Renal transplant and subclinical herpesvirus infection

肾移植与亚临床疱疹病毒感染

• 批准号: 7119928
• 负责人: Jodi M Smith
• 金额: $ 12.78万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7119928
• 关键词: Herpes simplex disease; artificial immunosuppression; cell population study; cellular immunity; chronic disease /disorder; clinical research; disease /disorder etiology; drug adverse effect; helper T lymphocyte; human subject; immunosuppressive; kidney disorder; kidney transplantation; lymphopenia; medical complication; opportunistic infections; pathologic process; patient oriented research; postoperative state

DESCRIPTION (provided by applicant): Chronic allograft nephropathy (CAN) has replaced acute rejection as the major cause of graft loss in renal transplant patients. The potent immunosuppressive regimens that have successfully decreased episodes of acute rejection increase the incidence and severity of viral infections. Multiple lines of evidence identify herpesvirus infections as a potential etiologic factor in the development and progression of CAN. We propose a 2-year prospective study in pediatric and young adult renal transplant recipients to test the following hypotheses; 1) that subclinical herpesvirus infections, in peripheral blood cells and/or renal biopsy tissue, are associated with the development of CAN, 2) that significant immunosuppression, defined by lymphopenia and/or low absolute T helper (CD4+) cell numbers, will correlate with an increased risk of subclinical herpesvirus infections, clinical viral disease, and/or CAN. By prospectively determining the temporal relationships between T-cell immunity, subclinical viral infection, and the development of CAN, these studies may be instrumental in developing preventive and/or treatment measures that can improve graft survival thereby greatly decreasing morbidity and mortality in renal transplant patients. This award will allow the applicant to complete her steady progress towards independence as a clinical researcher. Her completion of a Masters of Public Health in Epidemiology, her participation in numerous epidemiology oriented focus groups, and successful completion of transplantation-related clinical studies as a fellow, have already given her a strong background in clinical research. The expertise of the applicant's mentorship group in the areas of virology, immunology, pathology, and clinical transplant research, as well as the dynamic research environment, core facilities, and atmosphere of collaboration at the University of Washington, will allow the applicant to gain the additional vital skills to achieve her goal of successfully continuing independent clinical research in the field of renal transplantation.

描述（由申请人提供）： 慢性同种异体移植肾病（CAN）取代了急性排斥反应，这是肾移植患者移植物丧失的主要原因。成功减少急性排斥发作的有效免疫抑制方案会增加病毒感染的发生率和严重程度。多种证据鉴定疱疹病毒感染是罐头发展和发展的潜在病因因素。我们提出了一项为期两年的小儿和年轻成人肾移植接受者的前瞻性研究，以检验以下假设。 1) that subclinical herpesvirus infections, in peripheral blood cells and/or renal biopsy tissue, are associated with the development of CAN, 2) that significant immunosuppression, defined by lymphopenia and/or low absolute T helper (CD4+) cell numbers, will correlate with an increased risk of subclinical herpesvirus infections, clinical viral disease, and/or CAN.通过前瞻性确定T细胞免疫，亚临床病毒感染和CAN的发展之间的时间关系，这些研究可能对制定可以改善移植物存活的预防和/或治疗措施有用，从而大大降低了肾脏移植患者的发病率和死亡率。 该奖项将使申请人能够完成作为临床研究人员独立的稳定进步。她完成了流行病学公共卫生的硕士学位，她参与众多以流行病学为导向的焦点小组，并成功完成了与移植相关的临床研究，这已经为她提供了临床研究的强大背景。申请人指导小组在病毒学，免疫学，病理学和临床移植研究领域的专业知识，以及华盛顿大学的动态研究环境，核心设施和协作氛围，允许申请人能够获得其他重要技能，以成功地实现她在肾脏转移术领域成功地继续独立临床研究的目标。