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Basic Science and Immunology at the ISHLT 2016 Annual Meeting


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Javier Carbone, MD, PhD
Hospital General University Gregorio Marañon
Madrid, Spain
Javier.carbone@salud.madrid.org



The International Society for Heart and Lung Transplantation meeting is held annually to provide a forum for the most recent advances in the field of heart and lung transplantation. There continues to be a strong basic research component. Research on humoral and cellular factors that influence the interplay between the allograft and the host immune cells, and immunological factors that antagonize infectious complications, had great presence at the conference.

In the pre-meeting symposium 12, new information about polyfunctional immune responses was presented. Borrowing information from other viral diseases, effective vaccination is associated with a polyfunctional response; HIV elite controllers have a polyfunctional response; control of hepatitis C, tuberculosis and other infections have been linked to a polyfunctional response. Laurie Snyder wondered whether we can apply this to transplant. She proposed for us to consider CD4 and CD8 cells, use of CMV pp65 and CMV IE-1 peptide pools along with multicellular cytokines and markers including: IFN-gamma, TNF-alpha, IL-2, CD107a, lymphocyte subset analysis and a bioinformatic approach to determine a polyfunctional signature. Among receptor CMV+ lung recipients, 3 lymphocyte subsets were identified as useful biomarkers including CD8+/CD107a+/IFN-gamma+/IL2-/TNF-alpha- T-cells.

D Chatterjee presented data on polyreactive innate like B cells among graft infiltrating B cells in human CAV independent of donor specific antibodies (Communication 75).

In the area of genomics new advances were presented in pre-meeting symposium 14 and in distinct communications. Gene expression profiling (GEP) as a biomarker of immune system activity in cardiac transplantation is being evaluated as a predictor of complications related to over immune suppression including CMV infection, new malignancy and infection requiring hospitalization. GEP scores were found to be suppressed in patients prior to a CMV infection (Communication 21 by Shah et al). Donor derived cell free DNA is a new biomarker of allograft rejection. The lack of correlation between GEP scores and this new biomarker in heart recipients suggests that donor derived cell free DNA could offer complementary information to gene expression profiling (Communication 66 by Kobashigawa et al).

The immunology of aging was reviewed in the pre-meeting symposium 17. Evidence that CMV plays a role in driving T cell immunosenescence in lung recipients was reviewed by Daniel Goldstein.

In communication 109 (Hodge et al), increased cytotoxic pro-inflammatory CD8+ T-cells in the distal airways was associated with worse clinical outcomes in BOS patients.

Immunological anti polysaccharide antibody responses are supposed to be T-cell independent (i.e. do not require T cell help for B cell responses). In presentation number 227, Adam et al presented interesting unpublished data on an experimental model, suggesting that this is not always true. Anti-A antibody production required T-cell help.

In communication 229, by Lin et al we learned that NK cells require secretion of IFN-gamma to mediate CAV in an experimental model.

The potential role of circulating exosomes expressing cardiac self-antigens in the pathogenesis of CAV was evaluated by Sharma et al in communication 247.

Luciano Potena presented data of a new interesting functional assay to evaluate lymphocyte responses (T and NK) as a biomarker of infection in heart transplantation (communication 266). IL12 dependence of CMV specific CD4+ T cell responses during primary infection was assessed by Popescu et al in communication 351.

Halloran et al suggested that microarray analysis in endobronchial biopsies can reliably quantify changes characteristic of rejection in lung transplantation (Communication 406).

In the Plenary Session - Pushing New Scientific Frontiers, the potential influence of microbiota in immunology and transplantation was reviewed by Jonathan Bromberg. ■

Disclosure Statement: The author has no conflicts of interest to disclose.




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