Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective study
Ver/ abrir
Use este enlace para citar
http://hdl.handle.net/2183/22418
A non ser que se indique outra cousa, a licenza do ítem descríbese como Atribución-NoComercial-SinDerivadas 3.0 España
Coleccións
- INIBIC-ICATC - Artigos [178]
Metadatos
Mostrar o rexistro completo do ítemTítulo
Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective studyAutor(es)
Data
2017Cita bibliográfica
Sarmiento E, Jaramillo M, Calahorra L, et al. Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective study. J Heart Lung Transplant. 2017; 36(5): 529-539
Resumo
[Abstract] BACKGROUND: New biomarkers are necessary to improve detection of the risk of infection in heart transplantation. We performed a multicenter study to evaluate humoral immunity profiles that could better enable us to identify heart recipients at risk of severe infections.
METHODS: We prospectively analyzed 170 adult heart recipients at 8 centers in Spain. Study points were before transplantation and 7 and 30 days after transplantation. Immune parameters included IgG, IgM, IgA and complement factors C3 and C4, and titers of specific antibody to pneumococcal polysaccharide antigens (anti-PPS) and to cytomegalovirus (CMV). To evaluate potential immunologic mechanisms leading to IgG hypogammaglobulinemia, before heart transplantation we assessed serum B-cell activating factor (BAFF) levels using enzyme-linked immunoassay. The clinical follow-up period lasted 6 months. Clinical outcome was need for intravenous anti-microbials for therapy of infection.
RESULTS: During follow-up, 53 patients (31.2%) developed at least 1 severe infection. We confirmed that IgG hypogammaglobulinemia at Day 7 (defined as IgG <600 mg/dl) is a risk factor for infection in general, bacterial infections in particular, and CMV disease. At Day 7 after transplantation, the combination of IgG <600 mg/dl + C3 <80 mg/dl was more strongly associated with the outcome (adjusted odds ratio 7.40; 95% confidence interval 1.48 to 37.03; p = 0.014). We found that quantification of anti-CMV antibody titers and lower anti-PPS antibody concentrations were independent predictors of CMV disease and bacterial infections, respectively. Higher pre-transplant BAFF levels were a risk factor of acute cellular rejection.
CONCLUSION: Early immunologic monitoring of humoral immunity profiles proved useful for the identification of heart recipients who are at risk of severe infection.
Palabras chave
Complement
Heart transplantation
Hypogammaglobulinemia
Infection
Risk factor
Heart transplantation
Hypogammaglobulinemia
Infection
Risk factor
Versión do editor
Dereitos
Atribución-NoComercial-SinDerivadas 3.0 España
ISSN
1053-2498