2019 Fiscal Year Final Research Report

Development of molecular biological diagnosis and treatment algorithm for persistent EB virus infection after pediatric liver transplantation

Research Project

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Project/Area Number	17K10134
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Pediatrics
Research Institution	National Center for Child Health and Development
Principal Investigator	Fukuda Akinari 国立研究開発法人国立成育医療研究センター, 臓器移植センター, 診療部長 (60455417)
Co-Investigator(Kenkyū-buntansha)	阪本靖介国立研究開発法人国立成育医療研究センター, 臓器移植センター, 医長 (00378689) 笠原群生国立研究開発法人国立成育医療研究センター, 臓器移植センター, センター長 (30324651) 今留謙一国立研究開発法人国立成育医療研究センター, 高度感染症診断部, 部長 (70392488)
Project Period (FY)	2017-04-01 – 2020-03-31
Keywords	EBウイルス / 小児肝移植 / ウイルス感染症 / 分子生物学的診断
Outline of Final Research Achievements	The primary infection rate of EB virus after pediatric liver transplantation is about 60%, and the high EBV genome number often persists, which may lead to post-transplant lymphoproliferative disease (PTLD), which is highly fatal. PD-1 (programmed cell death-1) receptor is expressed on the surface of activated T cells. By measuring the expression level of PD-1 expressed by EBV-infected cells, it may be possible to identify the high risk group of PTLD onset. A study was conducted with the aim of constructing a therapeutic algorithm for identifying the high risk group of PTLD onset, and the combination of PD-1 positive rate in CD8+ T lymphocytes and Recent thymic emigrants was useful.
Free Research Field	小児肝移植
Academic Significance and Societal Importance of the Research Achievements	EBV自体，EBV感染細胞，宿主であるレシピエントの免疫細胞の状態という因子を新規のbiomarkerを組み合わせることによりhigh risk群を特定することで効率的かつ効果的にEBV感染に対する治療を行うことでPTLDの発症リスクを最小限とし，さらに不要な免疫抑制剤の減量による拒絶反応の頻度を減らすことができれば最終的に小児肝移植成績の向上につながる．