Kinetics of Torque Teno Virus-DNA Plasma Load Predict Rejection in Lung Transplant Recipients

Background Lung transplantation is the only therapeutic option in end stage lung diseases, however, survival after transplantation is limited by acute and chronic rejection or infectious events being results of inappropriate immunosuppression. Torque Teno Viruses (TTV) are ubiquitous DNA viruses in humans but not found to be causative for any disease. However, some reports suggest that TTV-DNA levels reflect the grade of immunosuppression with higher levels being found in more immunosuppressed individuals. Methods We investigated the TTV-DNA levels in 34 lung transplant recipients within their first year following transplantation by quantitative real-time PCR. Clinical data were extracted from charts. Results In accordance with previous results TTV-DNA levels increase after lung transplantation reaching a steady state after 3 months. TTV-DNA levels were not correlated with immunosuppressive trough levels and a selective increase was not observed with other DNA viruses. In steady state TTV-DNA levels were significantly higher in patients with infectious complications compared to the group of patients without. Additionally, TTV-DNA levels decreased significantly prior to biopsy-proven rejection. Sensitivity of a 10-fold decrease in TTV-DNA levels for a subsequent rejection episode was 0.74 with a specificity of 0.99. Conclusions In summary TTV-DNA might be used as an additional tool to monitor immunosuppression in lung transplant recipients. Higher TTV-DNA levels reflect more intense immunosuppression, whereas the TTV-DNA kinetic (ie, decrease of TTV-DNA levels) indicate rejection. Corresponding author: Dr. B. C. Frye, Department of Pneumology, University Medical Center, University of Freiburg, Killianstrasse 5, 79106 Freiburg, Phone: +49 (0)761 270 37060, Fax: +49 (0)761 270 37040. Mail: Joachim.mueller-quernheim@uniklinik-freiburg.de Authors' contribution: Research design: BCF, SB, VF, MG, HH, JMQ; Data collection: BCF, TCK, MG, IH, JMQ; Patient characterization: BCF, TCK, MG, IH, TD, MI, GZ, JMQ; Laboratory work: SB, VF, HH; Data analysis: BCF, SB, VF, GZ, HH, JMQ; Writing Paper: BCF, SB, VF, IH, GZ, HH, JMQ; Disclosure: All authors declare no conflicts of interest. Funding: No external funding Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2NodnLZ