HHV-6B infection, T-cell reconstitution, and graft-vs-host disease after hematopoietic stem cell transplantation.
Bone Marrow Transplant
; 53(12): 1508-1517, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-29795424
ABSTRACT
Successful and sustained CD4+ T-cell reconstitution is associated with increased survival after hematopoietic cell transplantation (HCT), but opportunistic infections may adversely affect the time and extent of immune reconstitution. Human herpesvirus 6B (HHV-6B) efficiently infects CD4+ T cells and utilizes as a receptor CD134 (OX40), a member of the TNF superfamily that antagonizes regulatory T-cell (Treg) activity. Reactivation of HHV-6B has been associated with aberrant immune reconstitution and acute graft-versus-host disease (aGVHD) after HCT. Given that Treg counts are negatively correlated with aGVHD severity, we postulate that one mechanism for the poor CD4+ T-cell reconstitution observed shortly after transplant may be HHV-6B infection and depletion of peripheral (extra-thymic) CD4+ T cells, including a subpopulation of Treg cells. In turn, this may trigger a series of adverse events resulting in poor clinical outcomes such as severe aGVHD. In addition, recent evidence has linked HHV-6B reactivation with aberrant CD4+ T-cell reconstitution late after transplantation, which may be mediated by a different mechanism, possibly related to central (thymic) suppression of T-cell reconstitution. These observations suggest that aggressive management of HHV-6B reactivation in transplant patients may facilitate CD4+ T-cell reconstitution and improve the quality of life and survival of HCT patients.
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Base de dados:
MEDLINE
Assunto principal:
Linfócitos T Reguladores
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Herpesvirus Humano 6
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Transplante de Células-Tronco Hematopoéticas
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Condicionamento Pré-Transplante
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Doença Enxerto-Hospedeiro
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article