Preservation of Antiviral Immunologic Efficacy Without Alloimmunity After Switch to Belatacept in Calcineurin Inhibitor–Intolerant Patients

Schaenman, Joanna; Rossetti, Maura; Pickering, Harry; Sunga, Gemalene; Wilhalme, Holly; Elashoff, David; Zhang, Qiuheng; Hickey, Michelle J.; Reddy, Uttam; Danovitch, Gabriel M.; Reed, Elaine F.; Bunnapradist, Suphamai

doi:10.1016/j.ekir.2022.10.015

Cited by 3 publications

(2 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the opposite, belatacept demonstrated minimal inhibitory effects on CMV-specific T cells likely because of an absence of effect on cells lacking CD28 [36,37]. While the antiviral immune response against CMV measured in vitro appears preserved under belatacept [38], high-risk belatacept-treated recipients show defects in sustaining CMV control [39], and exhibit high incidence of atypical lifethreatening CMV diseases [40]. Further research is needed to elucidate this gap.…”

Section: Immunosuppressive Therapy and CMV Immune Responsementioning

confidence: 99%

Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?

Bestard,

Kaminski,

Couzi

et al. 2023

Transpl Int

View full text Add to dashboard Cite

Utilizing assays that assess specific T-cell-mediated immunity against cytomegalovirus (CMV) holds the potential to enhance personalized strategies aimed at preventing and treating CMV in organ transplantation. This includes improved risk stratification during transplantation compared to relying solely on CMV serostatus, as well as determining the optimal duration of antiviral prophylaxis, deciding on antiviral therapy when asymptomatic replication occurs, and estimating the risk of recurrence. In this review, we initially provide an overlook of the current concepts into the immune control of CMV after transplantation. We then summarize the existent literature on the clinical experience of the use of immune monitoring in organ transplantation, with a particular interest on the outcomes of interventional trials. Current evidence indicates that cell-mediated immune assays are helpful in identifying patients at low risk for replication for whom preventive measures against CMV can be safely withheld. As more data accumulates from these and other clinical scenarios, it is foreseeable that these assays will likely become part of the routine clinical practice in organ transplantation.

show abstract

Section: Immunosuppressive Therapy and CMV Immune Responsementioning

confidence: 99%

Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?

Bestard,

Kaminski,

Couzi

et al. 2023

Transpl Int

View full text Add to dashboard Cite

show abstract

“…A study by Schaenmen et al. 3 published in this issue of KI Reports attempts to investigate the latter 2 issues in a prospective transplant cohort by assaying peripheral blood mononuclear cells (PBMCs) to study the immunologic impact of switching to belatacept maintenance immunosuppression. Specifically, the authors here investigated belatacept’s impact on T-cell phenotype in the context of donor-specific immunity (alloimmunity) and antiviral immunity.…”

mentioning

confidence: 99%

Walking the Line Between Antidonor and Antiviral Immunity: A Potential Role for Belatacept

Gunasekaran¹,

Pell²,

Menon³

2023

Kidney International Reports

View full text Add to dashboard Cite

Attenuation of Torque teno viral load over time in kidney transplantation recipients treated with calcineurin inhibitors is mitigated after conversion to belatacept

Bredewold,

Moest,

de Fijter

et al. 2024

Journal of Medical Virology

View full text Add to dashboard Cite

Torque Teno Virus (TTV) is a non‐pathogenic anellovirus, highly prevalent in healthy populations. Variations in its viral load have been associated with states of diminished immunity, as occurs after organ transplantation. It is hypothesized that TTV‐load might be used as a diagnostic tool to guide prescription and dosing of immunosuppressive drugs. Not much is known about the effects of combined immunosuppressive drugs on TTV replication in renal transplantation. Belatacept was introduced to counter side‐effects of calcineurin inhibitors (CNI). It was never widely adopted, mainly because its association with increased risk of rejection. To investigate the differential effects of a regimen based on calcineurin inhibitors versus belatacept on TTV‐loads, we measured TTV‐levels in 105 patients from two randomized controlled trials in kidney transplant recipients (KTRs). We observed that time after transplantation was inversely related to TTV‐levels of patients that remained on a CNI‐containing regime, whereas this decline over time was diminished after conversion to belatacept. In addition, a correlation with tacrolimus‐trough levels and age were found. Our study is the first report on the impact of conversion from CNI to belatacept on TTV‐levels in KTR. In conclusion, the time‐related decline in TTV‐levels is mitigated after conversion from CNI to belatacept.

show abstract

Preservation of Antiviral Immunologic Efficacy Without Alloimmunity After Switch to Belatacept in Calcineurin Inhibitor–Intolerant Patients

Cited by 3 publications

References 45 publications

Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?

Cytomegalovirus Cell-Mediated Immunity: Ready for Routine Use?

Walking the Line Between Antidonor and Antiviral Immunity: A Potential Role for Belatacept

Attenuation of Torque teno viral load over time in kidney transplantation recipients treated with calcineurin inhibitors is mitigated after conversion to belatacept

Contact Info

Product

Resources

About