Cytomegalovirus immunoglobulin G titers do not predict reactivation risk in immunocompetent hosts

Mansfield, Sara A.; Dwivedi, Varun; Elgharably, Haytham; Grießl, Marion; Zimmerman, Peter D.; Limaye, Ajit P.; Cook, Charles H.

doi:10.1002/jmv.25389

Cited by 12 publications

(9 citation statements)

References 44 publications

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“…Further studies are needed to unravel this seemingly conflicting feature of CMV-specific T cells. Large prospective studies in humans could provide further insight, but such studies may still be complicated given the possible impact of MHC heterogeneity in the human population compared to inbred mice [95]. Notably, the data discussed here reflect mainly the differentiation of the circulating CMV-specific T cells, which represents a subgroup of the total CD8 T-cell pool in the body.…”

Section: Discussionmentioning

confidence: 99%

The hallmarks of CMV-specific CD8 T-cell differentiation

Berg

Pardieck

Lanfermeijer

et al. 2019

Med Microbiol Immunol

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Upon cytomegalovirus (CMV) infection, large T-cell responses are elicited that remain high or even increase over time, a phenomenon named memory T-cell inflation. Besides, the maintained robust T-cell response, CMV-specific T cells seem to have a distinctive phenotype, characterized by an advanced differentiation state. Here, we will review this "special" differentiation status by discussing the cellular phenotype based on the expression of CD45 isoforms, costimulatory, inhibitory and natural killer receptors, adhesion and lymphocyte homing molecules, transcription factors, cytokines and cytotoxic molecules. In addition, we focus on whether the differentiation state of CMV-specific CD8 T cells is unique in comparison with other chronic viruses and we will discuss the possible impact of factors such as antigen exposure and aging on the advanced differentiation status of CMV-specific CD8 T cells.

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Section: Discussionmentioning

confidence: 99%

The hallmarks of CMV-specific CD8 T-cell differentiation

Berg

Pardieck

Lanfermeijer

et al. 2019

Med Microbiol Immunol

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“…Noteworthy, our patient was also treated with methylprednisolone during 15 days, which might add immunosuppressive effects and contribute to viral reactivation. Evidence supports corticosteroids association with viral infections, including CMV, either in immunocompetent or immunocompromised patients 9,23,24 …”

Section: Resultsmentioning

confidence: 99%

Safety of tocilizumab in COVID‐19 pregnant women and their newborn: A retrospective study

et al. 2021

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What is known and objective Tocilizumab is an IL‐6 receptor inhibitor agent which has been proposed as a candidate to stop the inflammatory phase of infection by the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). However, safety data of tocilizumab in pregnant women and their newborn are scarce. We aimed to describe maternal and neonatal safety outcomes associated with tocilizumab treatment in pregnant women with severe COVID‐19. Methods This is a retrospective study of severe COVID‐19 pregnant women, treated with tocilizumab in two Spanish hospitals between 1 March and 31 April 2020. Demographics, medical history, clinical and radiologic findings, treatment information and laboratory data of mothers and their newborns were collected from electronic medical records. Results and discussion A total of 12 pregnant women were identified to have received tocilizumab during pregnancy in the two hospitals. Median gestational age at admission was 27.7 weeks (interquartile range, 18.0–36.4). Most of them received lopinavir/ritonavir, azithromycin and hydroxychloroquine, two patients received corticosteroids and one received interferon beta 1B. All 12 pregnancies resulted in live births. Somatometric values were normal for all newborns, and evolution at 14 and 28 days was favourable for all of them. Hepatotoxicity was observed in 2 patients, which improved or resolved at discharge. Cytomegalovirus reactivation was detected in another patient who had also received corticosteroids for 15 days, causing a congenital infection in her newborn. Both hepatotoxicity and viral reactivation adverse events were classified as possibly related to tocilizumab administration according to Naranjo's causality algorithm. What is new and conclusions It does not appear that tocilizumab has detrimental effects for the mother and newborn. Close monitoring of infections should be considered, especially if other immunosuppressive agents are used.

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“…Finally, while elevations in CMV-specific IgG levels might correlate with the length or frequency of CMV recurrences in immunosuppressed patients, 32 their significance in immunocompetent individuals is unclear. 61 …”

Section: Discussionmentioning

confidence: 99%