Saliva as a source of HCMV DNA in allogeneic stem cell transplantation patients

Correia-Silva, Jeane F.; Bruna-Romero, Oscar; Resende, Renata Gonçalves; Miranda, L.; Oliveira, Fernando Bernardes de; Costa, Fernando Oliveira; Xavier, Sandra Guerra; Figueiredo-Neves, Suzane Pretti; Almeida, Henderson Celestino de; Bittencourt, Henrique; Gomez, Ricardo Santiago

doi:10.1111/j.1601-0825.2009.01637.x

Cited by 13 publications

(27 citation statements)

References 22 publications

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“…HCMV is an important factor for morbidity and long-term outcome after allo-HSCT [35]. It has also been reported that immunosuppression related to allo-HSCT affects HCMV reactivation in the oral cavity [6,7]. In our first study [6], we did not observe any impact of HCMV presence in the saliva on recipient survival, after allo-HSCT.…”

Section: Discussionmentioning

confidence: 47%

“…A previous study showed that the HCMV load in the saliva, detected by real-time PCR, had similar kinetics as compared with blood. Moreover, this study also indicated that saliva can be a useful source for real-time PCR analysis, for the monitoring and diagnosis of HCMV disease, among patients submitted to HSCT [7].…”

Section: Discussionmentioning

confidence: 99%

“…Oral fluid was collected by swab, as previously described [7]. Four milliliters of peripheral blood were collected in an EDTA tube for the PCR assay and stored at -20°C until processing.…”

Section: Qpcrmentioning

confidence: 99%

“…Human cytomegalovirus (HCMV) infection remains one of the most important causes of morbidity and mortality among allo-HSCT recipients [6,7]. Infection by HCMV may result not only in HCMV disease, but is also associated with other adverse effects due to its immunomodulatory actions; this might result in increased risk of bacterial, fungal and viral infections, and also of aGVHD [8].…”

mentioning

confidence: 99%

“…Deregulation of inflammatory cytokines is also associated with multiple symptoms (pain, sleep disturbance and depression) during neutropenia after allo-HSCT [3]. Interleukin-6 (IL-6) is an important pro-inflammatory cytokine involved in immune-mediated complications after allo-HSCT [5].Human cytomegalovirus (HCMV) infection remains one of the most important causes of morbidity and mortality among allo-HSCT recipients [6,7]. Infection by HCMV may result not only in HCMV disease, but is also associated with other adverse effects due to its immunomodulatory actions; this might result in increased risk of bacterial, fungal and viral infections, and also of aGVHD [8].…”

mentioning

confidence: 99%

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Cytokine Production and Human Cytomegalovirus Load in Allogeneic Hematopoietic Stem Cell Transplantation Outcome

TA¹

2016

Int J Immunother Cancer Res

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Objective: To investigate the impact of cytokine levels (IL-1β, IL-6, IL-10, IFN-γ and TNF-α) and Human cytomegalovirus (HCMV) load in the saliva and blood on the survival of allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients.Study Design: Samples were obtained from 63 patients 7 days before and 21 days after allo-HSCT. Cytokine levels were assessed by ELISA, and HCMV load was determined by real-time PCR. Results:The increase of IL-6 in the saliva and the reduction of IFN-γ in the blood before allo-HSCT were associated with increased risk of death. Moreover, the increase of IL-6 in the blood and of HCMV in the saliva after allo-HSCT were also associated with increased risk of death. Conclusions:Cytokine levels and HCMV load were associated with the increased risk of death. The findings suggest a potential function of these biomarkers in the determination of allo-HSCT survival.factor-α (TNF-α) and interleukin-1 (IL-1), could be increased as a result of disease, therapy, comorbidities or ongoing infections that occur before allo-HSCT. Second, immediately after allo-HSCT, the immune dysfunction caused by the conditioning regimen, which may produce tissue injury and consequently the production of inflammatory cytokines, may affect the reconstitution of white blood cells. Third, after allo-HSCT, activated, mature donor T-cells can set off a cytokine response that in turn stimulates host T-cell responses related to the onset of acute graft-versus-host disease (aGVHD) [3,4]. Immune dysfunction following allo-HSCT involves activated T-cells secreting interferon (IFN)-γ as well as other cytokines, which activate monocytes and dendritic cells. This process appears to be associated with the induction of aGVHD, resulting in significant morbidity and mortality. In addition, a prolonged immune deficiency characterized by lymphopenia and susceptibility to infection can occur [2]. Deregulation of inflammatory cytokines is also associated with multiple symptoms (pain, sleep disturbance and depression) during neutropenia after allo-HSCT [3]. Interleukin-6 (IL-6) is an important pro-inflammatory cytokine involved in immune-mediated complications after allo-HSCT [5].Human cytomegalovirus (HCMV) infection remains one of the most important causes of morbidity and mortality among allo-HSCT recipients [6,7]. Infection by HCMV may result not only in HCMV disease, but is also associated with other adverse effects due to its immunomodulatory actions; this might result in increased risk of bacterial, fungal and viral infections, and also of aGVHD [8].Allo-HSCT outcomes could be affected by factors such as HCMV infection, recipient/donor histocompatibility, patient/donor gender,

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

“…Oral fluid was collected by swab, as previously described [7]. Four milliliters of peripheral blood were collected in an EDTA tube for the PCR assay and stored at -20°C until processing.…”

Section: Qpcrmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Cytokine Production and Human Cytomegalovirus Load in Allogeneic Hematopoietic Stem Cell Transplantation Outcome

TA¹

2016

Int J Immunother Cancer Res

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Quantitative analysis of human herpesvirus‐6 and human cytomegalovirus in blood and saliva from patients with acute leukemia

Nefzi

Abid

Khélif

et al. 2014

Journal of Medical Virology

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Human herpesvirus-6 (HHV-6) and human cytomegalovirus (HCMV) DNAs were quantified by real-time PCR assays in blood and saliva obtained from 50 patients with acute leukemia at the time of diagnosis (50 of each matrix), aplasia (65 of each matrix), remission (55 of each matrix), and relapse (20 of each matrix) to evaluate which biological matrix was more suitable to identify a viral reactivation, search for a possible link between HHV-6 and HCMV reactivations, and evaluate the relations between viral loads and count of different leukocyte types in blood. The median HHV-6 loads were 136; 219; 226, and 75 copies/million cells in blood at diagnosis, aplasia, remission and relapse, respectively. The HCMV loads were 193 and 317 copies/million cells in blood at diagnosis and remission. In the saliva samples, the HHV-6 loads were 22,165; 15,238; 30,214, and 17,454 copies/million cells at diagnosis, aplasia, remission, and relapse, respectively. The HCMV loads were 8,991; 1,461; 2,980, and 4,283 copies/million cells at diagnosis, aplasia, remission, and relapse, respectively. The HHV-6 load in the blood was correlated to the counts of polymorphonuclear leukocytes (R(2) = 0.5; P < 0.0001) and lymphocytes (R(2) = 0.4; P = 0.001) and was not correlated to the monocyte counts (R(2) = 0.07; P = 0.7). Saliva appears to be a more sensitive biological matrix than whole blood in the detection of HHV-6 or HCMV reactivations. The HHV-6 and HCMV reactivations were linked only in saliva.

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Monitoring of oral cytomegalovirus DNA shedding for the prediction of viral DNAemia in allogeneic hematopoietic stem cell transplant recipients

Pascual

Solano

Torres

et al. 2018

Journal of Medical Virology

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Preemptive antiviral therapy based on detecting cytomegalovirus (CMV) DNAemia above a preestablished threshold is the mainstay strategy for the prevention of CMV disease in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients; nevertheless, CMV DNAemia, even at low levels, may increase mortality. We investigated whether surveillance of saliva for the presence of CMV DNA may anticipate the occurrence of CMV DNAemia. This was a prospective observational study with 53 consecutively enrolled allo-HSCT recipients. Saliva and plasma specimens were collected on a weekly basis from Day 0 to Day 100 after transplantation. CMV DNA was quantified in both specimen types using the Abbott Real-Time PCR assay (Abbott Molecular, Des Plaines, IL). CMV DNA was quantifiable in 44 (83%) patients: either in saliva (n = 1) or plasma (n = 12) only, or in both specimen types (n = 31). CMV oral shedding preceded the occurrence of CMV DNAemia in eight patients (18.2%), while the opposite pattern was observed in 21 patients (47.7%). The CMV DNA loads quantified in saliva and plasma correlated modestly (P = 0.33; P = 0.013) and did not differ in magnitude (P = 0.527). No transplantation factors, other than recipient CMV seropositivity, were associated with oral CMV DNA shedding; serum CMV IgG levels were comparable, regardless of the timing of the detection of CMV DNA at both sites. In summary, screening of saliva specimens for the presence of CMV DNA appear to be of limited value for anticipating the occurrence of CMV DNAemia in allo-HSCT recipients.

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Saliva as a source of HCMV DNA in allogeneic stem cell transplantation patients

Abstract: This study shows that the real time PCR test could be useful to identify HCMV DNA in saliva and to monitor patients at risk of cytomegalovirus disease after allogeneic hematopoietic stem cell transplant. However, further studies are necessary to confirm this data.

Cited by 13 publications

References 22 publications

Cytokine Production and Human Cytomegalovirus Load in Allogeneic Hematopoietic Stem Cell Transplantation Outcome

Cytokine Production and Human Cytomegalovirus Load in Allogeneic Hematopoietic Stem Cell Transplantation Outcome

Quantitative analysis of human herpesvirus‐6 and human cytomegalovirus in blood and saliva from patients with acute leukemia

Monitoring of oral cytomegalovirus DNA shedding for the prediction of viral DNAemia in allogeneic hematopoietic stem cell transplant recipients

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