Summary:
Many patients suffer febrile diseases soon after allogeneic stem cell transplantation (SCT). Some of the symptoms of viral infections and acute GVHD are often difficult to distinguish. However, an accurate diagnosis is important since the treatments for these conditions are different. It is known that MxA protein is specifically induced in patients with several viral infections. We investigated the cytoplasmic expression of MxA in the peripheral blood mononuclear cells (PBMCs) of patients with fever after allogeneic SCT using a newly generated monoclonal antibody (KM1135) and flow cytometry. The level of MxA expression was significantly higher in patients diagnosed with viral infections (n=6, cytomegalovirus in three, Epstein–Barr virus in one, human herpesvirus-6 in one, adenovirus in one) than control individuals (n=9) (P<0.05, Mann–Whitney test). The level of MxA in patients with aGVHD (n=7) was identical to that in controls. The level of MxA correlated well with the amount of the cytomegalovirus antigen-positive cells in the presence of acute GVHD in two patients. The measurement of MxA is simple and useful in distinguishing viral disease from acute GVHD after allogeneic SCT.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Landry ML, Fong CKY, Neddermann K, Solomon L . Disseminated adenovirus infection in an immunocompromised host. Am J Med 1987; 83: 555–559.
Jones B, Kramer SS, Saral R et al. Gastrointestinal inflammation after bone marrow transplantation: graft versus host disease or opportunistic infection? Am J Roentogenol 1988; 150: 277–281.
Yoshikawa T, Suga S, Asano Y et al. Human herpesvirus-6 infection in bone marrow transplantation. Blood 1991; 78: 1381–1384.
Kingreen D, Nitsche A, Beyer J, Siegert W . Herpes simplex infection of the jejunum occurring in the early post transplantation period. Bone Marrow Transplant 1997; 20: 989–991.
Washington K, Bentley RC, Green A et al. Gastric graft-versus-host disease: a blind histologic study. Am J Surg Pathol 1997; 21: 1037–1046.
Claviez A, Tiemann M, Wagner HJ et al. Epstein–Barr virus-associated post-transplant lymphoproliferative disease after bone marrow transplantation mimicking graft-versus-host disease. Pediatr Transplant 2000; 4: 151–155.
Schwartz JM, Wolford JL, Thornquist MD et al. Severe gastrointestinal bleeding after hematopoietic cell transplantation, 1987–1997: incidence, causes, and outcome. Am J Gastroenterol 2001; 96: 385–393.
Taylor JL, Grossberg SE . Recent progress in interferon research: molecular mechanisms of regulation, action, and virus circumvention. Virus Res 1990; 15: 1–26.
Niederwieser D, Herold M, Woloszczuk W et al. Endogenous IFN-gamma during human bone marrow transplantation. Transplantation 1990; 50: 620–625.
Chasty RC, Lamb WR, Gallati H et al. Serum cytokine levels in patients undergoing bone marrow transplantation. Bone Marrow Transplant 1993; 12: 331–336.
Grimm J, Zeller W, Zander AR . Soluble interleukin-2 receptor serum levels after allogeneic bone marrow transplantation as a marker for GVHD. Bone Marrow Transplant 1998; 21: 29–32.
Takatsuka H, Yamada S, Okamoto T et al. Predicting the severity of intestinal graft-versus-host disease from leukotriene B4 levels after bone marrow transplantation. Bone Marrow Transplant 2000; 26: 1313–1316.
Fujimori Y, Takatsuka H, Takemoto Y et al. Elevated interleukin(IL)-18 levels during acute graft-versus-host disease after allogeneic bone marrow transplantation. Br J Haematol 2000; 109: 652–657.
Sakata N, Yasui M, Okamura T et al. Kinetics of plasma cytokines after hematopoietic stem cell transplantation from unrelated donors: the ratio of plasma IL-10/sTNFR level as a potential prognostic marker in severe acute graft-versus-host disease. Bone Marrow Transplant 2001; 27: 1153–1161.
von Wusson P, Jakschies D, Hochkeppel HK et al. The human intracellular Mx-homologus protein is specifically induced by type I interferons. Eur J Immunol 1990; 20: 2015–2019.
Simon A, Fah J, Haller O, Staeheli P . Interferon-regulated Mx genes are not responsive to interleukin-1, tumor necrosis factor, and other cytokines. J Virol 1991; 65: 968–971.
Foster J, Schweizer M, Schumacher RF et al. MxA protein in infants and children with respiratory tract infection. Acta Paediatr 1996; 85: 163–167.
Halminen M, Ilonen J, Julkunen I et al. Expression of MxA protein in blood lymphocytes discriminates between viral and bacterial infections in febrile children. Pediatr Res 1997; 41: 647–650.
Chieux V, Hober D, Harvey J et al. The MxA protein levels in whole blood lysates of patients with various viral infections. J Virol Methods 1998; 70: 183–191.
Chieux V, Hober D, Chehadeh W et al. MxA protein in capillary blood of children with viral infections. J Med Virol 1999; 59: 547–551.
Przepiorka D, Weisdorf D, Marfin P et al. Consensus conference on acute GVHD grading. Bone Marrow Transplant 1995; 15: 825–828.
Knapp W, Strobl H, Majdic O . Flow cytometric analysis of cell-surface and intracellular antigens in leukemia diagnosis. Cytometry 1994; 18: 187–198.
Hovanessian AG, Meurs E, Aujean O et al. Antiviral response induction of specific proteins in cells treated with immune T (Type II) interferon analogous to that from viral interferon (Type I)-treated cells. Virology 1980; 104: 195–204.
Benech P, Merlin G, Revel M, Chebath J . 3′ End structure of the human (2′–5′) oligo A synthetase gene: prediction of two distinct proteins with cell type-specific expression. Nucleic Acids Res 1985; 13: 1267–1281.
Koscielniak E, Bruchelt G, Treuner J et al. Kinetics of restoration of interferon production after bone marrow transplantation in man. Bone Marrow Transplant 1987; 1: 379–387.
Ronni T, Melen K, Malygin A, Julkunen I . Control of IFN-inducible MxA gene expression in human cells. J Immunol 1993; 150: 1715–1726.
Acknowledgements
We thank Kyosuke Nagata and Akiko Furuya for providing the KM1135 antibody and Daniel Mrozek for proofreading the manuscript. We also thank the physicians and nurses who cared for the patients in this study.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yoshimasu, T., Manabe, A., Ebihara, Y. et al. MxA expression in patients with viral infection after allogeneic stem cell transplantation. Bone Marrow Transplant 32, 313–316 (2003). https://doi.org/10.1038/sj.bmt.1704128
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1704128