Evaluation of host cellular responses to Epstein-Barr virus (EBV) in adult lung transplant patients with EBV-associated diseases

Epstein-Barr virus (EBV) reactivation is commonly observed in lung transplant recipients (LTRs). However, cellular immune responses to EBV in adult LTRs have not been well described. We aimed to study CD4/CD8 ratio, EBV-specific T cells polyfunctional responses and phenotypic changes in natural killer (NK) cells in adult LTRs presenting with EBV-associated diseases. The CD4/CD8 ratio was significantly decreased in LTRs with EBV DNAemia compared with LTRs without EBV DNAemia and healthy controls (HCs). Stimulation with EBV lytic antigen BZLF1 peptide pools induced significant individual and polyfunctional responses from CD8(+)CD69(+) T cells. Frequencies of CD8(+)CD69(+) T cells expressing CD107a were significantly higher in LTRs without EBV DNAemia than in LTRs with DNAemia. Frequencies of CD8(+)CD69(+) T cells concurrently expressing CD107a, IFN-gamma, and TNF-alpha were significantly greater in LTRs with and without EBV DNAemia than in HCs. Finally, BZLF1 induced significantly higher frequencies of CD8(+)CD69(+) T cells expressing CD107a and IFN-gamma in LTRs without EBV DNAemia when compared with EBNA3B. Frequency of more differentiated CD56(dim)CD16(pos) NK cells was significantly decreased in LTRs with EBV DNAemia and PTLD compared with HCs. In conclusion, we noted the presence of significant changes in circulating cellular immune responses to EBV in adult LTRs.

Automated summary

Reactivation of Epstein-Barr virus (EBV) is often seen in lung transplant recipients (LTRs), but the cellular immune responses to EBV in adult LTRs have not been fully described. In this study, we found significant changes in CD4/CD8 ratio, EBV-specific CD8(+)CD69(+) T cell responses, and NK cell phenotypic changes in adult LTRs with EBV-associated diseases. These findings provide valuable insights into the immune responses to EBV in adult LTRs and may contribute to improved management of EBV-related complications.