Tacrolimus exposure windows responsible for Listeria monocytogenes infection susceptibility

Abstract

Transplantation is increasingly used in individuals with irreversible organ damage. An important consideration is preventing rejection of genetically foreign donor allograft tissues which requires life-long immune-suppressive therapies. Allograft rejection is primarily mediated by T cells, and post-transplant therapies primarily target these immune cell subsets. 1 The widely used calcineurin inhibitor, tacrolimus, is currently prescribed to >90% of solid organ transplant recipients. 2,3 Tacrolimus primarily inhibits T-cell activation, but does not discriminate between graft-specific cells that mediate donor tissue rejection from cells with other specificities that sustain host defense against microbial infection. Accordingly, transplant recipients are at increased infection risk, especially infection by intracellular pathogens such as Listeria monocytogenes (Lm) normally controlled by Tcell-mediated immunity. [4][5][6][7][8] Vaccination is an effective approach for boosting antimicrobial immunity against specific pathogens in defined developmental contexts. However, transplant recipients, especially in the first months following transplant, consistently show diminished responsiveness to both inactivated and live attenuated vaccines. [9][10][11] Another consideration is the risk of infection from live attenuated vaccines, compared with inactivated vaccines, in transplant recipients on

Nutrition in intestinal transplantation: centre stage or supporting act?

“…Transplant patients are more prone to opportunistic pathogens such as Listeria monocytogenes [50], but they also remain susceptible to common foodborne infections, which may lead to more severe or chronic illness.…”