Key result
TTV DNA plasma load was significantly associated with the type of immunosuppression regimen (p=0.023) and post-transplant time (p=0.041), with lower viral loads in patients on mTOR inhibitors.
Why the study?
Chronic deterioration of kidney graft function relates to inadequate immunosuppression, and monitoring Torque teno virus viral load may provide a novel tool to assess individual net immunosuppression.
Does Torque teno virus (TTV) viral load reflect the level of immunosuppression in paediatric kidney-transplanted patients?
Observational (n=45)
No
Does Torque teno virus (TTV) viral load reflect the level of immunosuppression in paediatric kidney-transplanted patients?
p-value: p=0.023
Torque teno virus viral load correlates with the strength of immunosuppression in pediatric kidney transplant recipients, suggesting its potential utility as a biomarker for immune monitoring.
Supports TTV load as potential biomarker for immunosuppression monitoring in pediatric kidney transplant; hypothesis-generating and requires prospective validation.
BACKGROUND: Chronic deterioration of kidney graft function is related to inadequate immunosuppression (IS). A novel tool to assess the individual net state of IS in transplanted patients might be the monitoring of Torque teno virus (TTV) viral load. TTV is a non-pathogen virus detectable in almost all individuals. TTV level in the peripheral blood has been linked to the immune-competence of its host and should thus reflect IS after solid organ transplantation. METHODS: TTV plasma load was quantified monthly by RT-PCR for a period of 1 year in 45 kidney-transplanted children. Post-transplant time was at least 3 months. The relation of the virus DNA levels to IS and transplant-specific clinical and laboratory parameters was analysed longitudinally. RESULTS: TTV DNA was detectable in 94.5% of the plasma samples. There was a significant association with the post-transplant follow-up time as well as with the type of IS regimen, with lower virus loads in patients after longer post-transplant time and mTOR inhibitor-based IS. Furthermore, a significant positive correlation with the dose of prednisolone and mycophenolate mofetil was found. CONCLUSIONS: TTV levels show an association/correlation with the strength of IS. Further studies are needed in order to evaluate TTV measurement as a tool for IS monitoring for hard clinical outcomes such as presence of donor-specific antibodies, rejections or infections-common consequences of insufficient or too intense IS.
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Uhl et al. (2020) conducted an observational in Paediatric kidney transplant recipients (n=45). Immunosuppression regimen and post-transplant time was evaluated on Association of mean TTV plasma load with clinical characteristics (post-transplant time and immunosuppression type) (p=0.023). TTV DNA plasma load was significantly associated with the type of immunosuppression regimen (p=0.023) and post-transplant time (p=0.041), with lower viral loads in patients on mTOR inhibitors.
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