Leading transplant specialists from 13 European university centers are pioneering a new approach to kidney transplant care using the Torque Teno virus (TTV) to monitor immune system activity. This innovative research aims to optimize immuno-suppressive drug dosing, reducing the risks of organ rejection and infection. Supported by Horizon 2020, the clinical trial involves over 260 kidney transplant recipients across Europe. If successful, this method could revolutionize post-transplant care and potentially extend benefits to other medical fields requiring precise immune system management.
More than 15,000 Europeans undergo kidney transplants on average each year, and while medical advances have helped many recipients enjoy healthy lives, the risks of organ rejection and infection remain huge challenges.
With each transplant, success depends on using carefully balanced doses of immuno-suppressive drugs to reduce the risk of infection and organ rejection. Decades of clinical trials, and medical practitioners’ keen instincts, tell us that there is an average level of drug dosing required to support the patient’s care and comfort.
However, this ‘golden middle’ of dosing is not an exact science. This is partly because health providers currently lack a way to measure the body’s immune system to determine if the organ recipient needs more or fewer immuno-suppressants.
How a small virus can help us measure the immune system activity
That could change, thanks to research being carried out by leading kidney transplant specialists at 13 university transplant centres in Austria, the Czech Republic, France, Germany, the Netherlands and Spain. Together we are conducting clinical studies into the use of the common but little-known Torque Teno virus (TTV) as a tool to minimise rejection or infection.
The word ‘virus’ typically has negative associations, as we know from the long and tragic struggle with the coronavirus. But the human body also produces armies of ‘good’ bacteria that defend against the ‘bad’ ones. As for TTV, previous studies have established that it exists in nearly all humans but is apathogenic – in other words, harmless.
Researchers involved in the kidney transplant study, believe that by tracking TTV levels in the blood, healthcare providers will finally have a tool at their disposal to monitor a transplant recipient’s immune system response. Having a clearer picture of what is happening would enable individualised immuno-suppressive drug doses to significantly improve post-transplant care.
Transplant recipients depend on these drugs not only to control the immune system’s urge to reject a foreign organ, but also ward off infection. Therefore, finding an effective and relatively unintrusive way to monitor the immune system and guide drug dosing on an individualised basis would be a major step in helping to reduce both rejection and infections.
That is where TTV comes into play. Research shows that a strong immune system can fend off TTV and reduce its concentration in the blood. By contrast, if an individual’s immune system is weak or suppressed by drugs, the virus is more prevalent in the blood. The ongoing trials aim to show that low concentrations of TTV signal a risk for organ rejection, while a high TTV load in the blood indicates a risk for infection.
If the clinical trials prove that using TTV as an ‘immuno-meter’ is safe and effective, this would be a big development that could help physicians optimise patient care.
One clinical trial leading to many positive effects
With support from Horizon 2020, our team of researchers is working with 260 kidney transplant recipients at the participating clinics and hospitals. The first group of 130 are being treated using conventional methods, while the second is undergoing TTV-guided dosing. There are no new surgical interventions being used, and the drugs are well-established, so the trials pose little risk to participants. Nonetheless, safety is the top priority. There are strict safety protocols for drug dosing and an independent safety monitoring board carries out regular reviews.
The TTV trials are in their early stages and may eventually need to be repeated beyond the EU to gather more diverse data. But we are confident the novel approach of using a ‘good’ virus as an immuno-meter could have positive outcomes for organ transplant recipients. Other medical fields where monitoring and controlling the immune system are critical to successful care, including oncology and rheumatology, could also benefit.
Author of the press release: Assoc.-Prof.Dr. Gregor Bond, PhD Medical University of Vienna, Department of Medicine III, Division of Nephrology and Dialysis
Contact information: Nicole Schmidt, Communication Manager, EUTEMA Research Services GmbH, schmidt@eutema-research.eu
