NK and T cell in patients with end-stage lung disorders waiting for lung transplantation in response to CMV infection.

Introduction: Cytomegalovirus(CMV)is the leading opportunistic infection in lung transplant recipients. CMV is associated with graft failure and decreased survival. Novel findings include advances in the diagnostic thresholds, in optimized methods, the development of new antiviral therapies leading to better control of infection. Aim and Objectives: Our aim is analyze NK and T cell subsets of patients waiting for LTX. We analyzed the cellular populations between reactive and non-reactive quantiferonCMV (QF) patients for prediction of immunological response to infection. Methods: 17 pre-LTX patients and 15 healthy controls has been enrolled. QF and INF-γ ELISA assay detection were applied. NK cell subsets and T cell and proliferation assay were detected before and after stimulation with pp-65 and IE-1 after stratification as QF+ and QF-. Results: Discrepancy emerged between serology and QF assay. Better proliferative capability emerged from patients QF+,in particular in CD8 and CD25 cells. CD56brCD16lowNKG2A+KIR+ resulted the best discriminatory cellular subsets. CD56brCD16low,adaptive/mem.like NK and CD8Teff resulted highly increased only on QF+ patients. Conclusions: This study provide new insight in terms of immunological response to CMV in patients waiting for LTX. QF more than serology is useful in the detection of patients able to response to viral infection. This study provide new evidence regarding the immunologic dysregulation in patients with end-stage lung disorders, particularly in NK and T cells biology.