Epstein-Barr virus infections are strongly dependent on activating and inhibitory KIR-HLA pairs after T-cell replate unrelated hematopoietic stem cell transplantation, the principles, and method of pairing analysis

HLA. 2019 Dec:94 Suppl 2:40-48. doi: 10.1111/tan.13770.

Abstract

Viral infections are the main cause of increased morbidity and mortality among recipients in allogeneic hematopoietic stem cell transplantation (HSCT). Natural killer (NK) cells fight virally infected cells provided directional activation of cytotoxicity. In this study, we analyzed the role of receptor-ligand pairs that include inhibitory or activating killer cell immunoglobulin-like receptors (KIRs) with their HLA class I ligands in the course of viral infections. The paper also presents an algorithm that allows performing automated inhibitory (i) KIR:HLA pairing and rechecking in the clinical setting. The obtained results indicate a significant adverse roles of reduced number of iKIR:HLA pairs (40% vs 9%; odds ratio [OR] = 6.67; P = .0057; 95% confidence interval [CI] 1.74-25.62) and the presence of activating KIR:HLA pairs (15% vs 5%, OR = 3.58, P = .028, 95% CI 1.19-10.73) in EBV infections post HSCT.

Keywords: EBV; HLA ligands; activating KIR; hematopoietic stem cell transplantation; infection; inhibitory KIR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cohort Studies
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / epidemiology
  • Epstein-Barr Virus Infections / immunology*
  • Epstein-Barr Virus Infections / metabolism*
  • Female
  • Follow-Up Studies
  • Graft Rejection / epidemiology
  • Graft Rejection / immunology
  • Graft Rejection / virology
  • HLA Antigens / metabolism*
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / epidemiology
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Histocompatibility Testing / methods*
  • Humans
  • Immunocompromised Host / immunology
  • Infant
  • Killer Cells, Natural / immunology
  • Male
  • Middle Aged
  • Protein Binding
  • Receptors, KIR / metabolism*
  • T-Lymphocytes / immunology*
  • Transplantation Immunology
  • Transplantation, Homologous / adverse effects
  • Unrelated Donors
  • Virus Activation / physiology
  • Young Adult

Substances

  • HLA Antigens
  • Receptors, KIR