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    Cytomegalovirus burden improves a predictive model identifying measures of vascular risk in renal transplant recipients and healthy adults

    Access Status
    Fulltext not available
    Authors
    Affandi, Jacquita
    Lee, Silvia
    Chih, Jun
    Brook, Emily
    Waters, Shelley
    Howson, P.
    Reid, Christopher
    Irish, A.
    Price, Patricia
    Date
    2020
    Type
    Journal Article
    
    Metadata
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    Citation
    Affandi, J.S. and Lee, S. and Chih, H.J. and Brook, E. and Waters, S. and Howson, P. and Reid, C.M. et al. 2020. Cytomegalovirus burden improves a predictive model identifying measures of vascular risk in renal transplant recipients and healthy adults. Journal of Medical Virology. 92 (12): pp. 3650-3657.
    Source Title
    Journal of Medical Virology
    DOI
    10.1002/jmv.25697
    ISSN
    0146-6615
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Population Health
    Curtin Medical School
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1068652
    URI
    http://hdl.handle.net/20.500.11937/89472
    Collection
    • Curtin Research Publications
    Abstract

    Cytomegalovirus (CMV) has been implicated in vascular pathologies and may warrant inclusion in cardiovascular predictive algorithms. We addressed this in healthy older adults and renal transplant recipients (RTR) as they retain a high burden of CMV. RTR (n = 45) stable more than 2 years after transplantation and 58 age-matched healthy adults were assessed. Plasma inflammatory biomarkers (soluble isoform of the interferon-β receptor [sIFNAR2], soluble tumour necrosis factorreceptor-1 [sTNFR1], soluble cluster of differentiation 14 [sCD14], C reactive protein, P-selectin, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1), and measures of CMV burden (antibodies, saliva CMV DNA, and interferon γ responses to CMV) were assessed in 2014 and evaluated in 2017 as predictors of vascular health—defined using flow-mediated dilatation (FMD), pulse wave velocity (PWV), and augmentation indices (Aix@ 75). Linear regression models adjusted for age, sex, and body mass index (BMI) were optimized to identify risk factors. In 2017, RTR had inferior vascular health marked by impaired FMD and PWV. Detectable CMV DNA (P =.02) was associated with impaired FMD, whilst CMV glycoprotein B (gB) antibody attenuated this effect (P =.03) (adjusted R2 =.42). In healthy adults, the optimal model for predicting FMD (R2 =.22) incorporated high P-selectin (P =.03) and low ICAM-1 (P =.03) levels with no significant impact of CMV. Elevated sIFNAR2 (P =.04) and gB antibody (P =.06) levels predicted increasing Aix@ 75 (poor vascular health) in healthy adults (R2 =.4), whilst optimal models for RTR (R2 =.37) linked low sIFNAR2 and CMV IE-1 antibody levels with lower Aix@ 75 (better vascular health). CMV IE-1 antibody was also protective in relation to PWV in healthy adults (R2 =.55). Overall, measures of active CMV replication were more predictive of impaired FMD in RTR than standard biomarkers, but increased CMV gB antibodies may be protective.

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