رسالة جامعية
Studies of specific immunity against viral infections in patients after stem cell transplantation
| العنوان: | Studies of specific immunity against viral infections in patients after stem cell transplantation |
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| المؤلفون: | Avetisyan, Gayane |
| بيانات النشر: | Institutionen för medicin, Huddinge Sjukhus / Department of Medicine at Huddinge University Hospital |
| سنة النشر: | 2007 |
| المجموعة: | Karolinska Institutet: Publications |
| مصطلحات موضوعية: | Stem cell transplantation, cytomegalovirus, influenza, cellular and humoral immunity, immunological monitoring, anti-viral treatment, vaccination |
| الوصف: | Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) experience a prolonged period of immune deficiency, resulting in significant morbidity and mortality from the infections. Viruses such as cytomegalovirus (CMV) and influenza virus are frequent causes of infectious complications following allo-HSCT. CMV is one of the most frequent pathogens causing life-threatening complications after HSCT. Factors like patient age, donor and recipient serostatus, type of conditioning, grade of graft versus host disease (GVHD), CMV viremia and number of CMV reactivations are all factors influencing virus reactivation and contributing to the development of the disease. Although CMV infection can be controlled by pre-emptive treatment based on sensitive diagnostic tests, there is a risk of unnecessary over-treatment, resulting in development of antiviral resistance and late onset of CMV disease. In our two CMV studies we aimed in paper I to use the immunological monitoring of CMV-specific responses to correlate transplantation factors to the recovery of cellular immunity in HSCT recipients, intending to understand how those factors influence the CMV-specific T cell reconstitution. The aim of paper II was to use the CMV-specific immunological monitoring to target antiviral therapy to patients at the highest risk of developing CMV disease. By correlating the intracellular interferon-gamma (IFN-γ) production by CMV-specific T lymphocytes with transplant factors (paper I) we observed that (a) CMV-specific T cell response is associated with a lower rate of CMV replication; (b) reduced intensity conditioning results in improved early T cell reconstitution; and (c) the recovery of CMV-specific immunity might be delayed in patients with CMV disease. Using the same method of monitoring CMV-specific immunity in the second study (paper II) we found that 25% of patients with late CMV DNAemia, who had CMV-specific immunity and lacked other risk factors of CMV disease, could be spared pre-emptive therapy without ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| وصف الملف: | application/pdf |
| اللغة: | English |
| ردمك: | 978-91-7357-339-9 91-7357-339-6 |
| العلاقة: | I. Avetisyan G, Larsson K, Aschan J, Nilsson C, Hassan M, Ljungman P (2006). "Impact on the cytomegalovirus (CMV) viral load by CMV-specific T-cell immunity in recipients of allogeneic stem cell transplantation." Bone Marrow Transplant 38(10): 687-92. Epub 2006 Sep 25 ::pmid::17001346; II. Avetisyan G, Aschan J, Hägglund H, Ringdén O, Ljungman P (2007). "Evaluation of intervention strategy based on CMV-specific immune responses after allogeneic SCT." Bone Marrow Transplant Aug 27: Epub ahead of print ::pmid::17724444; III. Avetisyan G, Ragnavölgyi E, Toth GT, Hassan M, Ljungman P (2005). "Cell-mediated immune responses to influenza vaccination in healthy volunteers and allogeneic stem cell transplant recipients." Bone Marrow Transplant 36(5): 411-5 ::pmid::15980884; IV. Avetisyan G, Aschan J, Hassan M, Ljungman P (2007). "Studies of immune responses to seasonal influenza vaccination in healthy volunteers and in patients after stem cell transplantation." (Submitted); 20071022avet; http://hdl.handle.net/10616/39646Test |
| الإتاحة: | http://hdl.handle.net/10616/39646Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B11E0F63 |
| قاعدة البيانات: | BASE |
| ردمك: | 9789173573399 9173573396 |
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