INCREASED IGM AND IGM IMMUNE COMPLEX-LIKE MATERIAL IN THE CIRCULATION OF RENAL-TRANSPLANT RECIPIENTS WITH PRIMARY CYTOMEGALOVIRUS INFECTIONS

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  • 1 January 1982
    • journal article
    • research article
    • Vol. 50  (3) , 515-524
Abstract
Of 60 consecutive adult recipients of cadaver kidney transplants, 12 had increased polyethyleneglycol (PEG) precipitable IgM immune complex-like material in their circulation in the first 4 mon. after transplantation. All 10 recipients with primary CMV and 2 of 4 with secondary CMV infections had significant elevations in PEG precipitable IgM that coincided with rises in their CMV antibody titers. Ultracentrifuge analysis demonstrated 2 peaks of PEG precipitable material with sedimentation rates of .apprx. 20S and .apprx. 40S. Total IgM levels also were increased in transplant recipients with CMV infections, but this was less specific and occurred in patients without CMV infections. The [complement component] C1q binding assay, which is more sensitive for IgG than IgM containing complexes, was positive in only 3 of 10 patients with primary CMV and none of 4 with secondary CMV. Granular deposits of IgM, but not IgG, were detected in the glomeruli of 6 of 7 transplants biopsied during CMV infection. The PEG-IgM assay was not influenced by rejection or prednisone therapy. Thus, transplant patients who develop primary CMV infections produce elevated levels of circulating IgM and IgM immune complex-like material. These findings may help to differentiate CMV infection from transplant rejection and to increase the understanding of the special pathogenic properties of CMV in transplant recipients.