Impaired Cytomegalovirus Immunity in Idiopathic Pulmonary Fibrosis Lung Transplant Recipients with Short Telomeres

Cytomegalovirus (CMV)-related morbidities remain one of the most common complications after lung transplantation and have been linked to allograft dysfunction, but the factors that predict high risk for CMV complications and effective immunity are incompletely understood. To determine if short telom...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2019-02, Vol.199 (3), p.362-376
Main Authors: Popescu, Iulia, Mannem, Hannah, Winters, Spencer A, Hoji, Aki, Silveira, Fernanda, McNally, Emily, Pipeling, Matthew R, Lendermon, Elizabeth A, Morrell, Matthew R, Pilewski, Joseph M, Hanumanthu, Vidya Sagar, Zhang, Yingze, Gulati, Swati, Shah, Pali D, Iasella, Carlo J, Ensor, Christopher R, Armanios, Mary, McDyer, John F
Format: Article
Language:English
Subjects:
Adult
Aged
Antigens
Cell growth
Cytokines
Cytomegalovirus
Cytomegalovirus - immunology
Cytomegalovirus Infections - complications
Cytomegalovirus Infections - immunology
Female
Humans
Idiopathic Pulmonary Fibrosis - complications
Idiopathic Pulmonary Fibrosis - immunology
Immunity
Infections
Lung Transplantation
Lung transplants
Lymphocytes
Male
Middle Aged
Morbidity
Mortality
Mutation
Original
Pathogenesis
Pulmonary fibrosis
Telomerase
Telomere - immunology
Transcription factors
Transplant Recipients - statistics & numerical data
Transplants & implants
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Summary:Cytomegalovirus (CMV)-related morbidities remain one of the most common complications after lung transplantation and have been linked to allograft dysfunction, but the factors that predict high risk for CMV complications and effective immunity are incompletely understood. To determine if short telomeres in idiopathic pulmonary fibrosis (IPF) lung transplant recipients (LTRs) predict the risk for CMV-specific T-cell immunity and viral control. We studied IPF-LTRs (n = 42) and age-matched non-IPF-LTRs (n = 42) and assessed CMV outcomes. We measured lymphocyte telomere length and DNA sequencing, and assessed CMV-specific T-cell immunity in LTRs at high risk for CMV events, using flow cytometry and fluorescence in situ hybridization. We identified a high prevalence of relapsing CMV viremia in IPF-LTRs compared with non-IPF-LTRs (69% vs. 31%; odds ratio, 4.98; 95% confidence interval, 1.95-12.50; P 
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201805-0825OC