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Conference Paper: Longitudinal study of viral loads and polyfunctional T cell responses towards epstein-barr virus in paediatric liver transplant recipients who developed post-transplant lymphoproliferative disorder

TitleLongitudinal study of viral loads and polyfunctional T cell responses towards epstein-barr virus in paediatric liver transplant recipients who developed post-transplant lymphoproliferative disorder
Authors
KeywordsPediatrics
Issue Date2014
PublisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.asp
Citation
The 2014 Joint Annual Scientific Meeting of the Hong Kong Paediatric Society and Hong Kong Paediatric Nurses Association, Hong Kong, 15 June 2014. In Hong Kong Journal of Paediatrics, 2014, v. 19 n. 3, p. 204 How to Cite?
AbstractThis study aims to investigate the long-term viral control and T-cell immunity towards Epstein-Barr virus (EBV) in paediatric liver transplant patients who developed posttransplant lymphoproliferative disorder (PTLD). We performed a longitudinal study on viral loads and T cell functions in six PTLD patients (two boys and four girls) up to 5 years after diagnosis. Median age at diagnosis was 2.4 years (range: 0.8-5.2 years). Primary disease was congenital biliary atresia with a median age of transplantation at 0.6 years (range: 0.5-1.3 years). Median time from date of transplantation to diagnosis of PTLD was 1.3 years (range: 0.3-4.7 years). All patients were seronegative towards EBV prior to transplantation and were maintained on a range of tacrolimus doses for immunosuppression. Three patients entered continual clinical remission after one course of rituximab while two patients had relapsed disease and one had persistent lymphocytosis requiring additional treatment with second course of rituximab or chemotherapy to enter clinical remission. Plasma EBV loads were determined by qPCR. Despite entering clinical remission, persistently elevated plasma loads were found in 4 of 6 patients indicating suboptimal long-term viral control. Two patients were selected for longitudinal profiling of EBV latent cycle and lytic cycle antigen-specific polyfunctional T-cell (PFC) responses from 1-4 years after PTLD diagnosis. Upon stimulation by overlapping peptides of EBNA1, EBNA3a/ 3b/3c and BZLF1, the production of three cytokines (IFN-, TNF-, IL-2) and expression of two cytotoxic markers (perforin, CD107a) were examined. Although CD4+ and CD8+ PFC responses could be detected at 3 years after diagnosis, the PFCs were predominantly perforinnegative and the proportion of PFCs with three-five functions was low ranging from 0-3 percent of total antigen-responsive T-cells. Long-term viral control is suboptimal concurrent with slow development of EBV-specific PFC responses signifying the continual risk of re-emergence of PTLD in this cohort of young PTLD patients.
DescriptionPoster Presentation
This journal issue (pp. 192-206) entitled: Proceedings of Congress: Joint Annual Scientific Meeting 2014: The Hong Kong Paediatric Society and Hong Kong Paediatric Nurses Association 15 June, 2014
Open Access Journal
Persistent Identifierhttp://hdl.handle.net/10722/209589
ISSN
2015 Impact Factor: 0.194
2015 SCImago Journal Rankings: 0.123

 

DC FieldValueLanguage
dc.contributor.authorWong, AMG-
dc.contributor.authorNing, RJ-
dc.contributor.authorChan, KH-
dc.contributor.authorChiang, AKS-
dc.date.accessioned2015-05-05T02:55:49Z-
dc.date.available2015-05-05T02:55:49Z-
dc.date.issued2014-
dc.identifier.citationThe 2014 Joint Annual Scientific Meeting of the Hong Kong Paediatric Society and Hong Kong Paediatric Nurses Association, Hong Kong, 15 June 2014. In Hong Kong Journal of Paediatrics, 2014, v. 19 n. 3, p. 204-
dc.identifier.issn1013-9923-
dc.identifier.urihttp://hdl.handle.net/10722/209589-
dc.descriptionPoster Presentation-
dc.descriptionThis journal issue (pp. 192-206) entitled: Proceedings of Congress: Joint Annual Scientific Meeting 2014: The Hong Kong Paediatric Society and Hong Kong Paediatric Nurses Association 15 June, 2014-
dc.descriptionOpen Access Journal-
dc.description.abstractThis study aims to investigate the long-term viral control and T-cell immunity towards Epstein-Barr virus (EBV) in paediatric liver transplant patients who developed posttransplant lymphoproliferative disorder (PTLD). We performed a longitudinal study on viral loads and T cell functions in six PTLD patients (two boys and four girls) up to 5 years after diagnosis. Median age at diagnosis was 2.4 years (range: 0.8-5.2 years). Primary disease was congenital biliary atresia with a median age of transplantation at 0.6 years (range: 0.5-1.3 years). Median time from date of transplantation to diagnosis of PTLD was 1.3 years (range: 0.3-4.7 years). All patients were seronegative towards EBV prior to transplantation and were maintained on a range of tacrolimus doses for immunosuppression. Three patients entered continual clinical remission after one course of rituximab while two patients had relapsed disease and one had persistent lymphocytosis requiring additional treatment with second course of rituximab or chemotherapy to enter clinical remission. Plasma EBV loads were determined by qPCR. Despite entering clinical remission, persistently elevated plasma loads were found in 4 of 6 patients indicating suboptimal long-term viral control. Two patients were selected for longitudinal profiling of EBV latent cycle and lytic cycle antigen-specific polyfunctional T-cell (PFC) responses from 1-4 years after PTLD diagnosis. Upon stimulation by overlapping peptides of EBNA1, EBNA3a/ 3b/3c and BZLF1, the production of three cytokines (IFN-, TNF-, IL-2) and expression of two cytotoxic markers (perforin, CD107a) were examined. Although CD4+ and CD8+ PFC responses could be detected at 3 years after diagnosis, the PFCs were predominantly perforinnegative and the proportion of PFCs with three-five functions was low ranging from 0-3 percent of total antigen-responsive T-cells. Long-term viral control is suboptimal concurrent with slow development of EBV-specific PFC responses signifying the continual risk of re-emergence of PTLD in this cohort of young PTLD patients.-
dc.languageeng-
dc.publisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.asp-
dc.relation.ispartofHong Kong Journal of Paediatrics (New series)-
dc.subjectPediatrics-
dc.titleLongitudinal study of viral loads and polyfunctional T cell responses towards epstein-barr virus in paediatric liver transplant recipients who developed post-transplant lymphoproliferative disorder-
dc.typeConference_Paper-
dc.identifier.emailChiang, AKS: chiangak@hku.hk-
dc.identifier.authorityChiang, AKS=rp00403-
dc.identifier.hkuros243058-
dc.identifier.volume19-
dc.identifier.issue3-
dc.identifier.spage204-
dc.identifier.epage204-
dc.publisher.placeHong Kong-

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