Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation
To improve lung transplant recipient (LungTx) outcome, it would be of great interest to measure the net state of immunosuppression to avoid both infection and rejection. Measurement of <i>Torquetenovirus</i> load (TTV load) has been proposed as a biomarker to monitor solid organ transpla...
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MDPI AG
2025-03-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/15/4/494 |
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| author | Victor M. Mora Emilio Rodrigo David Iturbe-Fernández Sheila Izquierdo Sandra Tello Adalberto Benito-Hernández Maria Mar García-Saiz David San Segundo María Victoria Francia Jose M. Cifrián |
| author_facet | Victor M. Mora Emilio Rodrigo David Iturbe-Fernández Sheila Izquierdo Sandra Tello Adalberto Benito-Hernández Maria Mar García-Saiz David San Segundo María Victoria Francia Jose M. Cifrián |
| author_sort | Victor M. Mora |
| collection | DOAJ |
| description | To improve lung transplant recipient (LungTx) outcome, it would be of great interest to measure the net state of immunosuppression to avoid both infection and rejection. Measurement of <i>Torquetenovirus</i> load (TTV load) has been proposed as a biomarker to monitor solid organ transplantation, but its relationship with immunosuppressive drugs, particularly mycophenolic acid (MPA), is not well understood. We performed a prospective study of 53 LungTx, measuring TTV load before transplantation, at week 3, and at month 3. Tacrolimus and MPA doses and levels were recorded, and an area under the MPA curve (AUC-MPA) was calculated at the third month. LungTx in the fourth quartile of TTV load at the third week and the third month exhibited a low risk of acute rejection (OR 0.113, 95% CI 0.013–0.953, <i>p</i> = 0.045) and a high risk of opportunistic infection from month 3 to 6 (OR 15.200, 95% CI 1.525–151.511, <i>p</i> = 0.020), respectively. TTV load was weakly related to tacrolimus trough level at month 3 (rho = 0.283, <i>p</i> = 0.040). Neither MPA blood levels nor AUC-MPA were related to TTV load, although only patients with a reduction in MPA dose from month 1 to 3 showed a smaller increase in TTV load (0.86, IQR 2.58 log10 copies/mL vs. 2.26, IQR 3.02 log10 copies/mL, <i>p</i> = 0.026). In conclusion, TTV load in LungTx is only partially related to exposure to immunosuppressive drugs. Other variables, such as inflammation, immunosenescence, and frailty, may influence the overall level of immunosuppression and TTV load. |
| format | Article |
| id | doaj-art-b3041f698b1c4c3eb97b5efae144de7d |
| institution | OA Journals |
| issn | 2218-273X |
| language | English |
| publishDate | 2025-03-01 |
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| series | Biomolecules |
| spelling | doaj-art-b3041f698b1c4c3eb97b5efae144de7d2025-08-20T02:17:24ZengMDPI AGBiomolecules2218-273X2025-03-0115449410.3390/biom15040494Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung TransplantationVictor M. Mora0Emilio Rodrigo1David Iturbe-Fernández2Sheila Izquierdo3Sandra Tello4Adalberto Benito-Hernández5Maria Mar García-Saiz6David San Segundo7María Victoria Francia8Jose M. Cifrián9Immunopathology Group, Respiratory Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Respiratory Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Respiratory Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Respiratory Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainClinical Pharmacology Department, Marqués de Valdecilla University Hospital-IDIVAL, 39005 Santander, SpainImmunopathology Group, Immunology Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainInfectious Diseases and Clinical Microbiology Group, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainImmunopathology Group, Respiratory Department, Marqués de Valdecilla University Hospital-IDIVAL, University of Cantabria, 39005 Santander, SpainTo improve lung transplant recipient (LungTx) outcome, it would be of great interest to measure the net state of immunosuppression to avoid both infection and rejection. Measurement of <i>Torquetenovirus</i> load (TTV load) has been proposed as a biomarker to monitor solid organ transplantation, but its relationship with immunosuppressive drugs, particularly mycophenolic acid (MPA), is not well understood. We performed a prospective study of 53 LungTx, measuring TTV load before transplantation, at week 3, and at month 3. Tacrolimus and MPA doses and levels were recorded, and an area under the MPA curve (AUC-MPA) was calculated at the third month. LungTx in the fourth quartile of TTV load at the third week and the third month exhibited a low risk of acute rejection (OR 0.113, 95% CI 0.013–0.953, <i>p</i> = 0.045) and a high risk of opportunistic infection from month 3 to 6 (OR 15.200, 95% CI 1.525–151.511, <i>p</i> = 0.020), respectively. TTV load was weakly related to tacrolimus trough level at month 3 (rho = 0.283, <i>p</i> = 0.040). Neither MPA blood levels nor AUC-MPA were related to TTV load, although only patients with a reduction in MPA dose from month 1 to 3 showed a smaller increase in TTV load (0.86, IQR 2.58 log10 copies/mL vs. 2.26, IQR 3.02 log10 copies/mL, <i>p</i> = 0.026). In conclusion, TTV load in LungTx is only partially related to exposure to immunosuppressive drugs. Other variables, such as inflammation, immunosenescence, and frailty, may influence the overall level of immunosuppression and TTV load.https://www.mdpi.com/2218-273X/15/4/494acute rejectionimmune responseimmunosuppressive drugsinfectionmonitoringmycophenolic acid |
| spellingShingle | Victor M. Mora Emilio Rodrigo David Iturbe-Fernández Sheila Izquierdo Sandra Tello Adalberto Benito-Hernández Maria Mar García-Saiz David San Segundo María Victoria Francia Jose M. Cifrián Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation Biomolecules acute rejection immune response immunosuppressive drugs infection monitoring mycophenolic acid |
| title | Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation |
| title_full | Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation |
| title_fullStr | Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation |
| title_full_unstemmed | Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation |
| title_short | Exploring the Association Between <i>Torquetenovirus</i> Viral Load and Immunosuppressive Drug Exposure in Lung Transplantation |
| title_sort | exploring the association between i torquetenovirus i viral load and immunosuppressive drug exposure in lung transplantation |
| topic | acute rejection immune response immunosuppressive drugs infection monitoring mycophenolic acid |
| url | https://www.mdpi.com/2218-273X/15/4/494 |
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