Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Clinical and Chemical Pathology

Hematopoietic stem cell transplant (SCT) is one of the most important lines of treatment of hematological and non hematological diseases which may be allogeneic, autologous using bone marrow, peripheral blood or placental blood. Human cytomegalovirus (CMV) infects 60-90% of individuals worldwide and remains latent in the infected host, CMV infection is an important cause of morbidity and mortality in immunosuppressed hematopoietic stem cell transplant (SCT) recipients. CMV-specific CD8+cytotoxic T lymphocytes play a critical role in suppressing CMV reactivation. The antigen-specific T lymphocytes may be enumerated without the requirement of in vitro stimulation by flowcytometry using major histocompatibility complex (MHC) tetramers. MHC tetramers are complexes between HLA class I or class II molecules and specific antigenic peptides conjugated to fluorochromes, These complexes bind to a distinct set of T-cell receptors on a subset of CD8-T cells. The iTAg MHC Tetramers show a greatly diminished binding to the general population of CD8 cells allowing for rapid and sensitive quantitative measurement of an individual patient's T cell response to a specific virus, So evaluation of MHC Tetramer measurement of this response and correlating it with recovery against CMV is expected to be of great help of planning antiviral therapy regimen. Post transplantation immunodeficiency needs immunotherapy or immunization strategies to control the recovery of T-cell responses against viral antigens, as well as those used to manage graft-versus-host disease and infection following transplantation

Issued also as CD