Chapter 73 : Cytomegalovirus

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The major immediate-early (MIE) promoter of cytomegalovirus (CMV) controls production of the immediate-early gene products. The majority of commercially available assays for CMV IgG antibodies use either viral lysate preparations or semipurified viral proteins as antibody binding targets; the sensitivities of these assays do not vary widely. Virus-specific T-cell-modulating activity by both types of dendritic cells (DCs) can be regulated through binding of natural ligands, such as lipopolysaccharides and CpG oligodeoxynucleotides, to tolllike receptors on the DCs. Circulating levels of anti-gB antibody have been shown to be inversely proportional to systemic viral load in human immunodeficiency virus (HIV)-infected patients, and high titers of glycoprotein-specific antibodies correlate with the absence of viral DNA in the blood of bone marrow transplant recipients. This suggests a role for antiglycoprotein antibodies in the prevention of CMV disease and in the modulation of its progression. Preliminary trials with one such mixture have shown promising results, but as many as four doses may be required to generate persistent neutralizing antibody responses. Importantly, seronegative recipients of seropositive kidneys who received this vaccine not only developed humoral and cellular immunity but also were protected from severe CMV disease. Adoptive immunotherapy has been proposed as an alternative to prophylactic treatments with antiviral drugs for the prevention of CMV disease in transplant recipients.

Citation: George K, Hoji A, Rinaldo, Jr. C. 2006. Cytomegalovirus, p 648-657. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch73
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