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Genomic Mutations of BK Polyomavirus in Patients after Kidney Transplantation: A Cross-Sectional Study in Vietnam. J Clin Med 2022; 11:jcm11092544. [PMID: 35566670 PMCID: PMC9101345 DOI: 10.3390/jcm11092544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022] Open
Abstract
Objectives: The purpose of this study was to identify the SNP sites and determine the BKV genotype circulating in kidney-transplant Vietnamese recipients based on the VP1 gene region. Methods: 344 samples were collected from post-kidney-transplant recipients at the 103 Vietnam Military Hospital to investigate the number of BKV infections. Positive samples with a sufficient virus concentration were analyzed by nested PCR in the VP1 region, sequencing detected genotyping and single-nucleotide polymorphism. Results: BKV infection was determined in 214 patients (62.2%), of whom 11 (5.1%) were diagnosed with BKV-associated nephropathy. Among the 90 BKV-I strains sequenced, 89 (98.88%) were strains of I/b-1 and 1 (1.12%) was strain I/b-2. The 60 BKV-IV strains had a greater diversity of subgroups, including 40% IV/a-1, 1.66% IV/a-2, 56.68% IV/c-1, and 1.16% IV/c-2. Additionally, of 11 cases diagnosed with BKVN, seven belonged to subgroup I/b-1 (63.6%) and four to subgroup IV/c-1 (36.4%). Moreover, 22 specific SNPs that were genotype I or IV were determined in this Vietnamese population. Specifically, at position 1745, for the Vietnamese BKV-IV strains, the SNP position (A→G) appeared in 57/60 samples (95%). This causes transformation of the amino acid N→S. This SNP site can enable detection of genotype IV in Vietnam. It represents a unique evolution pattern and mutation that has not been found in other international strains. Conclusion: The BKV-I genotype was more common than BKV-IV; however, mutations that occur on the VP1 typing region of BKV-IV strains were more frequent than in BKV-I strains.
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Muñoz-Gallego I, Díaz-Madridano N, Moral N, Pascual C, Polanco N, González E, Andrés A, Folgueira MD. Detection of BK polyomavirus genotypes to predict the development of BK polyomavirus-associated complications in kidney transplant recipients: A retrospective analysis. Transpl Infect Dis 2021; 23:e13615. [PMID: 33866657 DOI: 10.1111/tid.13615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/22/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study focused on the role that BK polyomavirus (BKPyV) genotypes can play in the development of BKPyV-associated complications in renal transplant recipients. METHODS A retrospective observational study (January 2015 to April 2018) was conducted by analyzing BKPyV genotypes in 180 blood samples with detectable BKPyV viral load (VL) > 1000 copies/mL, from 63 renal transplant recipients. VL and BKPyV genotypes detections were based on real-time PCR (rt-PCR)-specific assays. RESULTS Forty-four patients (44/63 [69.8%]) were men, and the median age was 55.0 (interquartile range 49.0-66.0 years). Eleven patients had clinical manifestations (11/63 [17.5%]). The most frequently detected genotypes were I (14/63 [22.2%]) and II (13/63 [20.6%]). Half of the patients (33/63 [52.4%]) had a mixed genotype, most with genotypes I and II (25/33 [75.8%]). Patients with infection by mixed genotypes showed VLs that were detected earlier (in the first year after transplantation) than those with a single genotype (25/33 [75.8%] vs 13/30 [43.3%], P = .009) and demonstrated greater risk of developing clinical manifestations associated with BKPyV (odds ratio 12.609, 95% confidence interval 1.503-105.807). Moreover, patients with first BKPyV VL > 10 000 copies/mL more frequently presented mixed genotypes (12/16 [75.0%] vs 21/47 [44.7%], P = .036). CONCLUSIONS The probability of developing clinical manifestations is higher in infections by mixed genotypes. Therefore, the detection of BKPyV genotypes by rt-PCR can provide relevant information to stratify patients' risk of BKPyV-associated complications and guide the clinical management of BKPyV infection in kidney transplant recipients.
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Affiliation(s)
- Irene Muñoz-Gallego
- Virology Laboratory, Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Nerea Díaz-Madridano
- Virology Laboratory, Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Noelia Moral
- Virology Laboratory, Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Consuelo Pascual
- Virology Laboratory, Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Natalia Polanco
- Nephrology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Esther González
- Nephrology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Amado Andrés
- Nephrology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.,Biomedical Research Institute imas12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - María Dolores Folgueira
- Virology Laboratory, Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.,Biomedical Research Institute imas12, Hospital Universitario 12 de Octubre, Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
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Shatizadeh Malekshahi S, Soleimanjahi H, Dorostkar F, Salimi V, Farahmand M. Survey of BK Virus in Renal Transplant Recipients in Iran: A Systematic Review and Meta-Analysis. Intervirology 2020; 64:1-9. [PMID: 33333504 DOI: 10.1159/000512132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 09/22/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION BK virus (BKV) infection in renal transplant (RT) recipients can cause hemorrhagic cystitis, transient renal dysfunction, and BKV nephropathy (BKVN). The prevalence and significance of BKV in RT recipients remain to be clarified in the Iranian population. The purpose of this review is to summarize the overall prevalence of BKV infection in RT recipients from previously published studies in Iran. METHODS We systematically reviewed articles through a comprehensive search of the main electronic and Persian national databases up to November 2019. RESULTS The overall pooled prevalence of BKV infection among the Iranian population was 23% (95% CI; 15-33%). Comparing these studies revealed that the prevalence of BKV in plasma samples ranges from 3 to 40%, in renal biopsies 1-13%, and in urine samples 10-49%. Due to substantial heterogeneity among reported studies (I2 = 93%, p < 0.01), random-effect meta-analysis was performed. BKV infection rate was slightly higher in women than men (16%, p = 0.04 vs. 14%, p < 0.01, respectively). The majority of the studies employed real-time PCR (24%, I2 = 93, p < 0.01) and analyzed plasma samples alone or in combination with other types of specimens. BKV prevalence from 5 cities among the Iranian population showed a higher prevalence rate in Guilan. CONCLUSION Our analysis provides a preliminary estimate of the epidemiology of BKV infection in RT recipients in Iran. These results arouse a need for more epidemiological studies of BKV infection in different unanalyzed regions in Iran. Early detection of BKV in RT recipients helps timely nephropathy diagnosis and prevents graft loss.
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Affiliation(s)
| | - Hoorieh Soleimanjahi
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Teheran, Iran
| | - Fariba Dorostkar
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Teheran, Iran
| | - Vahid Salimi
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Teheran, Iran
| | - Mohammad Farahmand
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Teheran, Iran,
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McIlroy D, Hönemann M, Nguyen NK, Barbier P, Peltier C, Rodallec A, Halary F, Przyrowski E, Liebert U, Hourmant M, Bressollette-Bodin C. Persistent BK Polyomavirus Viruria is Associated with Accumulation of VP1 Mutations and Neutralization Escape. Viruses 2020; 12:v12080824. [PMID: 32751274 PMCID: PMC7472262 DOI: 10.3390/v12080824] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023] Open
Abstract
To investigate the relationship between neutralization escape and persistent high-level BK polyomavirus replication after kidney transplant (KTx), VP1 sequences were determined by Sanger and next-generation sequencing in longitudinal samples from KTx recipients with persistent high-level viruria (non-controllers) compared to patients who suppressed viruria (controllers). The infectivity and neutralization resistance of representative VP1 mutants were investigated using pseudotype viruses. In all patients, the virus population was initially dominated by wild-type VP1 sequences, then non-synonymous VP1 mutations accumulated over time in non-controllers. BC-loop mutations resulted in reduced infectivity in 293TT cells and conferred neutralization escape from cognate serum in five out of six non-controller patients studied. When taken as a group, non-controller sera were not more susceptible to neutralization escape than controller sera, so serological profiling cannot predict subsequent control of virus replication. However, at an individual level, in three non-controller patients the VP1 variants that emerged exploited specific “holes” in the patient’s humoral response. Persistent high-level BK polyomavirus replication in KTx recipients is therefore associated with the accumulation of VP1 mutations that can confer resistance to neutralization, implying that future BKPyV therapies involving IVIG or monoclonal antibodies may be more effective when used as preventive or pre-emptive, rather than curative, strategies.
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Affiliation(s)
- Dorian McIlroy
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
- Faculté des Sciences et des Techniques, Université de Nantes, 44322 Nantes, France
- Correspondence: ; Tel.: +33-2-40-41-28-39
| | - Mario Hönemann
- Institut für Virologie, Universität Leipzig, 04103 Leipzig, Germany; (M.H.); (U.L.)
| | - Ngoc-Khanh Nguyen
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
| | - Paul Barbier
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
| | - Cécile Peltier
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
| | - Audrey Rodallec
- Service de Virologie, CHU Nantes, 44093 Nantes, France; (A.R.); (E.P.)
| | - Franck Halary
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
| | - Emilie Przyrowski
- Service de Virologie, CHU Nantes, 44093 Nantes, France; (A.R.); (E.P.)
| | - Uwe Liebert
- Institut für Virologie, Universität Leipzig, 04103 Leipzig, Germany; (M.H.); (U.L.)
| | - Maryvonne Hourmant
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
- Service de Néphrologie et Immunologie Clinique, CHU Nantes, 44093 Nantes, France
| | - Céline Bressollette-Bodin
- Centre de Recherche en Transplantation et Immunoologie (CRTI), UMR 1064, INSERM, Université de Nantes, 44093 Nantes, France; (N.-K.N.); (P.B.); (C.P.); (F.H.); (C.B.-B.)
- Institut de Transplantation Urologie-Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France;
- Service de Virologie, CHU Nantes, 44093 Nantes, France; (A.R.); (E.P.)
- Faculté de Médecine, Université de Nantes, 44093 Nantes, France
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Screening for BKV-DNAEMIA after renal transplantation in a resource limited setting. Diagn Microbiol Infect Dis 2020; 96:114979. [PMID: 32014346 DOI: 10.1016/j.diagmicrobio.2019.114979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/18/2019] [Accepted: 12/25/2019] [Indexed: 11/21/2022]
Abstract
Costs may hinder the implementation of BK polyomavirus (BKV)-DNAemia screening in resource-limited kidney transplant (KT) centers. We analyzed data from two studies to assess the performance and potential cost saving of a dual-step screening strategy based on the use of a preliminary qualitative semi-nested PCR (snPCR) assay followed by BKV-DNAemia quantification after KT. In the preliminary study, in which 130 samples from 33 KT recipients were screened for BKV-DNAemia, the estimated positive and negative predictive values of snPCR, as compared to quantitative PCR (qPCR), were 88% and 99%, respectively. In the second study, which included 84 KT recipients, BKV-DNAemia was detected by snPCR in 28/472 (5.9%) samples and confirmed by qPCR in 26 samples of 21 (25%) subjects. No graft loss occurred among KT recipients who developed BKV-DNAemia. Cost analyses suggested that this strategy might be a cost saving alternative for BKV-DNAemia screening for some resource-limited settings.
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Toan PQ, Bao Quyen LT, Thu Hang DT, My Anh TT, Cuong LM, Lanh NS, Su HX. Identification of BK Virus Genotypes in Recipients of Renal Transplant in Vietnam. Transplant Proc 2019; 51:2683-2688. [PMID: 31477425 DOI: 10.1016/j.transproceed.2019.03.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/12/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aims to investigate the prevalence and distribution of BK polyomavirus (BKV) genotypes in recipients of renal transplant in Vietnam. METHODS One hundred six patients who underwent renal transplantation were included in this study. These patients were from the Department of Nephrology, Military Hospital 103, Vietnam Military Medical University. Quantification and genotyping of the BK virus was performed using in-house molecular methods from urine and plasma samples. RESULTS BKV infection was detected in 82 patients (77.4%), including 58 patients who had the presence of both BK viremia and BK viruria, and 24 patients (22.60%) with BKV positive findings in the urine alone. Particularly, 16 patients (15.09%) had high BK viremia >104 copies/mL and 20 patients (18.9%) had BK viruria >107 copies/mL. BK virus nephropathy (BKVN) was confirmed in 6 patients (5.66%) by immunohistochemistry examination. Genotyping of BKV was performed successfully in 50 out of the 82 patients, with 36 out of 50 (72%) belonging to the BKV-I subtype and 14 out of 50 (28%) belonging to the BKV-IV subtype; no cases of genotypes II or III were observed. Using phylogenetic analysis of the subgroups, the BKV-I/b-1 subtype was found the predominant subgroup (100%), whereas BKV-IV included 21.43% of IV/a-1, 6.67% of IV/a-2, and 50% of IV/c-1, respectively. There remain 3 cases of BKV-IV (21.43%) that could not be categorized into any subgroups. In the 6 patients diagnosed BKVN, 5 of them were infected with subgroup I/b-1 (83.3%) and 1 patient was infected with subgroup IV/c-1 (16.7%). No significant difference between BKV genotypes was observed in relation to age, sex, HLA mismatch, viral load, BKVN, and immunosuppressive therapy. CONCLUSIONS This research indicated a high prevalence of BKV infection and BKV-I was predominant, followed by BKV-IV among recipients of renal transplant in Vietnam.
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Affiliation(s)
- Pham Quoc Toan
- Department of Nephrology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Dinh Thi Thu Hang
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Trinh Thi My Anh
- University of Science, National University of Hanoi, Vietnam; Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Manh Cuong
- Vietnam Border Defense Force Academy, Hanoi, Vietnam
| | - Nguyen Sy Lanh
- Department of Pathology, Viet Duc University Hospital, Hanoi, Vietnam
| | - Hoang Xuan Su
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam.
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7
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Anselmo A, Prezioso C, Saccà FA, Di Lella FM, Palmieri G, Tisone G, Pietropaolo V, Ciotti M. Kidney graft failure induced by BKPyV replication despite a strong reduction of the immunosuppressive therapy. J Med Virol 2019; 91:1698-1701. [PMID: 30866070 DOI: 10.1002/jmv.25458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 01/09/2023]
Abstract
BKPyV replication is a risk factor for the development of polyomavirus-associated nephropathy in kidney transplant recipients. Here, the case of a 42 years old Caucasian patient is described who developed a kidney allograft failure because of uncontrolled BKPyV replication 7 months after transplant despite a strong reduction of the immunosuppressive therapy. The genetic analysis of the noncoding control region did not show rearrangement but two point mutations at nucleotide positions 18 and 31 within P block. The mutation at position 31 involved the nuclear factor-1 site. Sequencing of the VP1 region revealed a subtype I/subgroup b-1.
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Affiliation(s)
- Alessandro Anselmo
- Department of Surgery Polyclinic Tor Vergata Foundation, Transplantation Surgery, Rome, Italy
| | - Carla Prezioso
- Department of Public Health and Infectious Diseases, "Sapienza" University, Rome, Italy
| | - Filippo Antonino Saccà
- Department of Surgery Polyclinic Tor Vergata Foundation, Transplantation Surgery, Rome, Italy
| | - Federica Maria Di Lella
- Department of Experimental Medicine, Section of Microbiology and Virology, University Hospital "Luigi Vanvitelli" of Naples, Naples, Italy
| | - Giampiero Palmieri
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Giuseppe Tisone
- Department of Surgery Polyclinic Tor Vergata Foundation, Transplantation Surgery, Rome, Italy.,Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University, Rome, Italy
| | - Marco Ciotti
- Department of Integrated Care Processes, Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
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Korth J, Anastasiou OE, Bräsen JH, Brinkhoff A, Lehmann U, Kribben A, Dittmer U, Verheyen J, Wilde B, Ciesek S, Witzke O, Widera M. The detection of BKPyV genotypes II and IV after renal transplantation as a simple tool for risk assessment for PyVAN and transplant outcome already at early stages of BKPyV reactivation. J Clin Virol 2019; 113:14-19. [PMID: 30771597 DOI: 10.1016/j.jcv.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/07/2019] [Accepted: 02/08/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND After reactivation the BK-polyomavirus (BKPyV) associated nephropathy (PyVAN) is observed in 1-10% of renal transplant recipients, of which up to 80% undergo graft failure. BKPyV reactivation after renal transplantation was associated with donor-derived serotypes against which the recipient has no immunological protection. However, PyVAN risk assessment seroactivity testing is a time-consuming and cost intensive process. OBJECTIVES Since BKPyV serotypes can be attributed to distinct genotypes I to IV, in the present study we retrospectively analyzed whether a simple PCR-based BKPyV genotyping assay might be a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation. STUDY DESIGN 56 patients who were renal transplanted and tested positive for BKPyV viremia were included into the study. The BKPyV-VP1-coding sequences were PCR-amplified, sequenced, and subjected to genotyping. For group specific analysis patients were grouped in genotype I (n = 46) and a second group including genotype II and IV (n = 10) and associated with their clinical outcomes. RESULTS The most abundant genotype I was detected in 46 of 56 (82%) patients, however, in the genotype II and IV group PyVAN was twice as frequent as compared to the genotype I group 24 months after transplantation (8 of 10 (80%) vs. 17 of 46 (37%); p = 0.001). Accordingly, graft failure was significantly more frequent in the genotype II and IV group (3 of 10 (30%) vs. 2 of 46 (4%); p = 0.007). CONCLUSION PCR-based BKPyV genotyping might represent a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation even if matched samples of the donor are not available.
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Affiliation(s)
- Johannes Korth
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany; Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany.
| | - Olympia Evdoxia Anastasiou
- Department of Gastroenterology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jan Hinrich Bräsen
- Institute for Pathology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Alexandra Brinkhoff
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ulrich Lehmann
- Institute for Pathology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Jens Verheyen
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Sandra Ciesek
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Marek Widera
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany
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9
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Martelli F, Mencarini J, Rocca A, Malva ND, Bartolozzi D, Giannecchini S. Polyomavirus microRNA in saliva reveals persistent infectious status in the oral cavity. Virus Res 2018. [DOI: 10.1016/j.virusres.2018.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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10
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Abstract
PURPOSE OF REVIEW Despite improvements in posttransplant care, BK virus (BKV) remains one of the most challenging posttransplant infections in kidney transplant recipients with high rates of allograft failure. In the absence of well tolerated and efficacious viral specific therapeutics, treatment is primarily focused on reduction of immunosuppression, which poses a risk of rejection and fails to lead to viral clearance in a number of patients. RECENT FINDINGS Recent work has turned toward preventive therapies analogous to those used for other infections like cytomegalovirus. These efforts have focused on the use of quinolone antibiotic prophylaxis to prevent BKV infection and pretransplant vaccination to boost humoral and cellular immunity. SUMMARY Despite promising in-vitro and observational data, quinolone antibiotic prophylaxis has not been effective in preventing BKV infection in prospective studies. However, prophylaxis with newer less toxic viral specific agents such as brincidofovir - the lipid oral formulation of cidofovir - may yet prove effective. Strategies focused on eliciting a humoral immune response to recombinant virus-like particles or using adoptive transfer of BKV-specific T cells have also shown significant potential to prevent BKV infection in organ transplant recipients.
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11
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BK polyomavirus genotypes Ia and Ib1 exhibit different biological properties in renal transplant recipients. Virus Res 2017; 243:65-68. [PMID: 29106916 DOI: 10.1016/j.virusres.2017.10.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/26/2017] [Accepted: 10/26/2017] [Indexed: 01/27/2023]
Abstract
BK polyomavirus (BKV) is an opportunist agent associated with nephropathy (BKVAN) in 1-10% of kidney transplant recipients. BKV is classified into genotypes or subgroups according to minor nucleotidic variations with unknown biological implications. Studies assessing the possible association between genotypes and the risk of BKVAN in kidney transplant patients have presented conflicting results. In these studies, genotype Ia, which is highly prevalent in Brazil, was less frequently found and, thus, comparative data on the biological properties of this genotype are lacking. In this study, BKV Ia and Ib1 genotypes were compared according to their viral load, genetic evolution (VP1 and NCCR) - in a cohort of renal transplant recipients. The patients infected with Ia (13/23; 56.5%) genotype exhibited higher viral loads in urine [>1.4 log over Ib1 (10/23; 43.5%); p=0.025]. In addition, genotype Ia was associated with diverse mutations at VP1 loops and sites under positive selection outside loops, which were totally absent in Ib1. Although the number of viremic patients was similar, the three patients who had BK nephropathy (BKVAN) were infected with Ia genotype. NCCR architecture (ww or rr) were not distinctive between Ia and Ib1 genotypes. Ia genotype, which is rare in other published BKV cohorts, presented some diverse biological properties in transplanted recipients in comparison to Ib1.
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12
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Viral Origin, Clinical Course, and Renal Outcomes in Patients With BK Virus Infection After Living-Donor Renal Transplantation. Transplantation 2016; 100:844-53. [PMID: 26720302 DOI: 10.1097/tp.0000000000001066] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND BK virus (BKV) nephropathy remains the main cause of renal graft loss after living-donor renal transplantation. The aim of the study was to investigate the source and factors influencing the course of BKV infection. METHODS We investigated 214 living donor-recipient pairs. Urine and blood of donors and recipients were tested by qPCR for the presence of BKV DNA before and after transplantation; genotyping of BKV subtypes was performed. RESULTS Eighty-five recipients (40%) had posttransplant BK viruria including 61 with additional viremia and 22 with nephropathy. Pretransplant urinary BKV shedding of donor or recipient was a significant risk factor for posttransplant viruria and viremia (OR, 4.52; CI, 2.33-8.77; P < 0.0001) and nephropathy (OR, 3.03; CI, 1.16-7.9; P = 0.02). In the BKV nephropathy group, urine and blood became BKV positive earlier than in the group with viruria and viremia. Renal function was worse in BKV-nephropathy compared with BKV-negative patients beginning at transplantation. Comparing BKV subtypes of donor and recipient before with the subtype of the infected recipient after transplantation, donor-derived transmission was identified in 24 of 28 corresponding pairs. BKV subtype IV had a higher prevalence in recipients with BKV nephropathy than in those with viruria and viremia (P = 0.045). CONCLUSIONS Pretransplant urinary BKV shedding of donor and recipient is a risk for posttransplant infection. Donor-derived BKV transmission is an important mode of infection. BKV subtype IV may be one of the viral determinants. Early BKV positivity of urine and blood indicates later BKV nephropathy. Decreased renal function may favor BKV infection.
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Darbinyan A, Major EO, Morgello S, Holland S, Ryschkewitsch C, Monaco MC, Naidich TP, Bederson J, Malaczynska J, Ye F, Gordon R, Cunningham-Rundles C, Fowkes M, Tsankova NM. BK virus encephalopathy and sclerosing vasculopathy in a patient with hypohidrotic ectodermal dysplasia and immunodeficiency. Acta Neuropathol Commun 2016; 4:73. [PMID: 27411570 PMCID: PMC4944483 DOI: 10.1186/s40478-016-0342-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/26/2016] [Indexed: 02/02/2023] Open
Abstract
Human BK polyomavirus (BKV) is reactivated under conditions of immunosuppression leading most commonly to nephropathy or cystitis; its tropism for the brain is rare and poorly understood. We present a unique case of BKV-associated encephalopathy in a man with hypohidrotic ectodermal dysplasia and immunodeficiency (HED-ID) due to IKK-gamma (NEMO) mutation, who developed progressive neurological symptoms. Brain biopsy demonstrated polyomavirus infection of gray and white matter, with predominant involvement of cortex and distinct neuronal tropism, in addition to limited demyelination and oligodendroglial inclusions. Immunohistochemistry demonstrated polyoma T-antigen in neurons and glia, but expression of VP1 capsid protein only in glia. PCR analysis on both brain biopsy tissue and cerebrospinal fluid detected high levels of BKV DNA. Sequencing studies further identified novel BKV variant and disclosed unique rearrangements in the noncoding control region of the viral DNA (BKVN NCCR). Neuropathological analysis also demonstrated an unusual form of obliterative fibrosing vasculopathy in the subcortical white matter with abnormal lysosomal accumulations, possibly related to the patient's underlying ectodermal dysplasia. Our report provides the first neuropathological description of HED-ID due to NEMO mutation, and expands the diversity of neurological presentations of BKV infection in brain, underscoring the importance of its consideration in immunodeficient patients with unexplained encephalopathy. We also document novel BKVN NCCR rearrangements that may be associated with the unique neuronal tropism in this patient.
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Gard L, Niesters HGM, Riezebos-Brilman A. A real time genotyping PCR assay for polyomavirus BK. J Virol Methods 2015; 221:51-6. [PMID: 25952730 DOI: 10.1016/j.jviromet.2015.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/25/2015] [Accepted: 04/14/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Polyomavirus BK (BKV) may cause nephropathy in renal transplant recipients and hemorrhagic cystitis in bone marrow recipients. We developed real-time PCRs (RT-PCR) to determine easily and rapidly the different BKV genotypes (BKGT) (I-IV). METHODS On the VP1 gene a duplex of RT-PCRs was developed and validated to differentiate the four main BKGT. 212 BKV positive samples (21 plasma, 191 urine) were tested with these specific PCRs. Of these 212 samples, 55 PCR results were additionally confirmed by sequencing a VP1 gene fragment (nucleotide 1630-1956). RESULTS For every genotype, a highly specific, precise and internally controlled assay was developed with a limit of detection of log 3 copies per ml. In 18 (8.5%) of these samples genotyping was not successful due to a low viral load. By sequence analysis, the genotype of 46 out of 55 and 2 out of 4 samples with double infection could be confirmed. CONCLUSIONS This study describes RT-PCRs for detection of the main BKGT. It proved to be rapid, cheap and sensitive compared to sequencing. Double infections can also be detected. This method will be of value to investigate the role of BKV infection in relation to the genotype.
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Affiliation(s)
- Lilli Gard
- Department of Medical Microbiology, Division of Clinical Virology, The University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - Hubert G M Niesters
- Department of Medical Microbiology, Division of Clinical Virology, The University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Annelies Riezebos-Brilman
- Department of Medical Microbiology, Division of Clinical Virology, The University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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15
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Sawinski D, Goral S. BK virus infection: an update on diagnosis and treatment. Nephrol Dial Transplant 2014; 30:209-17. [PMID: 24574543 DOI: 10.1093/ndt/gfu023] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BK virus, first isolated in 1971, is a significant risk factor for renal transplant dysfunction and allograft loss. Unfortunately, treatment options for BK virus infection are limited, and there is no effective prophylaxis. Although overimmunosuppression remains the primary risk factor for BK infection after transplantation, male gender, older recipient age, prior rejection episodes, degree of human leukocyte antigen mismatching, prolonged cold ischemia time, BK serostatus and ureteral stent placement have all been implicated as risk factors. Routine screening for BK has been shown to be effective in preventing allograft loss in patients with BK viruria or viremia. Reduction of immunosuppression remains the mainstay of BK nephropathy treatment and is the best studied intervention. Laboratory-based methods such as ELISPOT assays have provided new insights into the immune response to BK and may help guide therapy in the future. In this review, we will discuss the epidemiology of BK virus infection, screening strategies, treatment options and future research directions.
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Affiliation(s)
- Deirdre Sawinski
- Renal, Electrolyte, and Hypertension Division, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Simin Goral
- Renal, Electrolyte, and Hypertension Division, University of Pennsylvania Medical Center, Philadelphia, PA, USA
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BK polyomavirus subtype III in a pediatric renal transplant patient with nephropathy. J Clin Microbiol 2013; 51:4255-8. [PMID: 24048534 DOI: 10.1128/jcm.01801-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BK polyomavirus (BKV) is an emerging pathogen in immunocompromised individuals. BKV subtype III is rarely identified and has not previously been associated with disease. Here we provide the whole-genome sequence of a subtype III BKV from a pediatric kidney transplant patient with polyomavirus-associated nephropathy.
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Ledesma J, Bouza E, González-Nicolás M, de Viedma DG, Rodríguez-Sánchez B, Muñoz P. BK polyomavirus genotyping at inter- and intra-patient level in Spain. J Med Virol 2013; 85:1402-8. [DOI: 10.1002/jmv.23612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2013] [Indexed: 11/05/2022]
Affiliation(s)
- J. Ledesma
- Influenza and Respiratory Viruses Laboratory; National Center for Microbiology, ISCIII; Majadahonda, Madrid Spain
| | - E. Bouza
- Clinical Microbiology and Infectious Diseases Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón; Madrid Spain
- CIBER Enfermedades Respiratorias; CIBERES; Spain
| | - M.A. González-Nicolás
- Clinical Microbiology and Infectious Diseases Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - D. García de Viedma
- Clinical Microbiology and Infectious Diseases Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón; Madrid Spain
- CIBER Enfermedades Respiratorias; CIBERES; Spain
| | - B. Rodríguez-Sánchez
- Clinical Microbiology and Infectious Diseases Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - P. Muñoz
- Clinical Microbiology and Infectious Diseases Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón; Madrid Spain
- CIBER Enfermedades Respiratorias; CIBERES; Spain
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Detection of JC virus-specific immune responses in a novel humanized mouse model. PLoS One 2013; 8:e64313. [PMID: 23700470 PMCID: PMC3658964 DOI: 10.1371/journal.pone.0064313] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 04/11/2013] [Indexed: 12/12/2022] Open
Abstract
Progressive Multifocal Leukoencephalopathy (PML) is an often fatal disease caused by the reactivation of the JC virus (JCV). Better understanding of viral-host interactions has been hampered by the lack of an animal model. Engrafting NOD/SCID/IL-2-Rg (null) mice with human lymphocytes and thymus, we generated a novel animal model for JCV infection. Mice were inoculated with either a PML isolate, JCV Mad-4, or with JCV CY, found in the kidney and urine of healthy individuals. While mice remained asymptomatic following inoculation, JCV DNA was occasionally detected in both the blood and the urine compartments. Mice generated both humoral and cellular immune responses against JCV. Expressions of immune exhaustion marker, PD-1, on lymphocytes were consistent with response to infection. Using this model we present the first in vivo demonstration of virological and immunological differences between JCV Mad-4 and CY. This model may prove valuable for studying JCV host immune responses.
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White MK, Gordon J, Khalili K. The rapidly expanding family of human polyomaviruses: recent developments in understanding their life cycle and role in human pathology. PLoS Pathog 2013; 9:e1003206. [PMID: 23516356 PMCID: PMC3597531 DOI: 10.1371/journal.ppat.1003206] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Since their discovery in 1971, the polyomaviruses JC (JCPyV) and BK (BKPyV), isolated from patients with progressive multifocal leukoencephalopathy and polyomavirus-associated nephropathy, respectively, remained for decades as the only known members of the Polyomaviridae family of viruses of human origin. Over the past five years, the application of new genomic amplification technologies has facilitated the discovery of several novel human polyomaviruses (HPyVs), bringing the present number to 10. These HPyVs share many fundamental features in common such as genome size and organization. Infection by all HPyVs is widespread in the human population, but they show important differences in their tissue tropism and association with disease. Much remains unknown about these new viruses. In this review, we discuss the problems associated with studying HPyVs, such as the lack of culture systems for the new viruses and the gaps in our basic understanding of their biology. We summarize what is known so far about their distribution, life cycle, tissue tropism, their associated pathologies (if any), and future research directions in the field.
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Affiliation(s)
- Martyn K. White
- Department of Neuroscience, Center for Neurovirology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jennifer Gordon
- Department of Neuroscience, Center for Neurovirology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Kamel Khalili
- Department of Neuroscience, Center for Neurovirology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
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Factors Influencing Viral Clearing and Renal Function During Polyomavirus BK–Associated Nephropathy After Renal Transplantation. Transplantation 2012; 94:396-402. [DOI: 10.1097/tp.0b013e31825a505d] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Konietzny R, Fischer R, Ternette N, Wright CA, Turney BW, Chakera A, Hughes D, Kessler BM, Pugh CW. Detection of BK virus in urine from renal transplant subjects by mass spectrometry. Clin Proteomics 2012; 9:4. [PMID: 22537312 PMCID: PMC3460760 DOI: 10.1186/1559-0275-9-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 04/11/2012] [Indexed: 01/11/2023] Open
Abstract
Background The diagnosis and management of BK virus (BKV) reactivation following renal transplantation continues to be a significant clinical problem. Following reactivation of latent virus, impaired cellular immunity enables sustained viral replication to occur in urothelial cells, which potentially leads to the development of BKV-associated nephropathy (BKVAN). Current guidelines recommend regular surveillance for BKV reactivation through the detection of infected urothelial cells in urine (decoy cells) or viral nucleic acid in urine or blood. However, these methods have variable sensitivity and cannot routinely distinguish between different viral subtypes. We therefore asked whether mass spectrometry might be able to overcome these limitations and provide an additional non-invasive technique for the surveillance of BKV and identification of recipients at increased risk of BKVAN. Results Here we describe a mass spectrometry (MS)-based method for the detection of BKV derived proteins directly isolated from clinical urine samples. Peptides detected by MS derived from Viral Protein 1 (VP1) allowed differentiation between subtypes I and IV. Using this approach, we observed an association between higher decoy cell numbers and the presence of the VP1 subtype Ib-2 in urine samples derived from a cohort of 20 renal transplant recipients, consistent with the hypothesis that certain viral subtypes may be associated with more severe BKVAN. Conclusions This is the first study to identify BK virus proteins in clinical samples by MS and that this approach makes it possible to distinguish between different viral subtypes. Further studies are required to establish whether this information could lead to stratification of patients at risk of BKVAN, facilitate distinction between BKVAN and acute rejection (AR), and ultimately improve patient treatment and outcomes.
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Affiliation(s)
- Rebecca Konietzny
- Centre for Cellular and Molecular Physiology, Henry Wellcome Building for Molecular Physiology, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK.
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Pastrana DV, Brennan DC, Çuburu N, Storch GA, Viscidi RP, Randhawa PS, Buck CB. Neutralization serotyping of BK polyomavirus infection in kidney transplant recipients. PLoS Pathog 2012; 8:e1002650. [PMID: 22511874 PMCID: PMC3325208 DOI: 10.1371/journal.ppat.1002650] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 03/02/2012] [Indexed: 12/20/2022] Open
Abstract
BK polyomavirus (BKV or BKPyV) associated nephropathy affects up to 10% of kidney transplant recipients (KTRs). BKV isolates are categorized into four genotypes. It is currently unclear whether the four genotypes are also serotypes. To address this issue, we developed high-throughput serological assays based on antibody-mediated neutralization of BKV genotype I and IV reporter vectors (pseudoviruses). Neutralization-based testing of sera from mice immunized with BKV-I or BKV-IV virus-like particles (VLPs) or sera from naturally infected human subjects revealed that BKV-I specific serum antibodies are poorly neutralizing against BKV-IV and vice versa. The fact that BKV-I and BKV-IV are distinct serotypes was less evident in traditional VLP-based ELISAs. BKV-I and BKV-IV neutralization assays were used to examine BKV type-specific neutralizing antibody responses in KTRs at various time points after transplantation. At study entry, sera from 5% and 49% of KTRs showed no detectable neutralizing activity for BKV-I or BKV-IV neutralization, respectively. By one year after transplantation, all KTRs were neutralization seropositive for BKV-I, and 43% of the initially BKV-IV seronegative subjects showed evidence of acute seroconversion for BKV-IV neutralization. The results suggest a model in which BKV-IV-specific seroconversion reflects a de novo BKV-IV infection in KTRs who initially lack protective antibody responses capable of neutralizing genotype IV BKVs. If this model is correct, it suggests that pre-vaccinating prospective KTRs with a multivalent VLP-based vaccine against all BKV serotypes, or administration of BKV-neutralizing antibodies, might offer protection against graft loss or dysfunction due to BKV associated nephropathy.
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Affiliation(s)
- Diana V. Pastrana
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Daniel C. Brennan
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Nicolas Çuburu
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Gregory A. Storch
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Raphael P. Viscidi
- Department of Pediatrics, Johns Hopkins Medical Center, Baltimore, Maryland, United States of America
| | - Parmjeet S. Randhawa
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
| | - Christopher B. Buck
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland, United States of America
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Bárcena-Panero A, Van Ghelue M, Khan MTH, Echevarría JE, Fedele G, Moens U. BK virus-associated infection in cerebrospinal fluid of neurological patients and mutation analysis of the complete VP1 gene in different patient groups. J Cell Physiol 2011; 227:136-45. [DOI: 10.1002/jcp.22711] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Matsuda Y, Qazi Y, Iwaki Y. A rapid and efficient method BK polyomavirus genotyping by high-resolution melting analysis. J Med Virol 2011; 83:2128-34. [DOI: 10.1002/jmv.22239] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Anzivino E, Bellizzi A, Mitterhofer AP, Tinti F, Barile M, Colosimo MT, Fioriti D, Mischitelli M, Chiarini F, Ferretti G, Taliani G, Pietropaolo V. Early monitoring of the human polyomavirus BK replication and sequencing analysis in a cohort of adult kidney transplant patients treated with basiliximab. Virol J 2011; 8:407. [PMID: 21849069 PMCID: PMC3179958 DOI: 10.1186/1743-422x-8-407] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 08/17/2011] [Indexed: 01/08/2023] Open
Abstract
Background Nowadays, better immunosuppressors have decreased the rates of acute rejection in kidney transplantation, but have also led to the emergence of BKV-associated nephropathy (BKVAN). Therefore, we prospectively investigated BKV load in plasma and urine samples in a cohort of kidney transplants, receiving basiliximab combined with a mycophenolate mofetil-based triple immunotherapy, to evaluate the difference between BKV replication during the first 3 months post-transplantation, characterized by the non-depleting action of basiliximab, versus the second 3 months, in which the maintenance therapy acts alone. We also performed sequencing analysis to assess whether a particular BKV subtype/subgroup or transcriptional control region (TCR) variants were present. Methods We monitored BK viruria and viremia by quantitative polymerase chain reaction (Q-PCR) at 12 hours (Tx), 1 (T1), 3 (T2) and 6 (T3) months post-transplantation among 60 kidney transplant patients. Sequencing analysis was performed by nested-PCR with specific primers for TCR and VP1 regions. Data were statistically analyzed using χ2 test and Student's t-test. Results BKV was detected at Tx in 4/60 urine and in 16/60 plasma, with median viral loads of 3,70 log GEq/mL and 3,79 log GEq/mL, respectively, followed by a significant increase of both BKV-positive transplants (32/60) and median values of viruria (5,78 log GEq/mL) and viremia (4,52 log GEq/mL) at T2. Conversely, a significantly decrease of patients with viruria and viremia (17/60) was observed at T3, together with a reduction of the median urinary and plasma viral loads (4,09 log GEq/mL and 4,00 log GEq/mL, respectively). BKV TCR sequence analysis always showed the presence of archetypal sequences, with a few single-nucleotide substitutions and one nucleotide insertion that, interestingly, were all representative of the particular subtypes/subgroups we identified by VP1 sequencing analysis: I/b-2 and IV/c-2. Conclusions Our results confirm previous studies indicating that BKV replication may occur during the early hours after kidney transplantation, reaches the highest incidence in the third post-transplantation month and then decreases within the sixth month, maybe due to induction therapy. Moreover, it might become clinically useful whether specific BKV subtypes or rearrangements could be linked to a particular disease state in order to detect them before BKVAN onset.
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Affiliation(s)
- Elena Anzivino
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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