Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) specific CD4(+ )and CD8(+) T cells in SARS- CoV- 2-unexposed donors has been explained by the presence of T cells primed... Show moreDetection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) specific CD4(+ )and CD8(+) T cells in SARS- CoV- 2-unexposed donors has been explained by the presence of T cells primed by other coronaviruses. However, based on the relatively high frequency and prevalence of cross-reactive T cells, we hypothesized cytomegalovirus (CMV) may induce these cross-reactive T cells. Stimulation of pre-pandemic cryo-preserved peripheral blood mononuclear cells (PBMCs) with SARS- CoV- 2 peptides revealed that frequencies of SARS- CoV- 2-specific T cells were higher in CMVseropositive donors. Characterization of these T cells demonstrated that membrane-specific CD4(+ )and spike-specific CD8(+) T cells originate from cross-reactive CMVspecific T cells. Spike-specific CD8(+ )T cells recognize SARS- CoV- 2 spike peptide FVSNGTHWF (FVS) and dissimilar CMV pp65 peptide IPSINVHHY (IPS) presented by HLA- B*35:01. These dual IPS/FVS-reactive CD8(+) T cells were found in multiple donors as well as severe COVID- 19 patients and shared a common T cell receptor (TCR), illustrating that IPS/FVS- cross-reactivity is caused by a public TCR. In conclusion, CMVspecific T cells cross react with SARS-CoV- 2, despite low sequence homology between the two viruses, and may contribute to the pre-existing immunity against SARS-CoV- 2. Show less
Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) specific CD4(+ )and CD8(+) T cells in SARS- CoV- 2-unexposed donors has been explained by the presence of T cells primed... Show moreDetection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) specific CD4(+ )and CD8(+) T cells in SARS- CoV- 2-unexposed donors has been explained by the presence of T cells primed by other coronaviruses. However, based on the relatively high frequency and prevalence of cross-reactive T cells, we hypothesized cytomegalovirus (CMV) may induce these cross-reactive T cells. Stimulation of pre-pandemic cryo-preserved peripheral blood mononuclear cells (PBMCs) with SARS- CoV- 2 peptides revealed that frequencies of SARS- CoV- 2-specific T cells were higher in CMVseropositive donors. Characterization of these T cells demonstrated that membrane-specific CD4(+ )and spike-specific CD8(+) T cells originate from cross-reactive CMVspecific T cells. Spike-specific CD8(+ )T cells recognize SARS- CoV- 2 spike peptide FVSNGTHWF (FVS) and dissimilar CMV pp65 peptide IPSINVHHY (IPS) presented by HLA- B*35:01. These dual IPS/FVS-reactive CD8(+) T cells were found in multiple donors as well as severe COVID- 19 patients and shared a common T cell receptor (TCR), illustrating that IPS/FVS- cross-reactivity is caused by a public TCR. In conclusion, CMVspecific T cells cross react with SARS-CoV- 2, despite low sequence homology between the two viruses, and may contribute to the pre-existing immunity against SARS-CoV- 2. Show less
Background: The detection and follow up of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viral loads (VL) are crucial in the management of immunocompromised patients. Recently, molecular CE... Show moreBackground: The detection and follow up of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viral loads (VL) are crucial in the management of immunocompromised patients. Recently, molecular CE-IVD assays for detection and quantification of CMV and EBV have been launched for use on the random-access and sample-to-result NeuMoDx 96 and 288 platforms (Qiagen). Objective: Evaluating the qualitative and quantitative performance of the NeuMoDx CMV and EBV assays in clinical specimens compared to a lab developed tests (LDT) and the CE-IVD assays on the Abbott m2000 system. Method: Both a prospective and a retrospective panel, compiled of non-detectable (ND), non-quantifiable (NQ) and quantifiable VLs in plasma samples have been evaluated for both CMV and EBV: NeuMoDx versus LDT and NeuMoDx versus Abbott m2000. Quantitative agreement was determined for samples with a quantifiable VL on both systems. Results: Qualitative and quantitative agreement between the NeuMoDx and LUMC's LDT CMV assays was 88%. Qualitative agreement between the NeuMoDx and Abbott m2000 CMV assays was 92% and quantitative agreement was 87%. Qualitative and quantitative agreement between the NeuMoDx and the LDT EBV assays was 87%. Qualitative agreement between the NeuMoDx and Abbott m2000 EBV assays was 91% and quantitative agreement was 0%. Conclusion: These data show that the NeuMoDx assays are suitable for both detection and quantification of CMV and EBV in a medium-to high throughput diagnostic setting, but that differences in sensitivity and quantification (for EBV, NeuMoDx versus Abbott m2000) warrant an extensive transition period when using the respective assays for following VL in patient samples. Show less
Rozhnova, G.; Kretzschmar, M.E.; Klis, F. van der; Baarle, D. van; Korndewal, M.J.; Vossen, A.C.; M. van boven 2020
Background Infection with cytomegalovirus (CMV) is highly prevalent worldwide and can cause severe disease in immunocompromised persons and congenitally infected infants. The disease burden caused... Show moreBackground Infection with cytomegalovirus (CMV) is highly prevalent worldwide and can cause severe disease in immunocompromised persons and congenitally infected infants. The disease burden caused by congenital CMV infection is high, especially in resource-limited countries. Vaccines are currently under development for various target groups. Methods We evaluated the impact of vaccination strategies and hygiene intervention using transmission models. Model parameters were estimated from a cross-sectional serological population study (n=5179) and a retrospective birth cohort (n=31,484), providing information on the age- and sex-specific CMV prevalence and on the birth prevalence of congenital CMV (cCMV). Results The analyses show that vertical transmission and infectious reactivation are the main drivers of transmission. Vaccination strategies aimed at reducing transmission from mother to child (vaccinating pregnant women or women of reproductive age) can yield substantial reductions of cCMV in 20 years (31.7-71.4% if 70% of women are effectively vaccinated). Alternatively, hygiene intervention aimed at preventing CMV infection and re-infection of women of reproductive age from young children is expected to reduce cCMV by less than 2%. The effects of large-scale vaccination on CMV prevalence can be substantial, owing to the moderate transmissibility of CMV at the population level. However, as CMV causes lifelong infection, the timescale on which reductions in CMV prevalence are expected is in the order of several decades. Elimination of CMV infection in the long run is only feasible for a vaccine with a long duration of protection and high vaccination coverage. Conclusions Vaccination is an effective intervention to reduce the birth prevalence of cCMV. Population-level reductions in CMV prevalence can only be achieved on a long timescale. Our results stress the value of vaccinating pregnant women and women of childbearing age and provide support for the development of CMV vaccines and early planning of vaccination scenarios and rollouts. Show less
Redeker, A.; Remmerswaal, E.B.M.; Gracht, E.T.I. van der; Welten, S.P.M.; Hollt, T.; Koning, F.; ... ; Arens, R. 2018
This thesis describes the consequences of congenital cytomegalovirus infection in Dutch children up to six years of age. The first chapter is a general introduction on this topic. The second... Show moreThis thesis describes the consequences of congenital cytomegalovirus infection in Dutch children up to six years of age. The first chapter is a general introduction on this topic. The second chapter discusses the seroprevalence of cytomegalovirus infection in the Netherlands. The third chapter describes the design of the CROCUS-study, which was used to investigate the long-term consequences of congenital cytomegalovirus infection. In chapter four the clinical consequences of congenital cytomegalovirus infection are discussed. Chapter five elaborates about the consequences of congenital cytomegalovirus infection on the child development and the quality of life of children and their parents. In the sixth chapter the cost of illness of congenital cytomegalovirus infection is calculated. The last chapter is a general discussion on the long-term consequences of congenital cytomegalovirus infection. Show less
Berge, I. ten; Heutinck, K.; Yapici, U.; Stokman, G.; Florquin, S.; Kooten, C. van; ... ; Claas, F. 2014
