Torquetenovirus from bronchoalveolar lavage fluid as a biomarker for lung infection among immunocompromised hosts

Abstract

Aim: Torquetenovirus (TTV) was a promising biomarker for immunity, while lung regional TTV for evaluating the opportunistic infection among immunocompromised hosts (ICH) was unclear. Materials & methods: In the ICH and non-ICH populations, we compared the susceptibility to opportunistic infections, clinical severity and the prognosis between subgroups, respectively. Results: ICH with detectable bronchoalveolar lavage fluid (BALF)-TTV were more susceptible to lung aspergillosis and Mycobacterium infections. Furthermore, our data demonstrated that the ICH cohort with detectable BALF-TTV represented a higher clinical severity and a worse prognosis, while the above findings were not found in the non-ICH population. Conclusion: Our findings demonstrated that the BALF-TTV could act as an effective predictor for opportunistic infection for ICH that complemented the CD4⁺ T cell counts.

Article highlights

Background

• In clinical practice, the population base of immunocompromised host (ICH) and the incidence of severe infection complications are increasing.

• Torquetenovirus (TTV) was demonstrated to be associated with the immune constitution and immune-related adverse outcomes in post-transplant recipients independent of the CD4⁺ T cell count.

Methods

• The potential of lung regional TTV as a risk biomarker for ICH was investigated according to its relationship with lung opportunistic infections, clinical severity and clinical outcomes.

Results

• We found that the detectable TTV from bronchoalveolar lavage fluid (BALF) could act as an immune predictive biomarker for the susceptibility to opportunistic pathogens and prognosis for immunocompromised hosts independent of CD4⁺ T cell counts, while the above findings were not shown in the non-ICH population.

Conclusion

• We established a novel lung regional biomarker for predicting lung opportunistic infection.

• Furthermore, this study was likely to guide further studies to investigate the specific connection between TTV included lung microbial diversity and host immunity.

Keywords: :

• biomarker
• immunocompromised host (ICH)
• lung infection
• metagenomic next-generation sequencing
• torquetenovirus (TTV)

Acknowledgments

The authors thank the patients, the nurses and clinical staff who are providing care for the patient, and the staff at the local and state health departments. The authors are very grateful to Q Zhan from China-Japan Friendship Hospital for his insightful comments on this study.

Author contributions

C Chen conceived the idea, designed it and supervised the study. ZW Zhu and Y Wang designed and performed the statistical analysis. WW Ning and C Liu participated in clinical care and data collection. All authors wrote, reviewed, and approved the final version of the manuscript.

Financial disclosure

The project was supported by grant of Suzhou City (grant number SYS2021034) and Jiangsu Provincial Medical Key Discipline (grant number ZDXK202201). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. This study also supported by group of the wild goose formation leading flight plan and author Cheng Chen is one of the team members. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval (This study was approved by the Institutional Review Boards of The First Affiliated Hospital of Soochow University [Ic. 317 in 2022]) and/or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

The project was supported by grant of Suzhou City (grant number SYS2021034) and Jiangsu Provincial Medical Key Discipline (grant number ZDXK202201).