Journal Article

Mucorales-Specific T Cells in Patients with Hematologic Malignancies

Del Giovane, Cinzia, Romani, Luigina, Morselli, Monica, Candoni, Anna, Comoli, Patrizia, Vallerini, Daniela, Lewis, Russell E., Potenza, Leonardo, Maccaferri, Monica, Viale, Pier Luigi, Barozzi, Patrizia, Maffei, Rossana, Rossi, Giulio, Maertens, Johan, Paolini, Ambra, Fanin, Renato, Beauvais, Anne, Luppi, Mario, Forghieri, Fabio, Morandi, Uliano, Narni, Franco, Quadrelli, Chiara, Marasca, Roberto, Riva, Giovanni, Messerotti, Andrea, Fantuzzi, Valeria, Codeluppi, Mauro, Gilioli, Andrea, Latgè, Jean Paul, Colaci, Elisabetta, Cesaro, Simone, Mussini, Cristina, Stefani, Alessandro

2016

Overview

Invasive mucormycosis (IM) is an emerging life-threatening fungal infection. It is difficult to obtain a definite diagnosis and to initiate timely intervention. Mucorales-specific T cells occur during the course of IM and are involved in the clearance of the infection. We have evaluated the feasibility of detecting Mucorales-specific T cells in hematological patients at risk for IM, and have correlated the detection of such cells with the clinical conditions of the patients. By using an enzyme linked immunospot assay, the presence of Mucorales-specific T cells in peripheral blood (PB) samples has been investigated at three time points during high-dose chemotherapy for hematologic malignancies. Mucorales-specific T cells producing interferon-γ, interleukin-10 and interleukin-4 were analysed in order to detect a correlation between the immune response and the clinical picture. Twenty-one (10.3%) of 204 patients, accounting for 32 (5.3%) of 598 PB samples, tested positive for Mucorales-specific T cells. Two groups could be identified. Group 1, including 15 patients without signs or symptoms of invasive fungal diseases (IFD), showed a predominance of Mucorales-specific T cells producing interferon-gamma. Group 2 included 6 patients with a clinical picture consistent with invasive fungal disease (IFD): 2 cases of proven IM and 4 cases of possible IFD. The proven patients had significantly higher number of Mucorales-specific T cells producing interleukin-10 and interleukin-4 and higher rates of positive samples by using derived diagnostic cut-offs when compared with the 15 patients without IFD. Mucorales-specific T cells can be detected and monitored in patients with hematologic malignancies at risk for IM. Mucorales-specific T cells polarized to the production of T helper type 2 cytokines are associated with proven IM and may be evaluated as a surrogate diagnostic marker for IM.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Aged / Analysis / Antigens / Aspergillus fumigatus / Biological response modifiers / Biology and Life Sciences / Blood cancer / Bone marrow / Cancer / Care and treatment / Chemotherapy / Cytokines / Diagnostic systems / Emergency medical care / Enzymes / Epidemiology / Feasibility studies / Female / Fungal diseases / Fungal infections / Fungi / Geriatrics / Health aspects / Hematology / Humans / Immune clearance / Immune response / Immune system / Immunocompromised Host / Infection / Infections / Infectious diseases / Interferon / Interleukin 10 / Interleukin 4 / Internal medicine / Leukemia, Myeloid, Acute - immunology / Leukemia, Myeloid, Acute - microbiology / Lymphocytes / Lymphocytes T / Male / Medical diagnosis / Medicine / Medicine and Health Sciences / Middle Aged / Mucorales / Mucorales - immunology / Mucormycosis / Mucormycosis - diagnostic imaging / Mucormycosis - immunology / Mucormycosis - microbiology / Mycoses / Patients / Pediatrics / Peripheral blood / Radiography / Research and Analysis Methods / T cells / Th2 Cells - immunology / Th2 Cells - microbiology / Thoracic surgery / Young Adult