Research Group

  • Dr Martina Sester, Principal Investigator
  • Dr Urban Sester, Collaborator
  • Dr Heinrike Wilkens, Collaborator
  • Dr Barbara C. Gärtner, Collaborator

Location

  • University of the Saarland, Homburg, Germany

Title

  • Improving Management of Cytomegalovirus Complications after Transplantation

Healthcare dealing with infectious diseases after organ transplantation is critically dependent on sensitive and specific diagnostic tools and targeted therapeutic strategies. Cytomegalovirus (CMV) remains the most common viral pathogen resulting in clinically important CMV-disease with a significant adverse effect on long-term graft function in recipients of solid organ transplants. CMV is generally non-symptomatic in immunocompetent individuals being well-controlled by the cellular arm of specific immunity, whereas it may escape from tight control in immunocompromised patients after solid organ transplantation.

This project is based on a clear need for research into how best to prevent, diagnose and manage CMV-related infectious complications in transplant patients. The currently used diagnostic assays for monitoring infectious complications comprise assays that give evidence for viral replication, whereas the analysis of individual immunocompetence towards CMV is generally neglected. As CMV-specific T cells are of fundamental importance for the efficient control of viral replication, an immune-based strategy may represent a promising alternative to viral load monitoring in predicting CMV reactivations in patients after transplantation. As the quantity, the phenotype and functionality of virus-specific T-cells mirror the state of viral infection, precise knowledge of the immune-based regulatory mechanisms that contribute to increased CMV replication after transplantation, may improve the early identification of patients at risk for viral reactivation. This knowledge will be implemented directly into the development of as yet unavailable immune-based diagnostic assays for use in clinical routine. Moreover, the manipulation of the functionality of CMV-specific T-cells in the individual patient in vitro will have a strong impact as a novel therapeutic strategy in patients with drug-refractory infections. Together this may ultimately lead to a significant progress in the management of both direct CMV-related complications as well as indirect, graft-deteriorating side effects in the long term.

Progress Report
Final Report