Cytomegalovirus exposure, immune exhaustion and cancer occurrence in renal transplant recipients.
Fiche publication
Date publication
septembre 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BORG Christophe, Pr CHALOPIN Jean-Marc, Pr DUCLOUX Didier, Pr WORONOFF Macha
Tous les auteurs :
Courivaud C, Bamoulid J, Gaugler B, Roubiou C, Arregui C, Chalopin JM, Borg C, Tiberghien P, Woronoff-Lemsi MC, Saas P, Ducloux D
Lien Pubmed
Résumé
The role of Cytomegalovirus (CMV) in carcinogenesis is controversial. We studied whether CMV may contribute to cancer occurrence in renal transplant recipients. We studied a prospective cohort of 455 consecutive patients who received a kidney transplant between January 1995 and December 2006. All cancers and types of cancers were assessed. Lymphocyte phenotype and cytokines production were analysed according to CMV status in a subset population of this cohort. Mean follow-up was 84 +/- 29 months. One hundred and nineteen cancers (26.2%) occurred during the study follow-up. There was a higher cumulated incidence of cancers in CMV-exposed patients (30.4% vs. 20%; P=0.018). Mean time to cancer occurrence was shorter in CMV-exposed patients than in CMV-naive patients (4.7 +/- 2.6 vs. 6.7 +/- 2.8; P = 0.001). Cox regression analysis revealed that both pretransplant CMV exposure (HR, 1.83; 95% CI, 1.17-2.88; P = 0.009) and post-transplant CMV replication (HR, 2.17; 95% CI, 1.02-4.59; P = 0.044) were risk factors for cancer. Among CD8+ T cells, exhausted T cells assessed as CD57+CD28- were expanded in CMV-exposed patients (26 +/- 20 vs. 9 +/- 8%; P < 0.0001), whereas CD8+CD57+IL2- cells were more frequent in CMV-exposed patients. Our results highly suggest that CMV increases the risk of cancer after transplantation.
Référence
Transpl Int. 2012 Sep;25(9):948-55