Volume 14, Issue 6 pp. 618-625

Original article

Pre-transplant myeloid dendritic cell deficiency associated with cytomegalovirus infection and death after kidney transplantation

Q. Sun,

Q. Sun

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Nephrology, Beijing ChaoYang Hospital, Capital Medical University, Beijing, China

Search for more papers by this author

E.C. Hall,

E.C. Hall

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

Y. Huang,

Y. Huang

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

P. Chen,

P. Chen

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

K. Dibadj,

K. Dibadj

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

M. Murawski,

M. Murawski

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

R. Shraybman,

R. Shraybman

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

K. Van Kirk,

K. Van Kirk

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

V. Tang,

V. Tang

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

R. Peng,

R. Peng

Department of Pathology, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

P.R. Patton,

P.R. Patton

Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

M.J. Clare-Salzler,

M.J. Clare-Salzler

Department of Pathology, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

B. Kaplan,

B. Kaplan

Departments of Surgery, Medicine, and Pharmacology, University of Arizona School of Medicine, Tucson, Arizona, USA

Search for more papers by this author

D.L. Segev,

D.L. Segev

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

K.L. Womer,

Corresponding Author

K.L. Womer

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to: Karl L. Womer, MD, Ross Building 947, 720 Rutland Avenue, Baltimore, MD 21205, USA

Tel: 410-502-3707

Fax: 410-502-5944

E-mail: [email protected]

Search for more papers by this author

Q. Sun,

Q. Sun

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Nephrology, Beijing ChaoYang Hospital, Capital Medical University, Beijing, China

Search for more papers by this author

E.C. Hall,

E.C. Hall

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

Y. Huang,

Y. Huang

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

P. Chen,

P. Chen

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

K. Dibadj,

K. Dibadj

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

M. Murawski,

M. Murawski

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

R. Shraybman,

R. Shraybman

Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

K. Van Kirk,

K. Van Kirk

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

V. Tang,

V. Tang

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

R. Peng,

R. Peng

Department of Pathology, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

P.R. Patton,

P.R. Patton

Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

M.J. Clare-Salzler,

M.J. Clare-Salzler

Department of Pathology, University of Florida College of Medicine, Gainesville, Florida, USA

Search for more papers by this author

B. Kaplan,

B. Kaplan

Departments of Surgery, Medicine, and Pharmacology, University of Arizona School of Medicine, Tucson, Arizona, USA

Search for more papers by this author

D.L. Segev,

D.L. Segev

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

K.L. Womer,

Corresponding Author

K.L. Womer

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to: Karl L. Womer, MD, Ross Building 947, 720 Rutland Avenue, Baltimore, MD 21205, USA

Tel: 410-502-3707

Fax: 410-502-5944

E-mail: [email protected]

Search for more papers by this author

First published: 06 June 2012

https://doi.org/10.1111/j.1399-3062.2012.00750.x

Citations: 3

Share a link

Email
Wechat
Bluesky

Abstract

Background

Dendritic cells (DCs) are potent antigen-presenting cells critical for immunity. We previously demonstrated a significant association between pre-transplant blood myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) deficiency and post-transplant BK viremia in renal transplant recipients. In the current post-hoc analysis, we studied the association of these same pre-transplant DC levels with other post-transplant outcomes.

Methods

Pre-transplant peripheral blood mDC and pDC levels were quantified using flow cytometry in 78 patients undergoing kidney transplantation. Post-transplant outcomes were analyzed, including infection, rejection, and patient death, with a median follow-up of 5.3 years. Associations between DC levels and outcomes were assessed using logistic regression analysis and Cox proportional hazards models.

Results

An independent association of mDC levels with post-transplant cytomegalovirus infection (adjusted odds ratio 7.0, P = 0.01) and patient death (adjusted hazard ratio 13.0, P = 0.015) was found. No associations were demonstrated between levels of either DC subtype and bacterial infections or rejection.

Conclusions

Pre-transplant mDC deficiency is significantly associated with CMV infection and death after kidney transplantation.

Supporting Information

References

1 Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999; 341 (23): 1725–1730.
10.1056/NEJM199912023412303
CAS PubMed Web of Science® Google Scholar
2 Dharnidharka VR, Caillard S, Agodoa LY, Abbott KC. Infection frequency and profile in different age groups of kidney transplant recipients. Transplantation 2006; 81 (12): 1662–1667.
10.1097/01.tp.0000226068.66819.37
PubMed Web of Science® Google Scholar
3 Dharnidharka VR, Stablein DM, Harmon WE. Post-transplant infections now exceed acute rejection as cause for hospitalization: a report of the NAPRTCS. Am J Transplant 2004; 4 (3): 384–389.
10.1111/j.1600-6143.2004.00350.x
PubMed Web of Science® Google Scholar
4 Ziegler-Heitbrock L, Ancuta P, Crowe S, et al. Nomenclature of monocytes and dendritic cells in blood. Blood 2010; 116 (16): e74–e80.
10.1182/blood-2010-02-258558
CAS PubMed Web of Science® Google Scholar
5 Womer KL, Guerra G, Dibadj K, et al. Immunosuppression reduction for BK virus nephropathy: a case for caution. Transpl Infect Dis 2007; 9 (3): 244–248.
10.1111/j.1399-3062.2007.00204.x
CAS PubMed Web of Science® Google Scholar
6 Hackstein H, Renner FC, Bohnert A, et al. Dendritic cell deficiency in the blood of kidney transplant patients on long-term immunosuppression: results of a prospective matched-cohort study. Am J Transplant 2005; 5 (12): 2945–2953.
10.1111/j.1600-6143.2005.01101.x
CAS PubMed Web of Science® Google Scholar
7 Womer KL, Peng R, Patton PR, et al. The effects of renal transplantation on peripheral blood dendritic cells. Clin Transplant 2005; 19 (5): 659–667.
10.1111/j.1399-0012.2005.00405.x
PubMed Web of Science® Google Scholar
8 Matsuda H, Suda T, Hashizume H, et al. Alteration of balance between myeloid dendritic cells and plasmacytoid dendritic cells in peripheral blood of patients with asthma. Am J Respir Crit Care Med 2002; 166 (8): 1050–1054.
10.1164/rccm.2110066
PubMed Web of Science® Google Scholar
9 Lim WH, Kireta S, Thomson AW, Russ GR, Coates PT. Renal transplantation reverses functional deficiencies in circulating dendritic cell subsets in chronic renal failure patients. Transplantation 2006; 81 (2): 160–168.
10.1097/01.tp.0000188620.72969.56
PubMed Web of Science® Google Scholar
10 Hesselink DA, Betjes MG, Verkade MA, Athanassopoulos P, Baan CC, Weimar W. The effects of chronic kidney disease and renal replacement therapy on circulating dendritic cells. Nephrol Dial Transplant 2005; 20 (9): 1868–1873.
10.1093/ndt/gfh897
PubMed Web of Science® Google Scholar
11 Hesselink DA, Vaessen LM, Hop WC, et al. The effects of renal transplantation on circulating dendritic cells. Clin Exp Immunol 2005; 140 (2): 384–393.
10.1111/j.1365-2249.2005.02755.x
CAS PubMed Web of Science® Google Scholar
12 Womer KL, Huang Y, Herren H, et al. Dendritic cell deficiency associated with development of BK viremia and nephropathy in renal transplant recipients. Transplantation 2010; 89 (1): 115–123.
10.1097/TP.0b013e3181bc6096
PubMed Web of Science® Google Scholar
13 Gupta A, Kumar CA, Ningappa M, et al. Elevated myeloid: plasmacytoid dendritic cell ratio associates with late, but not early, liver rejection in children induced with rabbit anti-human thymocyte globulin. Transplantation 2009; 88 (4): 589–594.
10.1097/TP.0b013e3181b11f12
CAS PubMed Web of Science® Google Scholar
14 Hagendorens MM, Ebo DG, Schuerwegh AJ, et al. Differences in circulating dendritic cell subtypes in cord blood and peripheral blood of healthy and allergic children. Clin Exp Allergy 2003; 33 (5): 633–639.
10.1046/j.1365-2222.2003.01649.x
CAS PubMed Web of Science® Google Scholar
15 Beckebaum S, Cicinnati VR, Dworacki G, et al. Reduction in the circulating pDC1/pDC2 ratio and impaired function of ex vivo-generated DC1 in chronic hepatitis B infection. Clin Immunol 2002; 104 (2): 138–150.
10.1006/clim.2002.5245
CAS PubMed Web of Science® Google Scholar
16 Feldman S, Stein D, Amrute S, et al. Decreased interferon-alpha production in HIV-infected patients correlates with numerical and functional deficiencies in circulating type 2 dendritic cell precursors. Clin Immunol 2001; 101 (2): 201–210.
10.1006/clim.2001.5111
CAS PubMed Web of Science® Google Scholar
17 Paulus C, Krauss S, Nevels M. A human cytomegalovirus antagonist of type I IFN-dependent signal transducer and activator of transcription signaling. Proc Natl Acad Sci U S A 2006; 103 (10): 3840–3845.
10.1073/pnas.0600007103
CAS PubMed Web of Science® Google Scholar
18 Nathan C. Neutrophils and immunity: challenges and opportunities. Nat Rev Immunol 2006; 6 (3): 173–182.
10.1038/nri1785
CAS PubMed Web of Science® Google Scholar
19 Athanassopoulos P, Vaessen LM, Maat AP, et al. Preferential depletion of blood myeloid dendritic cells during acute cardiac allograft rejection under controlled immunosuppression. Am J Transplant 2005; 5 (4 Pt 1): 810–820.
10.1111/j.1600-6143.2005.00777.x
PubMed Web of Science® Google Scholar
20 Palucka K, Ueno H, Zurawski G, Fay J, Banchereau J. Building on dendritic cell subsets to improve cancer vaccines. Curr Opin Immunol 2010; 22 (2): 258–263.
10.1016/j.coi.2010.02.010
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume14, Issue6

December 2012

Pages 618-625

Pre-transplant myeloid dendritic cell deficiency associated with cytomegalovirus infection and death after kidney transplantation

Abstract

Background

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Pre-transplant myeloid dendritic cell deficiency associated with cytomegalovirus infection and death after kidney transplantation

Abstract

Background

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Related

Information