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Impact of cytomegalovirus reactivation just before liver transplantation:A prospective cohort study

World Journal of Gastrointestinal Pathophysiology 2021年第3期12卷 51-58页

作者： claudio marcel b stadnik Cassia Ferreira b Caurio Edison M Rodrigues-Filho Wagner L Nedel Guido PC Cantisani Maria L Zanotelli Alessandro C Pasqualotto Infection Control Department Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Molecular biology Laboratory Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Intensive Care Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Liver Transplant Unit Santa Casa de Misericordia de Porto AlegrePorto Alegre 90075075RSBrazil Infectious Diseases Unit Universidade Federal de Ciencias da Saude de Porto AlegrePorto Alegre 90035075RSBrazil

bACKGROUND Cytomegalovirus(CMV)is the most common viral pathogen after liver transplantation(LT).Although reactivation of CMV infection is generally described in the context of immunosuppression,it has also been described in critically ill immunocompetent patients including cirrhotic *** To determine the incidence of reactivated CMV prior to *** This was a prospective cohort study evaluating adult patients who underwent LT between 2014 and 2016.A plasma sample was obtained from all patients for CMV quantitative real-time PCR testing right before *** were followed for at least 1 year to assess the following outcomes:Incidence of CMV infection,organ rejection and overall *** A total of 72 patients were *** patients died before transplantation,thus 68 patients were followed up for a median of 44 mo(20-50 mo).In 23/72 patients(31.9%)CMV was reactivated before ***-transplantation,16/68(23.5%)patients had CMV infection and that was significantly associated with the recipient being CMV negative and a CMV-positive *** CMV reactivation was not associated with overall mortality(log rank:0.9).CONCLUSION This study shows that CMV infection is common in patients with chronic liver disease just before LT,but the clinical impact of this infection seems to be negligible.

关键词： Liver transplantation Cytomegalovirus infection Quantitative real-time PCR Risk factors Liver cirrhosis Molecular biology

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Meplazumab in hospitalized adults with severe COVID-19(DEFLECT):a multicenter,seamless phase 2/3,randomized,third-party double-blind clinical trial

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Signal Transduction and Targeted Therapy 2023年第2期8卷 842-850页

作者： Huijie bian Liang Chen Zhao-Hui Zheng Xiu-Xuan Sun Jie-Jie Geng Ruo Chen Ke Wang Xu Yang Shi-Rui Chen Si-Yu Chen Rong-Hua Xie Kui Zhang Jin-Lin Miao Jun-Feng Jia Hao Tang Shuang-Shuang Liu Hong-Wei Shi Yong Yang Xiao-Chun Chen Vinay Malhotra Nosheen Nasir Iffat Khanum Faisal Mahmood Saeed Hamid claudio marcel berdun stadnik Kengi Itinose Caroline Cândida Carvalho de Oliveira Cesar Dusilek Lucas Rivabem Adilson Joaquim Westheimer Cavalcante Suzara Souto Lopes Wladmir Faustino Saporito Fábio JoséConcilio Fucci Jesus Abraham Simon-Campos Ling Wang Lin-Na Liu Qing-Yi Wang Ding Wei Zheng Zhang Zhi-Nan Chen Ping Zhu Department of Cell biology of National Translational Science Center for Molecular Medicine and Department of Clinical Immunology of Xijing Hospital Fourth Military Medical UniversityXi’anChina Shanghai Engineering Research Center of Organ Repair School of MedicineShanghai UniversityShanghaiChina Jiangsu Pacific Meinuoke biopharmaceutical Co.Ltd ChangzhouChina Pulse Heart Institute Cardiology Services MultiCare Institute for Research&InnovationTacomaWAUSA Department of Medicine The Aga Khan UniversityKarachiPakistan Infection Control Service Irmandade Santa Casa de Misericord de Porto AlegrePorto AlegreBrazil Clinical Research Department Hospital do RocioCampo LargoBrazil CEMEC-Centro Multidisciplinar de Estudos Clínicos São Bernardo do CampoBrazil Chronos Pesquisa Clinica BrasíliaBrazil Pesquisare Saúde Santo AndréBrazil Instituto de Moléstias Cardiovasculares Tatuí TatuíBrazil Kohler&Milstein Research/Hospital Agustín O’Horán MéridaMexico College of Military Preventive Medicine Fourth Military Medical UniversityXi’anChina Department of Pharmaceutics Tangdu HospitalFourth Military Medical UniversityXi’anChina Department of Foreign Languages Fourth Military Medical UniversityXi’anChina

Meplazumab,a humanized CD147 antibody,has shown favourable safety and efficacy in our previous clinical *** DEFLECT(NCT04586153),167 patients with severe COVID-19 were enroled and randomized to receive three dosages of meplazumab and a *** at 0.12 mg/kg,compared to the placebo group,showed clinical benefits in significantly reducing mortality by 83.6%(2.4%vs.14.6%,p=0.0150),increasing the proportion of patients alive and discharged without supplemental oxygen(82.9%vs.70.7%,p=0.0337)and increasing the proportion of patients who achieved sustained clinical improvement(41.5%vs.31.7%).The response rate in the 0.2 mg/kg group was relatively increased by 16.0%compared with the placebo group(53.7%vs.46.3%).Meplazumab also reduced the viral loads and multiple cytokine *** with the placebo group,the 0.3 mg/kg significantly increased the virus negative rate by 40.6%(p=0.0363)and reduced IL-8 level(p=0.0460);the 0.2 mg/kg increased the negative conversion rate by 36.9%,and reduced IL-4(p=0.0365)and IL-8 levels(p=0.0484).In this study,the adverse events occurred at a comparable rate across the four groups,with no unexpected safety findings *** conclusion,meplazumab promoted COVID-19 convalescence and reduced mortality,viral load,and cytokine levels in severe COVID-19 population with good safety profile.

关键词： clinical mortality dosage

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