour cytotoxicity through accumulation of NKG2C+ NK cells in healthy humans. Clin Exp Immunol 2016; 185:239-51. [PMID: 26940026 PMCID: PMC4955006 DOI: 10.1111/cei.12785] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/27/2016] [Accepted: 02/29/2016] [Indexed: 12/22/2022] Open
Abstract
Cytomegalovirus (CMV) infection markedly expands NKG2C+/NKG2A- NK cells, which are potent killers of infected cells expressing human leucocyte antigen (HLA)-E. As HLA-E is also over-expressed in several haematological malignancies and CMV has been linked to a reduced risk of leukaemic relapse, we determined the impact of latent CMV infection on NK cell cytotoxicity against four tumour target cell lines with varying levels of HLA-E expression. NK cell cytotoxicity against K562 (leukaemia origin) and U266 (multiple myeloma origin) target cells was strikingly greater in healthy CMV-seropositive donors than seronegative donors and was associated strongly with target cell HLA-E and NK cell NKG2C expression. NK cell cytotoxicity against HLA-E transfected lymphoma target cells (221.AEH) was ∼threefold higher with CMV, while NK cell cytotoxicity against non-transfected 721.221 cells was identical between the CMV groups. NK cell degranulation (CD107a(+) ) and interferon (IFN)-γ production to 221.AEH cells was localized almost exclusively to the NKG2C subset, and antibody blocking of NKG2C completely eliminated the effect of CMV on NK cell cytotoxicity against 221.AEH cells. Moreover, 221.AEH feeder cells and interleukin (IL)-15 were found to expand NKG2C(+) /NKG2A(-) NK cells preferentially from CMV-seronegative donors and increase NK cell cytotoxicity against HLA-E(+) tumour cell lines. We conclude that latent CMV infection enhances NK cell cytotoxicity through accumulation of NKG2C(+) NK cells, which may be beneficial in preventing the initiation and progression of haematological malignancies characterized by high HLA-E expression.
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Affiliation(s)
- A. B. Bigley
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - K. Rezvani
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - N. Shah
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - T. Sekine
- Department of Stem Cell Transplantation, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - N. Balneger
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - M. Pistillo
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - N. Agha
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - H. Kunz
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - D. P. O'Connor
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
| | - C. M. Bollard
- Program for Cell Enhancement and Technologies for Immunotherapy, Sheikh Zayed Institute for Pediatric Surgical Innovation and Center for Cancer and Immunology ResearchChildren's National Health SystemWashingtonDCUSA
| | - R. J. Simpson
- Laboratory of Integrated Physiology, Department of Health and Human PerformanceUniversity of HoustonHoustonTXUSA
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16
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Torre-Cisneros J, Aguado J, Caston J, Almenar L, Alonso A, Cantisán S, Carratalá J, Cervera C, Cordero E, Fariñas M, Fernández-Ruiz M, Fortún J, Frauca E, Gavaldá J, Hernández D, Herrero I, Len O, Lopez-Medrano F, Manito N, Marcos M, Martín-Dávila P, Monforte V, Montejo M, Moreno A, Muñoz P, Navarro D, Pérez-Romero P, Rodriguez-Bernot A, Rumbao J, San Juan R, Vaquero J, Vidal E. Management of cytomegalovirus infection in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations. Transplant Rev (Orlando) 2016; 30:119-43. [DOI: 10.1016/j.trre.2016.04.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 02/06/2023]
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17
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Alvarado-Hernández DL, Benítez-Sánchez A, Rodríguez-Cuevas JS, Rosales-Saavedra T, Guerra-Palomares SE, Comas-García A, Noyola DE, García-Sepúlveda CA. Killer-cell immunoglobulin-like receptors and cytomegalovirus reactivation during late pregnancy. Int J Immunogenet 2016; 43:189-99. [PMID: 27277336 DOI: 10.1111/iji.12271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/29/2016] [Accepted: 05/05/2016] [Indexed: 11/28/2022]
Abstract
Human cytomegalovirus (CMV) represents an important public health concern as it is associated with severe morbidity and mortality in transplant recipients, HIV-infected individuals and pregnant women given the risk of congenital infection. Congenital CMV is a leading cause of neurological sequelae, developmental delay and birth defects worldwide. Cytomegalovirus can be transmitted to the foetus following maternal infection or reactivation. NK cells expressing killer-cell immunoglobulin-like receptors (KIR) are part of the innate immune system and the first line of defence against viral incursions. Previous reports have shown that KIR genes are associated with CMV infections in the post-transplant setting. In this study, we set out to determine whether a protective effect of KIR genes over CMV infection is seen in Mexican pregnant women. Cytomegalovirus infection was assessed through nucleic acid testing in 200 pregnant women and 600 healthy blood donors comprising the Mexican mestizo reference population. Killer-cell immunoglobulin-like receptors and HLA-C genotypes were obtained from 200 pregnant women and 300 reference samples using a comprehensive PCR-SSP approach. We observed statistically lower carrier frequencies of cB03|tA01 gene-content haplotype, of cB03 haplotype motif, of the KIR2DL5 + 2DS3/2DS5 gene pair and of KIR2DL5 amongst CMV-positive pregnant women in comparison with those CMV negative. None of these were associated with CMV status in the reference population. Logistic regression analysis revealed that the most important factor determining CMV status during third-trimester pregnancies was the KIR2DL5 + 2DS3/2DS5 gene pair (OR 0.376 (95%CI 0.174, 0.811, P = 0.013). Our results indicate that CMV-protective KIR gene associations described in Caucasoid populations are also present in the genetically distinct Mexican mestizo population. Our results suggest that certain KIR gene combinations provide protection against CMV infections occurring during late-term pregnancies, a finding of utmost epidemiological importance given its implication with congenital CMV infections.
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Affiliation(s)
- D L Alvarado-Hernández
- Laboratorio de Genómica Viral y Humana, Facultad de Medicina UASLP, San Luis Potosí, México
| | - A Benítez-Sánchez
- División de Gineco-Obstetricia, Hospital Central 'Dr. Ignacio Morones Prieto', San Luis Potosí, México
| | - J S Rodríguez-Cuevas
- División de Gineco-Obstetricia, Hospital Central 'Dr. Ignacio Morones Prieto', San Luis Potosí, México
| | - T Rosales-Saavedra
- Laboratorio de Genómica Viral y Humana, Facultad de Medicina UASLP, San Luis Potosí, México
| | - S E Guerra-Palomares
- Laboratorio de Genómica Viral y Humana, Facultad de Medicina UASLP, San Luis Potosí, México
| | - A Comas-García
- Departamento de Microbiología, Facultad de Medicina UASLP, San Luis Potosí, México
| | - D E Noyola
- Departamento de Microbiología, Facultad de Medicina UASLP, San Luis Potosí, México
| | - C A García-Sepúlveda
- Laboratorio de Genómica Viral y Humana, Facultad de Medicina UASLP, San Luis Potosí, México
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18
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Blanco-Lobo P, Bulnes-Ramos Á, McConnell MJ, Navarro D, Pérez-Romero P. Applying lessons learned from cytomegalovirus infection in transplant patients to vaccine design. Drug Discov Today 2016; 21:674-81. [DOI: 10.1016/j.drudis.2016.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/10/2016] [Accepted: 03/04/2016] [Indexed: 01/30/2023]
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19
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Brockmeyer P, Hemmerlein B, Kruppa J, Kauffmann P, Tröltzsch M, Schliephake H, Gruber RM. The time interval between primary surgery and adjuvant therapy determines prognosis of oral squamous cell carcinomas. Oral Oncol 2015; 51:e82-e85. [DOI: 10.1016/j.oraloncology.2015.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 08/28/2015] [Accepted: 08/30/2015] [Indexed: 11/28/2022]
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20
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Killer immunoglobulin-like receptor gene repertoire influences viral load of primary human cytomegalovirus infection in renal transplant patients. Genes Immun 2014; 15:562-8. [DOI: 10.1038/gene.2014.53] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/29/2014] [Accepted: 05/05/2014] [Indexed: 02/06/2023]
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21
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Gonzalez A, Schmitter K, Hirsch HH, Garzoni C, van Delden C, Boggian K, Mueller NJ, Berger C, Villard J, Manuel O, Meylan P, Stern M, Hess C. KIR-associated protection from CMV replication requires pre-existing immunity: a prospective study in solid organ transplant recipients. Genes Immun 2014; 15:495-9. [DOI: 10.1038/gene.2014.39] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/29/2014] [Accepted: 06/03/2014] [Indexed: 01/08/2023]
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