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首页> 外文期刊>Journal of Clinical Microbiology >Utility of Major Leukocyte Subpopulations for Monitoring Secondary Cytomegalovirus Infections in Renal-Allograft Recipients by PCR
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Utility of Major Leukocyte Subpopulations for Monitoring Secondary Cytomegalovirus Infections in Renal-Allograft Recipients by PCR

机译：主要白细胞亚群通过PCR监测同种异体肾移植受体继发性巨细胞病毒感染的效用。

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The feasibility of the major peripheral blood leukocyte (PBL) subsets for use in qualitative and quantitative PCR to monitor secondary cytomegalovirus (CMV) infection and ganciclovir therapy was assessed with 188 blood samples derived from 40 CMV immunoglobulin G-positive renal-allograft recipients. In pp65 antigen-positive patients all leukocyte fractions, but only 79.5% of plasma preparations, were PCR positive. In pp65 antigen-negative samples from patients after antiviral treatment only 7.3% of polymorphonuclear cell (PMNL) samples, but 81.8% of peripheral blood mononuclear cells (PBMC), and 10.9% of plasma samples remained PCR positive. Similarly, in patients with latent infections only 5.0% of PMNL, but 51.7% of PBMC preparations, and 8.0% of plasma samples were PCR positive. Regarding patients with active CMV infection, CMV DNA copy numbers in PMNL correlated significantly with pp65 antigen-positive cell counts before and after onset of ganciclovir therapy. Significant differences in CMV DNA copy numbers in PMNL and plasma were observed (i) between patients with symptomatic infection and those with asymptomatic infection and (ii) between patients with active infection and those with latent infection. In contrast, PBMC harbored equally low CMV DNA levels both in patients with active infection and those with latent infections, and no decline of CMV DNA load in PBMC was observed during antiviral treatment. We conclude that detection of CMV DNA in PMNL, not in PBMC, is associated with active infections and is more sensitive than detection of CMV DNA in plasma. Negative PCR results for PMNL after antiviral therapy indicate recovery, and fewer unwanted positive results occur compared to PBMC and plasma. Therefore, purified PMNL should be preferred for analysis by qualitative CMV PCR to avoid unwanted positive results. The CMV DNA load in PBMC compared with that in PMNL is negligible during active infection, so mixed PBL are sufficient for use in quantitative PCR.
机译：主要的外周血白细胞（PBL）亚组用于定性和定量PCR监测继发巨细胞病毒（CMV）感染和更昔洛韦治疗的可行性，使用来自40个CMV免疫球蛋白G阳性肾移植患者的188个血液样本进行了评估。在pp65抗原阳性患者中，所有白细胞级分（但仅占血浆制剂的79.5％）均为PCR阳性。在经过抗病毒治疗的患者的pp65抗原阴性样本中，只有7.3％的多形核细胞（PMNL）样本，但是81.8％的外周血单核细胞（PBMC）和10.9％的血浆样本保持PCR阳性。同样，在潜伏感染患者中，PMNL仅占5.0％，而PBMC制剂占51.7％，血浆样品占8.0％，均为PCR阳性。对于活动性CMV感染患者，更昔洛韦治疗开始和之后PMNL中CMV DNA拷贝数与pp65抗原阳性细胞计数显着相关。观察到（i）有症状感染的患者和无症状感染的患者之间以及（ii）活动感染的患者和潜伏感染的患者之间PMNL和血浆中CMV DNA拷贝数存在显着差异。相反，在活动性感染患者和潜伏性感染患者中，PBMC的CMV DNA水平均较低，并且在抗病毒治疗期间未观察到PBMC中CMV DNA负荷的下降。我们得出结论，在PMNL中而不是在PBMC中检测CMV DNA与活动性感染相关，并且比在血浆中检测CMV DNA更为灵敏。抗病毒治疗后PMNL的PCR阴性结果表明已恢复，与PBMC和血浆相比，发生的不良阳性结果更少。因此，纯化的PMNL应优选用于定性CMV PCR分析，以避免不必要的阳性结果。在主动感染期间，PBMC中的PMV与PMNL中的CMV DNA负载可忽略不计，因此混合的PBL足以用于定量PCR。

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