• M Koldehoff, D W Beelen, and A H Elmaagacli.
• Department of Bone Marrow Transplantation, West German Cancer Center, Medical School of University of Duisburg-Essen, Essen, Germany.
• Transpl Infect Dis. 2013 Oct 1;15(5):533-9.

IntroductionToll-like receptors (TLRs) detect invading pathogens through several pattern-recognition mechanisms and play a central role in the regulation of the immune system. In allogeneic hematopoietic stem cell transplantation (HSCT), the frequent opportunistic fungal infections remain an important cause of mortality and morbidity in these highly immunocompromised patients.MethodsWe analyzed 154 patients after allogeneic HSCT for acute leukemia for TLR4 gene variants 1063A/G (D299G) and 1363C/T (T399I) with their respective donors, and correlated the results with the incidence of invasive aspergillosis (IA) infection after transplant.ResultsProbable and proven IA in recipients was significantly increased if either recipients or donors exhibited one of the two TLR4 gene variants. In addition, recipients with TLR gene variants and IA showed a delayed T cell and NKT cell immune reconstitution after transplant. Increased susceptibility for IA was not associated with an increased rate of death-in-remission or decreased estimate for overall survival.ConclusionThese findings reinforce the importance of genetic variants in innate immunity and IA among the recipients of allogeneic HSCT.© 2013 John Wiley & Sons A/S.

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