| 1. |
- Lidehäll, Anna Karin, 1975-, et al.
(author)
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T cell control of primary and latent cytomegalovirus infections in healthy subjects
- 2005
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In: Journal of Clinical Immunology. - : Springer Science and Business Media LLC. - 0271-9142 .- 1573-2592. ; 25:5, s. 473-481
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Journal article (peer-reviewed)abstract
- The T cell repertoire required to control acute and latent CMV infection in otherwise healthy individuals was examined using both functional analysis and a wide range of MHC I tetramers. Both frequency and function of CMV specific T cells varied considerably between subjects, however, within subjects values remained stable over time. In total 16 ± 3.5 CMV specific T cells/μl blood was detected, with obvious immunodominance between different CMV epitopes. Most subjects with latent infection showed low CMV specific T cell activity, whereas a subgroup (1/3) of individuals was high in either frequency or function of their CMV specific T cells. Patients with acute infection displayed high initial, but rapidly decreasing, numbers of CMV specific cells. In conclusion, a majority of healthy individuals readily seem to control latent CMV infection, whereas a subpopulation (1/3) of individuals uses a large proportion of their CD8+ T cell repertoire to control the infection.
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| 2. |
- Sund, Bill, et al.
(author)
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Del 1 : Varans och pengarnas väg
- 2006
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In: Häleri. - Stockholm : Brottsförebyggande rådet, (BRÅ). ; , s. 11-35
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Book chapter (other academic/artistic)
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| 3. |
- Sund, Fredrik, 1969-
(author)
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Cytomegalovirus Infection in Immunocompetent and Renal Transplant Patients : Clinical Aspects and T-cell Specific Immunity
- 2008
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Doctoral thesis (other academic/artistic)abstract
- Cytomegalovirus (CMV) is a β-herpesvirus that, after primary infection, establishes a life-long persistence in the human host. Up to 90% of humans are infected with CMV, that is kept under control by CMV-specific CD8+ and CD4+ T cells. In patients with an impaired cellular immunity, however, CMV infections can be life-threatening. Thus, it is vital to identify risk factors and target high-risk patients. In this thesis we have evaluated low-dose valacyclovir prophylaxis in renal transplant patients and studied CMV-specific T cell immunity in healthy and renal transplant patients. In renal transplant patients, the CMV serostatus of both the recipient (R) and the donor (D) has a major impact on the risk of developing CMV disease. In the high-risk D+/R- population, >50% are likely to develop CMV disease in the absence of prophylaxis and/or pre-emptive therapy. We have used low-dose valacyclovir prophylaxis for high-risk renal transplant patients, and graft and patient survival up to 5 years after transplantation was comparable to data reported for other prophylactic protocols. The incidence of CMV disease and graft rejection during the first year after transplantation was also comparable to that achieved with other protocols, and without the adverse effects reported for other therapies. In the D+/R+ population, with a 15-35% risk of developing CMV disease, it is important to identify those individuals that are subject to a higher risk because of risk factors other than CMV serostatus. We therefore measured several immunologic parameters in renal transplant patients and in immunocompetent individuals with latent and primary CMV infection. In patients with a primary symptomatic CMV infection, CMV-specific CD8+ T cells peaked within a month after onset of symptoms but declined rapidly. In renal transplant patients, we found that the reduction in IFNγ-producing CMV-specific CD4+ T cells at 2 months post-transplantation may predict high-grade CMV DNAemia.
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