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Helle F, Aubry A, Morel V, Descamps V, Demey B, Brochot E. Neutralizing Antibodies Targeting BK Polyomavirus: Clinical Importance and Therapeutic Potential for Kidney Transplant Recipients. J Am Soc Nephrol 2024; 35:1425-1433. [PMID: 39352862 PMCID: PMC11452134 DOI: 10.1681/asn.0000000000000457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
Most of the world's adult population is latently infected by the BK polyomavirus. It causes asymptomatic infection in healthy individuals but emerged as a threat to kidney transplant recipients because of virus-associated nephropathy caused by immunosuppressive therapy. In these conditions, when a functional cellular response is impaired by immunosuppression, neutralizing antibodies may play a major role because they can directly prevent infection of target cells, independently of cell-mediated immunity, by binding to the viral particles. Studying the contribution of anti-BK virus neutralizing antibodies in viral control has long been hampered by the lack of convenient in vitro models, but major progress has been made in the past decade. The four BK virus genotypes have been demonstrated to behave as distinct serotypes. A low recipient neutralizing antibody titer against the donor's serotype before kidney transplant has been significantly associated with BK virus replication after transplant. Different mechanisms exploited by the BK virus to evade neutralizing antibodies have been described. Recent studies also support the potential benefit of administering intravenous Igs or monoclonal neutralizing antibodies as a therapeutic strategy, and more interestingly, this could also be used as preventive or preemptive therapy before advanced kidney damage has occurred. Besides, neutralizing antibodies could be induced by vaccination. In this review, we summarize accumulated knowledge on anti-BK virus neutralizing antibodies as well as their clinical importance and therapeutic potential for kidney transplant recipients.
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Affiliation(s)
- Francois Helle
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
| | - Aurélien Aubry
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Virologie, Centre Hospitalier Universitaire, Amiens, France
| | - Virginie Morel
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Virologie, Centre Hospitalier Universitaire, Amiens, France
| | - Véronique Descamps
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Virologie, Centre Hospitalier Universitaire, Amiens, France
| | - Baptiste Demey
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Virologie, Centre Hospitalier Universitaire, Amiens, France
| | - Etienne Brochot
- UR-UPJV4294, Agents Infectieux, Résistance et chimiothérapie (AGIR), Centre Universitaire de Recherche en Santé, Université de Picardie Jules Verne, Amiens, France
- Laboratoire de Virologie, Centre Hospitalier Universitaire, Amiens, France
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2
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Parajuli S, Aziz F, Zhong W, Djamali A. BK polyomavirus infection: more than 50 years and still a threat to kidney transplant recipients. FRONTIERS IN TRANSPLANTATION 2024; 3:1309927. [PMID: 38993764 PMCID: PMC11235301 DOI: 10.3389/frtra.2024.1309927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/08/2024] [Indexed: 07/13/2024]
Abstract
BK polyomavirus (BKPyV) is a ubiquitous human polyomavirus and a major infection after kidney transplantation, primarily due to immunosuppression. BKPyV reactivation can manifest as viruria in 30%-40%, viremia in 10%-20%, and BK polyomavirus-associated nephropathy (BKPyVAN) in 1%-10% of recipients. BKPyVAN is an important cause of kidney graft failure. Although the first case of BKPyV was identified in 1971, progress in its management has been limited. Specifically, there is no safe and effective antiviral agent or vaccine to treat or prevent the infection. Even in the current era, the mainstay approach to BKPyV is a reduction in immunosuppression, which is also limited by safety (risk of de novo donor specific antibody and rejection) and efficacy (graft failure). However, recently BKPyV has been getting more attention in the field, and some new treatment strategies including the utilization of viral-specific T-cell therapy are emerging. Given all these challenges, the primary focus of this article is complications associated with BKPyV, as well as strategies to mitigate negative outcomes.
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Affiliation(s)
- Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Fahad Aziz
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Weixiong Zhong
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Arjang Djamali
- Department of Medicine, Maine Medical Center Maine Health, Portland, ME, United States
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3
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Peretti A, Scorpio DG, Kong WP, Pang YYS, McCarthy MP, Ren K, Jackson M, Graham BS, Buck CB, McTamney PM, Pastrana DV. A multivalent polyomavirus vaccine elicits durable neutralizing antibody responses in macaques. Vaccine 2023; 41:1735-1742. [PMID: 36764908 PMCID: PMC9992340 DOI: 10.1016/j.vaccine.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
In 2019, there were about 100,000 kidney transplants globally, with more than a quarter of them performed in the United States. Unfortunately, some engrafted organs are lost to polyomavirus-associated nephropathy (PyVAN) caused by BK and JC viruses (BKPyV and JCPyV). Both viruses cause brain disease and possibly bladder cancer in immunosuppressed individuals. Transplant patients are routinely monitored for BKPyV viremia, which is an accepted hallmark of nascent nephropathy. If viremia is detected, a reduction in immunosuppressive therapy is standard care, but the intervention comes with increased risk of immune rejection of the engrafted organ. Recent reports have suggested that transplant recipients with high levels of polyomavirus-neutralizing antibodies are protected against PyVAN. Virus-like particle (VLP) vaccines, similar to approved human papillomavirus vaccines, have an excellent safety record and are known to induce high levels of neutralizing antibodies and long-lasting protection from infection. In this study, we demonstrate that VLPs representing BKPyV genotypes I, II, and IV, as well as JCPyV genotype 2 produced in insect cells elicit robust antibody titers. In rhesus macaques, all monkeys developed neutralizing antibody titers above a previously proposed protective threshold of 10,000. A second inoculation, administered 19 weeks after priming, boosted titers to a plateau of ≥ 25,000 that was maintained for almost two years. No vaccine-related adverse events were observed in any macaques. A multivalent BK/JC VLP immunogen did not show inferiority compared to the single-genotype VLP immunogens. Considering these encouraging results, we believe a clinical trial administering the multivalent VLP vaccine in patients waiting to receive a kidney transplant is warranted to evaluate its ability to reduce or eliminate PyVAN.
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Affiliation(s)
- Alberto Peretti
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, MD 20892, United States
| | - Diana G Scorpio
- Viral Pathogenesis Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, United States
| | - Wing-Pui Kong
- Virology Core, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, United States
| | - Yuk-Ying S Pang
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, MD 20892, United States
| | - Michael P McCarthy
- Department of Infectious Diseases-Vaccines, MedImmune, Gaithersburg, MD 20878, United States
| | - Kuishu Ren
- Department of Infectious Diseases-Vaccines, MedImmune, Gaithersburg, MD 20878, United States
| | - Moriah Jackson
- Viral Pathogenesis Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, United States
| | - Barney S Graham
- Viral Pathogenesis Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, United States
| | - Christopher B Buck
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, MD 20892, United States.
| | - Patrick M McTamney
- Department of Infectious Diseases-Vaccines, MedImmune, Gaithersburg, MD 20878, United States
| | - Diana V Pastrana
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, MD 20892, United States
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4
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Prezioso C, Pietropaolo V, Moens U, Ciotti M. JC polyomavirus: a short review of its biology, its association with progressive multifocal leukoencephalopathy, and the diagnostic value of different methods to manifest its activity or presence. Expert Rev Mol Diagn 2023; 23:143-157. [PMID: 36786077 DOI: 10.1080/14737159.2023.2179394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
INTRODUCTION JC polyomavirus is the causative agent of progressive multifocal leukoencephalopathy (PML), a demyelinating disease resulting from the lytic infection of oligodendrocytes that may develop in immunosuppressed individuals: HIV1 infected or individuals under immunosuppressive therapies. Understanding the biology of JCPyV is necessary for a proper patient management, the development of diagnostic tests, and risk stratification. AREAS COVERED The review covers different areas of expertise including the genomic characterization of JCPyV strains detected in different body compartments (urine, plasma, and cerebrospinal fluid) of PML patients, viral mutations, molecular diagnostics, viral miRNAs, and disease. EXPERT OPINION The implementation of molecular biology techniques improved our understanding of JCPyV biology. Deep sequencing analysis of viral genomes revealed the presence of viral quasispecies in the cerebrospinal fluid of PML patients characterized by noncoding control region rearrangements and VP1 mutations. These neurotropic JCPyV variants present enhanced replication and an altered cell tropism that contribute to PML development. Monitoring these variants may be relevant for the identification of patients at risk of PML. Multiplex realtime PCR targeting both the LTAg and the archetype NCCR could be used to identify them. Failure to amplify NCCR should indicate the presence of a JCPyV prototype speeding up the diagnostic process.
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Affiliation(s)
- Carla Prezioso
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy.,IRCSS San Raffaele Roma, Microbiology of Chronic Neuro-Degenerative Pathologies Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Ugo Moens
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway Tromsø, Norway
| | - Marco Ciotti
- Virology Unit, Polyclinic Tor Vergata Rome, Italy
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5
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Piri Cinar B, Konuskan B, Anlar B, Ozakbas S. Narrative review based on fingolimod therapy in pediatric MS. SAGE Open Med 2023; 11:20503121231171996. [PMID: 37181277 PMCID: PMC10170592 DOI: 10.1177/20503121231171996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
The course of pediatric-onset multiple sclerosis and adult multiple sclerosis shows some clinical differences. The rate of having a second attack after the first clinical event is 80% in children and around 45% in adults but the time to the second event is similar in all age groups. The pediatric group usually has a more aggressive onset than adults. On the other hand, a higher rate of complete recovery is observed in pediatric-onset multiple sclerosis after the first clinical event compared to the adult group. Despite a highly active initial disease course, pediatric-onset multiple sclerosis patients show a slower increase in disability than patients with adult-onset disease. This is thought to be due to greater remyelination capacity and plasticity of the developing brain. The management of pediatric-onset multiple sclerosis includes safety issues as well as effective disease control. In the pediatric-onset multiple sclerosis group, similar to adult multiple sclerosis, injectable treatments have been used for many years with reasonable efficacy and safety. Since 2011, oral treatments and then infusion treatments have been approved and used effectively in adult multiple sclerosis and have gradually entered clinical use in the pediatric-onset multiple sclerosis group. However, clinical trials are fewer, smaller, and include shorter follow-up due to the much lower prevalence of pediatric-onset multiple sclerosis than adult multiple sclerosis. This is particularly important in the era of recent disease-modifying treatments. This review of the literature presents existing data on the safety and efficacy of fingolimod, pointing to a relatively favorable profile.
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Affiliation(s)
- Bilge Piri Cinar
- Samsun University, Samsun, Turkey
- Bilge Piri Cinar, Neurology Department, School of Medicine, Samsun University, Samsun, Turkey.
| | - Bahadır Konuskan
- University of Health Sciences Turkey, Etlik City Hospital, Ankara, Turkey
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6
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Yaghobi R, Afshari A, Roozbeh J. Host and viral
RNA
dysregulation during
BK
polyomavirus
infection in kidney transplant recipients. WIRES RNA 2022:e1769. [DOI: 10.1002/wrna.1769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Ramin Yaghobi
- Shiraz Transplant Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Afsoon Afshari
- Shiraz Nephro‐Urology Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Jamshid Roozbeh
- Shiraz Nephro‐Urology Research Center Shiraz University of Medical Sciences Shiraz Iran
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7
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Furmaga J, Kowalczyk M, Furmaga-Rokou O, Rokos CA, Zapolski T, Krakowski L, Jakubczak A, Rudzki S. Genotypes and Variants of BKPyV in Organ Donors after Brain Death. Int J Mol Sci 2022; 23:ijms23169173. [PMID: 36012435 PMCID: PMC9409029 DOI: 10.3390/ijms23169173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
Kidney transplantation from a donor with latent BKPyV might be the cause of serious complications, such as BK virus-associated nephropathy. The aim of the study was to determine the prevalence of BKPyV infection in donors after brain death (DBDs), to analyse the molecular variation of BKPyV and to compare clinical and inflammation parameters of DBDs infected with various genotypes of BKPyV. BKPyV was investigated in blood and urine samples of 103 DBDs using PCR followed by sequencing and bioinformatic analysis, and the viral load was assessed by qPCR. Clinical parameters, including cellular markers of inflammation were assessed. The results confirm high prevalence of BKPyV (48%),and genotype IV (49%) over genotype I (43%) and the co-infection with genotypes I and IV in 8.2%. Viral load ranged from 102 to 107 copies/mL, with an average of 1.92 × 106 copies/mL. No specific markers for BKPyV infection were detected among the parameters tested. Infection with genotype I may be associated with the adverse impact on thekidney function, while infection with genotype IV was associated with the anemia Not only the viral load but also the genotype of BKPyV may have an impact on the course of infection.
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Affiliation(s)
- Jacek Furmaga
- Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, 20-954 Lublin, Poland
| | - Marek Kowalczyk
- Institute of Quality Assessment and Processing of Animal Products, University of Life Sciences in Lublin, 20-950 Lublin, Poland
- Correspondence: (M.K.); (A.J.); Tel.: +48-81-445-67-27 (M.K.); +48-81-445-69-92 (A.J.)
| | - Olga Furmaga-Rokou
- Department of Radiology, General Hospital of Thessaloniki George Papanicolaou, 56403 Thessaloniki, Greece
| | - Christos A. Rokos
- Department of Otolaryngology, Head and Neck Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 54636 Thessaloniki, Greece
| | - Tomasz Zapolski
- Department of Cardiology, Medical University of Lublin, 20-954 Lublin, Poland
| | - Leszek Krakowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Gleboka 30, 20-612 Lublin, Poland
| | - Andrzej Jakubczak
- Institute of Biological Basis of Animal Production, Faculty of Animal Sciences and Bioeconomy, University of Life Sciences in Lublin, 20-950 Lublin, Poland
- Correspondence: (M.K.); (A.J.); Tel.: +48-81-445-67-27 (M.K.); +48-81-445-69-92 (A.J.)
| | - Sławomir Rudzki
- Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, 20-954 Lublin, Poland
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8
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BK Virus Nephropathy in Kidney Transplantation: A State-of-the-Art Review. Viruses 2022; 14:v14081616. [PMID: 35893681 PMCID: PMC9330039 DOI: 10.3390/v14081616] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/10/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
BK virus maintains a latent infection that is ubiquitous in humans. It has a propensity for reactivation in the setting of a dysfunctional cellular immune response and is frequently encountered in kidney transplant recipients. Screening for the virus has been effective in preventing progression to nephropathy and graft loss. However, it can be a diagnostic and therapeutic challenge. In this in-depth state-of-the-art review, we will discuss the history of the virus, virology, epidemiology, cellular response, pathogenesis, methods of screening and diagnosis, evidence-based treatment strategies, and upcoming therapeutics, along with the issue of re-transplantation in patients.
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9
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Molecular Epidemiology and Variation of the BK Polyomavirus in the Population of Central and Eastern Europe Based on the Example of Poland. Viruses 2022; 14:v14020209. [PMID: 35215804 PMCID: PMC8878621 DOI: 10.3390/v14020209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 02/04/2023] Open
Abstract
The BK polyomavirus (BKPyV) is a widespread pathogen in humans. Polymorphism of the region encoding the VP1 protein of BKPyV provides the basis for classifying the virus into types and subtypes, whose frequency varies depending on geographic location. The aim of our study was to determine the frequency of BKPyV in the Polish population and to assess its variation by analysing polymorphism in the typing region. The study was conducted on 168 healthy, Polish volunteers, whose blood (plasma) and urine were sampled. The virus was detected using PCR, products, sequenced and subjected to bioinformatic analysis. In addition, viral load was assessed by qPCR. The presence of the genetic material of the BK virus was noted in 61/168 urine samples but in none of the plasma sample. Sequencing and phylogenetic analysis confirmed that the BKPyV isolates were of types I and IV, dominant in Europe (63.93% and 36.07%, respectively). All isolates from genotype I belonged to subtype Ib-2, showing polymorphism at position 1809 with a frequency of 61.54% (G1809A) and 38.46% (G1809C). To the best of our knowledge, this is the first study of this magnitude on the genetic variation of BKPyV among healthy volunteers in Poland.
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10
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Myint TM, Chong CHY, Wyld M, Nankivell B, Kable K, Wong G. Polyoma BK Virus in Kidney Transplant Recipients: Screening, Monitoring, and Management. Transplantation 2022; 106:e76-e89. [PMID: 33908382 DOI: 10.1097/tp.0000000000003801] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Polyomavirus BK virus (BKPyV) infection is an important complication of kidney transplantation and allograft failure. The prevalence of viremia is 10%-15%, compared with BK-associated nephropathy (BKPyVAN) at 3%-5%. Given that there are no effective antiviral prophylaxis or treatment strategies for BKPyVAN, active screening to detect BKPyV viremia is recommended, particularly during the early posttransplant period. Immunosuppression reduction to allow viral clearance may avoid progression to severe and irreversible allograft damage. The frequency and duration of screening are highly variable between transplant centers because the evidence is reliant largely on observational data. While the primary treatment goals center on achieving viral clearance through immunosuppression reduction, prevention of subsequent acute rejection, premature graft loss, and return to dialysis remain as major challenges. Treatment strategies for BKPyV infection should be individualized to the recipient's underlying immunological risk and severity of the allograft infection. Efficacy data for adjuvant therapies including intravenous immunoglobulin and cidofovir are sparse. Future well-powered and high-quality randomized controlled trials are needed to inform evidence-based clinical practice for the management of BKPy infection.
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Affiliation(s)
- Thida Maung Myint
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Newcastle Transplant Unit, John Hunter Hospital, Newcastle, NSW, Australia
| | - Chanel H Y Chong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Melanie Wyld
- Department of Renal Medicine, Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Brian Nankivell
- Department of Renal Medicine, Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Kathy Kable
- Department of Renal Medicine, Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Department of Renal Medicine, Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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11
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Hosseini-Moghaddam SM, Xu Q, Jevnikar AM, House AA, Luke P, Campigotto A, Kum JJY, Singh G, Alharbi H, Speechley MR. The effect of human leukocyte antigen A1 and B35-Cw4 on sustained BK polyomavirus DNAemia after renal transplantation. Clin Transplant 2020; 34:e14110. [PMID: 33053214 DOI: 10.1111/ctr.14110] [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: 07/02/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022]
Abstract
Human leukocyte antigen (HLA) class I presentation pathway plays a central role in natural killer (NK) cell and cytotoxic T-cell activities against BK polyomavirus (BKPyV) DNAemia. We determined the risk of sustained BKPyV DNAemia in 175 consecutive renal transplant recipients considering the simultaneous effect of donor/recipient HLA class I antigens and pre- or post-transplant variables. Median (IQR) age was 53 (44-64) years, and 37% of patients were female. 40 patients (22.9%) developed sustained BKPyV DNAemia [median (IQR) viral load: 9740 (4350-17 125) copies/ml]. In the Cox proportional hazard analysis, HLA-A1 (HR: 3.06, 95% CI: 1.51-6.17) and HLA-B35-Cw4 (HR: 4.63, 95% CI: 2.12-10.14) significantly increased the risk of sustained BKPyV DNAemia, while 2 HLA-C mismatches provided a marginally protective effect (HR: 0.32, 95% CI: 0.10-0.98). HLA-Cw4 is a ligand for NK cell inhibitory receptor, and HLA-B35 is in strong linkage disequilibrium with the HLA-Cw4 allele. The association between HLA-B35-Cw4 expression and sustained BKPyV DNAemia supports the important role of cytotoxic T cells and NK cells that would normally control BKPyV activation through engagement with immunoglobulin-like killer receptors (KIRs). Further studies are required to investigate the effect of HLA-C alleles along with NK cell activity against BKPyV DNAemia.
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Affiliation(s)
- Seyed M Hosseini-Moghaddam
- Division of Infectious Diseases, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.,Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Qingyong Xu
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada.,Histocompatibility Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anthony M Jevnikar
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Andrew A House
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Patrick Luke
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Aaron Campigotto
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jina J Y Kum
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada.,Department of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London, ON, Canada
| | - Gagandeep Singh
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Hajed Alharbi
- Multiorgan Transplant Program, London Health Sciences Centre, Western University, London, ON, Canada
| | - Mark R Speechley
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
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12
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Toppinen M, Pratas D, Väisänen E, Söderlund-Venermo M, Hedman K, Perdomo MF, Sajantila A. The landscape of persistent human DNA viruses in femoral bone. Forensic Sci Int Genet 2020; 48:102353. [PMID: 32668397 DOI: 10.1016/j.fsigen.2020.102353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022]
Abstract
The imprints left by persistent DNA viruses in the tissues can testify to the changes driving virus evolution as well as provide clues on the provenance of modern and ancient humans. However, the history hidden in skeletal remains is practically unknown, as only parvovirus B19 and hepatitis B virus DNA have been detected in hard tissues so far. Here, we investigated the DNA prevalences of 38 viruses in femoral bone of recently deceased individuals. To this end, we used quantitative PCRs and a custom viral targeted enrichment followed by next-generation sequencing. The data was analyzed with a tailor-made bioinformatics pipeline. Our findings revealed bone to be a much richer source of persistent DNA viruses than earlier perceived, discovering ten additional ones, including several members of the herpes- and polyomavirus families, as well as human papillomavirus 31 and torque teno virus. Remarkably, many of the viruses found have oncogenic potential and/or may reactivate in the elderly and immunosuppressed individuals. Thus, their persistence warrants careful evaluation of their clinical significance and impact on bone biology. Our findings open new frontiers for the study of virus evolution from ancient relics as well as provide new tools for the investigation of human skeletal remains in forensic and archaeological contexts.
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Affiliation(s)
- Mari Toppinen
- Department of Virology, University of Helsinki, Finland
| | - Diogo Pratas
- Department of Virology, University of Helsinki, Finland; Department of Electronics, Telecommunications and Informatics, University of Aveiro, Portugal; Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Portugal
| | | | | | - Klaus Hedman
- Department of Virology, University of Helsinki, Finland; HUSLAB, Helsinki University Hospital, Finland
| | | | - Antti Sajantila
- Department of Forensic Medicine, University of Helsinki, Finland; Forensic Medicine Unit, Finnish Institute of Health and Welfare, Finland.
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13
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Hussain I, Tasneem F, Gilani US, Arshad MI, Farhan Ul Haque M, Abbas Z, Umer M, Shahzad N. Human BK and JC polyomaviruses: Molecular insights and prevalence in Asia. Virus Res 2020; 278:197860. [PMID: 31911182 DOI: 10.1016/j.virusres.2020.197860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 12/11/2022]
Abstract
Polyomaviridae family consists of small circular dsDNA viruses. Out of the 14 human polyomaviruses described so far, BKPyV and JCPyV have been studied extensively since their discovery in 1971. Reportedly, both BKPyV and JCPyV are widely distributed across the globe with the frequency of 80-90 % in different populations. The primary infection of these viruses is usually asymptomatic and latent which is activated as a consequence of immunosuppression. Activated BKPyV and JCPyV viruses lead to the development of BK Virus Associated Nephropathy and Progressive Multifocal Leukoencephalopathy, respectively. Immense progress has been made during the last few decades regarding the molecular understanding of polyomaviruses. Epidemiology of polyomaviruses has also been studied extensively. However, most of the epidemiological studies have focused on European and American populations. Therefore, limited data is available regarding the geographical distribution of these potentially oncogenic viruses in Asian countries. In this article, we have presented a compendium of latest advances in the molecular understanding of polyomaviruses and their pathobiology. We also present a comprehensive review of published literature regarding the epidemiology and prevalence of BKPyV and JCPyV in Asian regions. For this purpose, a thorough search of available online resources was performed. As a result, we retrieved 24 studies for BKPyV and 22 studies for JCPyV, that describe their prevalence in Asia. These studies unanimously report high occurrence of both BKPyV and JCPyV in Asian populations. The available data from these studies was categorized into two groups: on the basis of prevalence (low, medium and high) and disease development (healthy and diseased). Altogether, Korean population hasbeen evidenced to possess highest frequency of BKPyV (66.7 %), while JCPyV was found to be most prevalent in Taiwan (88 %). Due to high and ubiquitous distribution of these viruses, frequent studies are required to develop a better understanding regarding the epidemiology and pathobiology of these viruses in Asia.
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Affiliation(s)
- Iqra Hussain
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Fareeda Tasneem
- Department of Zoology, University of the Punjab, Lahore, Pakistan
| | - Usman Shah Gilani
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | | | | | - Zaigham Abbas
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Muhammed Umer
- Queensland Micro- and Nanotechnology Centre (QMNC), Griffith University, Nathan, QLD, 4111, Australia
| | - Naveed Shahzad
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan.
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14
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Hashida Y, Higuchi T, Matsui K, Shibata Y, Nakajima K, Sano S, Daibata M. Genetic Variability of the Noncoding Control Region of Cutaneous Merkel Cell Polyomavirus: Identification of Geographically Related Genotypes. J Infect Dis 2019; 217:1601-1611. [PMID: 29409030 DOI: 10.1093/infdis/jiy070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
Background Merkel cell polyomavirus (MCPyV) is a ubiquitous cutaneous virus that causes Merkel cell carcinoma, which develops preferentially in white populations from Europe and North America. However, the genomic variations of MCPyV among ethnic groups have not been well delineated, and even less is known regarding alterations in the noncoding control region (NCCR) in the general population. Methods MCPyV strains recovered from skin swab specimens from 250 healthy participants with distinct ethnicities and geographic origins were subjected to sequencing analysis of the NCCR. Results A 25-base pair tandem repeat caused by a 25-base pair insertion within the NCCR was found predominantly in Japanese and East Asian individuals. Based on the presence of 2 other insertions and a deletion, the NCCR could be classified further into 5 genotypes. This tandem repeat was also found exclusively in the NCCR from Japanese patients with Merkel cell carcinoma, while other genotypes were detected in white patients from Europe and North America. Conclusions Our results suggest that the MCPyV NCCR varies according to ethnicity and that assessing the short NCCR sequence provides a rapid and simple means for identification of the Japanese and East Asian variant genotype. It remains to be established whether these NCCR variations are associated differentially with the pathogenesis of MCPyV-driven Merkel cell carcinoma between regions with varying endemicity.
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Affiliation(s)
- Yumiko Hashida
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tomonori Higuchi
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kiyohiko Matsui
- Clinical Laboratory Science, Nitobe Bunka College, Tokyo, Japan
| | - Yuka Shibata
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masanori Daibata
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
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15
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Nqebelele NU, Dickens C, Dix-Peek T, Duarte R, Naicker S. JC Virus and APOL1 Risk Alleles in Black South Africans With Hypertension-Attributed CKD. Kidney Int Rep 2019; 4:939-945. [PMID: 31317116 PMCID: PMC6611950 DOI: 10.1016/j.ekir.2019.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 01/13/2023] Open
Abstract
Introduction The polyomaviruses, John Cunningham (JC) and BK, infect humans, with primary infection occurring in childhood. First-degree relatives of African American individuals with nondiabetic chronic kidney disease (CKD) who had 2 apolipoprotein L1 (APOL1) risk variants had a lower prevalence of kidney disease in the presence of JC viruria. This study determined the prevalence of polyomavirus infections and their effects, in the presence APOL1 risk alleles, on CKD. Methods Sixty-four black South African individuals with hypertension-attributed CKD with an estimated glomerular filtration rate (eGFR) ≤60 ml/min per 1.73 m2, 44 first-degree relatives, and 56 unrelated controls were included. Viral DNA was extracted from urine and genomic DNA from blood using the Maxwell automated platform. Viral-load quantification was determined using Genesig polyomavirus kits. Genotyping of the APOL1 G1 and G2 variants was by polymerase chain reaction-restriction fragment length polymorphism. Results The prevalence of JC viruria was significantly higher in controls (36%) and first-degree relatives (20%) than in patients with CKD (3%, P < 0.001). Although patients with CKD and their first-degree relatives had similar socioeconomic status scores, we found a lower prevalence of JC viruria in patients with CKD compared with their first-degree relatives, who had normal kidney function. The absence of John Cunningham virus (JCV), DNA was a strong predictor of CKD (odds ratio [OR] 43.43; 95% confidence interval [CI] 7.39-255.20; P < 0.001). Conclusion There was a strong association between the absence of JC viruria and CKD. Studies with a larger sample are essential to determine the renoprotective effects of JCV and its interactions with APOL1.
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Affiliation(s)
- Nolubabalo U Nqebelele
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline Dickens
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Therese Dix-Peek
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Raquel Duarte
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Saraladevi Naicker
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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16
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Chong S, Antoni M, Macdonald A, Reeves M, Harber M, Magee CN. BK virus: Current understanding of pathogenicity and clinical disease in transplantation. Rev Med Virol 2019; 29:e2044. [PMID: 30958614 DOI: 10.1002/rmv.2044] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/28/2019] [Accepted: 03/01/2019] [Indexed: 12/19/2022]
Abstract
BK polyomavirus (BKV) is an important cause of graft loss in renal transplant recipients that continues to pose a significant challenge to clinicians due to its frequently unpredictable onset, persistence, and the lack of effective antiviral agents or prevention strategies. This review covers our current understanding of epidemiology, viral transmission and disease progression, and treatment and prevention strategies that have been used to manage this disease.
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Affiliation(s)
- Stephanie Chong
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Michelle Antoni
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, London, UK
| | - Andrew Macdonald
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, London, UK
| | - Matthew Reeves
- Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London, UK
| | - Mark Harber
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Ciara N Magee
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
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17
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Grellier J, Hirsch HH, Mengelle C, Esposito L, Hebral AL, Bellière J, Weissbach F, Izopet J, Del Bello A, Kamar N. Impact of donor BK polyomavirus replication on recipient infections in living donor transplantation. Transpl Infect Dis 2018; 20:e12917. [PMID: 29800505 DOI: 10.1111/tid.12917] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/02/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Multiple risk factors for BK polyomavirus (BKPyV) replication after kidney transplantation have been described. Here, we investigated the impact of living donors' urinary BKPyV shedding and recipients' BKPyV antibody status pre-transplant on BKPyV replication during the first year post-transplantation. METHODS We assessed a cohort of living kidney donors and their paired recipients (n = 121). All donors were tested before transplantation, and recipients were tested before and after transplantation for BKPyV viruria and viremia. BKPyV-specific serology was assessed in all recipients at transplantation. RESULTS Ten of 121 donors (8.3%) had urinary BKPyV shedding pre-transplant, none had viremia. Overall, 33 (27.3%) recipients developed viruria after transplantation: 7 had received a kidney from a donor with BK viruria (7/10 positive donors) and 26 had received a kidney from a donor without BK viruria (26/111 negative donors; P = .0015). Fifteen (12.4%) recipients developed BK viremia after transplantation: 3 received a kidney from a donor with viruria (3/10 positive donors, 30%) and 12 received a kidney from a donor without viruria (12/111 negative donors, 11%; P = .08). One patient developed proven nephropathy. Ninety-one percent of recipients were seropositive for BKPyV. No relationship between recipients' sero-reactivity at transplantation and post-transplant BKPyV replication was observed. Pre-transplant donor urinary shedding was an independent risk factor for post-transplant BKPyV replication. CONCLUSION Screening living kidney donors for BKPyV can identify recipients at higher risk for BKPyV replication after transplantation who may benefit from intensified post-transplant screening and treatment strategies.
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Affiliation(s)
- Jimmy Grellier
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Hans H Hirsch
- Transplantation and Clinical Virology, Department of Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland
| | | | - Laure Esposito
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Anne Laure Hebral
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Julie Bellière
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Fabian Weissbach
- Transplantation and Clinical Virology, Department of Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland
| | - Jacques Izopet
- Laboratory of Virology, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| | - Arnaud Del Bello
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
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18
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Abstract
Urine culture and microscopy techniques are used to profile the bacterial species present in urinary tract infections. To gain insight into the urinary flora, we analyzed clinical laboratory features and the microbial metagenome of 121 clean-catch urine samples. 16S rDNA gene signatures were successfully obtained for 116 participants, while metagenome sequencing data was successfully generated for samples from 49 participants. Although 16S rDNA sequencing was more sensitive, metagenome sequencing allowed for a more comprehensive and unbiased representation of the microbial flora, including eukarya and viral pathogens, and of bacterial virulence factors. Urine samples positive by metagenome sequencing contained a plethora of bacterial (median 41 genera/sample), eukarya (median 2 species/sample) and viral sequences (median 3 viruses/sample). Genomic analyses suggested cases of infection with potential pathogens that are often missed during routine urine culture due to species specific growth requirements. While conventional microbiological methods are inadequate to identify a large diversity of microbial species that are present in urine, genomic approaches appear to more comprehensively and quantitatively describe the urinary microbiome.
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19
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Verghese PS, Schmeling DO, Filtz EA, Matas AJ, Balfour HH. The impact of recipient BKV shedding before transplant on BKV viruria, DNAemia, and nephropathy post-transplant: A prospective study. Pediatr Transplant 2017; 21:10.1111/petr.12942. [PMID: 28557148 PMCID: PMC5511090 DOI: 10.1111/petr.12942] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 12/20/2022]
Abstract
We previously demonstrated that detectable BKV replication in donor urine pretransplant was significantly associated with post-transplant recipient BKV viremia. In this 4-year prospective study, we assessed whether recipient BKV replication pretransplant was associated with post-transplant viremia/BKV nephropathy. We studied 220 primary adult and pediatric organ transplant recipients for 490 person-years and 2100 clinical visits. BKV viruria was detectable in 28 (16%), 26 adults and two children; and viremia in none pretransplant. Post-transplant viruria occurred in all recipients with pretransplant BKV viruria, significantly more than in recipients without pretransplant viruria on univariate (P<.005) and multivariate analysis including type of organ transplanted and immunosuppression type (P .008). Time to post-transplant viruria was significantly shorter in recipients with pretransplant viruria (P .01). By univariate and multivariate analysis, BKV viruria in recipients pretransplant did not impact post-transplant BKV viremia (P=.97 and .97, respectively) even when stratified by type of organ transplant (kidney P=.6; liver P=.5). The peak serum and urine BKV PCR post-transplant were not significantly different in patients with pretransplant BKV viruria and no one developed BK nephropathy. In conclusion, recipient BKV viruria prior to transplant predicts post-transplant viruria but not viremia or BKV nephropathy.
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Affiliation(s)
- PS Verghese
- Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, MN 55454, US
| | - DO Schmeling
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center, Minneapolis, MN 55454, US
| | - EA Filtz
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center, Minneapolis, MN 55454, US
| | - AJ Matas
- Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN 55454, US
| | - HH Balfour
- Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, MN 55454, US,Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center, Minneapolis, MN 55454, US
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20
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Trang VD, Rockett R, Jeoffreys N, Trung NV, Hai An HP, Kok J, Dwyer DE. BK polyomavirus: a review of the virology, pathogenesis, clinical and laboratory features, and treatment. Future Virol 2017. [DOI: 10.2217/fvl-2017-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BK polyomavirus (BKPyV) is a non-enveloped, circular dsDNA virus with a genome of approximately 5100 base pairs. It can be divided into four major genotypes, but the effects of different genotypes on clinical disease are uncertain. Primary BKPyV infection is generally acquired asymptomatically in childhood. It establishes low-level persistence in many tissues, particularly the genitourinary tract. Reactivation can lead to severe disease including BKPyV-associated nephropathy confirmed by renal biopsy, hemorrhagic cystitis and meningoencephalitis. Nucleic acid amplification testing of blood and urine is the main diagnostic and prognostic test for BKPyV infection. The treatment of BKPyV infection has concentrated on reduction in immunosuppressive therapy. Recent studies suggest that antiviral drugs have demonstrated only modest benefit, but adoptive T-cell therapies offer potential advances.
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Affiliation(s)
- Van Dinh Trang
- Clinical Laboratory, National Hospital of Tropical Diseases, 78-Giai Phong, Dong Da, Hanoi, Vietnam
- Western Clinical School, Westmead Hospital, The University of Sydney, NSW 2006, Australia
| | - Rebecca Rockett
- Center for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, NSW Health Pathology, Westmead Hospital, Westmead NSW 2145, Australia
| | - Neisha Jeoffreys
- Center for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, NSW Health Pathology, Westmead Hospital, Westmead NSW 2145, Australia
| | - Nguyen Vu Trung
- Clinical Laboratory, National Hospital of Tropical Diseases, 78-Giai Phong, Dong Da, Hanoi, Vietnam
- Department of Medical Microbiology, Hanoi Medical University, No. 1 Ton That Tung St, Dong Da, Hanoi, Vietnam
| | - Ha Phan Hai An
- Department of International Cooperation, Hanoi Medical University, No. 1 Ton That Tung St, Dong Da, Hanoi, Vietnam
- Kidney Diseases & Dialysis Department, Viet Duc Hospital, No. 40 Trang Thi St, Hoan Kiem, Hanoi, Vietnam
| | - Jen Kok
- Center for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, NSW Health Pathology, Westmead Hospital, Westmead NSW 2145, Australia
| | - Dominic E Dwyer
- Western Clinical School, Westmead Hospital, The University of Sydney, NSW 2006, Australia
- Center for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, NSW Health Pathology, Westmead Hospital, Westmead NSW 2145, Australia
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21
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Hussain I, Tasneem F, Umer M, Pervaiz A, Raza M, Arshad MI, Shahzad N. Specific and quantitative detection of Human polyomaviruses BKPyV and JCPyV in the healthy Pakistani population. Virol J 2017; 14:86. [PMID: 28438210 PMCID: PMC5404684 DOI: 10.1186/s12985-017-0752-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The BK Polyomavirus (BKPyV) and JC polyomavirus (JCPyV) infections are widespread in human population and have been associated with severe kidney and brain disorders, respectively. The viruses remain latent primarily in reno-urinary tract, reactivating only in case of a compromised immune system. The seroepidemiology and molecular prevalence of BKPyV and JCPyV have been widely studied both in healthy and immunocompromised patients worldwide. However, data regarding the prevalence of these viruses in the immunocompetent or apparently healthy Pakistani population is lacking. Herein, we present the first ever report on quantitative prevalence of BKPyV and JCPyV in the peripheral blood of a randomly selected cohort of healthy Pakistani population. METHODS A total of 266 whole blood samples were examined. The subjects were divided into three age groups: ≤ 25 years (young), 26-50 years (middle) and ≥ 51 years (elder). Absolute real time PCR assay was designed to quantify the BKPyV and JCPyV viral copy numbers in the range of 106 to 100 copies/mL. RESULTS Overall, BKPyV was detected in 27.1% (72/266) individuals while JCPyV in 11.6% (31/266) indicating significant difference (p < 0.005) in the distribution of these two viruses. The prevalence of BKPyV significantly decreased from 51% (49/96) in young age group to 8.2% (7/85) in eldest age group. Whereas, JCPyV positivity rate slightly increased from 8.3% (8/96) in young age group to 11.8% (10/85) in elder age group. The median viral load was calculated as 6.2 log and 3.38 log copies/mL of blood for BKPyV and JCPyV, respectively. Notably, no significant difference in viral load of either of the subtypes was found between different age groups. CONCLUSION The current study provides an important baseline data on the prevalence and viral load of circulating BKPyV and JCPyV in Pakistani population. The prevalence and viral load of BKPyV was comparatively higher than JCPyV. The prevalence of BKPyV significantly decreased with increase in age while JCPyV positivity rate slightly increased with increasing age. Viral load of both BKPyV and JCPyV was not correlated with the individual ages.
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Affiliation(s)
- Iqra Hussain
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Fareeda Tasneem
- Department of Zoology, University of the Punjab, Lahore, Pakistan
| | - Muhammed Umer
- National Institute for Biotechnology & Genetic Engineering, Faisalabad, Pakistan
| | - Ayesha Pervaiz
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Muslim Raza
- Department of Mathematics and Statistics, Virtual University of Pakistan, Lahore, Pakistan
| | | | - Naveed Shahzad
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan.
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22
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Wunderink HF, van der Meijden E, van der Blij-de Brouwer CS, Zaaijer HL, Kroes ACM, van Zwet EW, Rotmans JI, Feltkamp MCW. Stability of BK polyomavirus IgG seroreactivity and its correlation with preceding viremia. J Clin Virol 2017; 90:46-51. [PMID: 28355579 DOI: 10.1016/j.jcv.2017.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/25/2017] [Accepted: 03/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recently we showed that the level of BK polyomavirus (BKPyV) IgG seroreactivity in kidney donors predicted viremia and BKPyV-associated nephropathy in kidney transplant recipients (KTRs). This observation could be explained by assuming a direct association between BKPyV seroreactivity and the amount of persistent infectious virus in the renal allograft. OBJECTIVES Since the renal BKPyV reservoir is probably sowed by viremia during primary BKPyV infection, we systematically analysed the dynamics of BKPyV IgG seroreactivity in relation to preceding BKPyV viremia in KTRs and healthy individuals. STUDY DESIGN A cohort of 85 KTRs consisting of BKPyV viremic and nonviremic subjects was analysed for BKPyV IgG seroreactivity at five fixed time points until one year after transplantation. A cohort of 87 healthy blood donors (HBDs) was used as controls. RESULTS Baseline BKPyV seropositivity was high in both KTRs and HBDs, and the baseline mean BKPyV IgG level comparable. BKPyV IgG levels in nonviremic KTRs and HBDs remained stable during follow-up, while a considerable increase was observed in viremic KTRs (p=0.015). The increase of BKPyV seroreactivity in viremic KTRs was associated with the duration and peak level of BKPyV viremia. CONCLUSIONS BKPyV IgG seroreactivity was stable over time in immunocompetent subjects, which enables the use of this potential pretransplantation biomarker in kidney donors. The observed dose-dependent relationship of BKPyV IgG seroreactivity with preceding BKPyV replication is in agreement with the assumption that BKPyV seroreactivity reflects past BKPyV activity and correlates with the amount of latent BKPyV residing within a kidney allograft.
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Affiliation(s)
- Herman F Wunderink
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Els van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Hans L Zaaijer
- Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - Aloys C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik W van Zwet
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariet C W Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
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23
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Wunderink HF, van der Meijden E, van der Blij-de Brouwer CS, Mallat MJK, Haasnoot GW, van Zwet EW, Claas ECJ, de Fijter JW, Kroes ACM, Arnold F, Touzé A, Claas FHJ, Rotmans JI, Feltkamp MCW. Pretransplantation Donor-Recipient Pair Seroreactivity Against BK Polyomavirus Predicts Viremia and Nephropathy After Kidney Transplantation. Am J Transplant 2017; 17:161-172. [PMID: 27251361 DOI: 10.1111/ajt.13880] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/11/2016] [Accepted: 05/18/2016] [Indexed: 01/25/2023]
Abstract
Kidney transplant donors are not currently implicated in predicting BK polyomavirus (BKPyV) infection in kidney transplant recipients. It has been postulated, however, that BKPyV infection originates from the kidney allograft. Because BKPyV seroreactivity correlates with BKPyV replication and thus might mirror the infectious load, we investigated whether BKPyV seroreactivity of the donor predicts viremia and BKPyV-associated nephropathy (BKPyVAN) in the recipient. In a retrospective cohort of 407 living kidney donor-recipient pairs, pretransplantation donor and recipient sera were tested for BKPyV IgG levels and correlated with the occurrence of recipient BKPyV viremia and BKPyVAN within 1 year after transplantation. Donor BKPyV IgG level was strongly associated with BKPyV viremia and BKPyVAN (p < 0.001), whereas recipient BKPyV seroreactivity showed a nonsignificant inverse trend. Pairing of high-BKPyV-seroreactive donors with low-seroreactive recipients resulted in a 10-fold increased risk of BKPyV viremia (hazard ratio 10.1, 95% CI 3.5-29.0, p < 0.001). In multivariate analysis, donor BKPyV seroreactivity was the strongest pretransplantation factor associated with viremia (p < 0.001) and BKPyVAN (p = 0.007). The proportional relationship between donor BKPyV seroreactivity and recipient infection suggests that donor BKPyV seroreactivity reflects the infectious load of the kidney allograft and calls for the use of pretransplantation BKPyV serological testing of (potential) donors and recipients.
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Affiliation(s)
- H F Wunderink
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | - E van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - M J K Mallat
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - G W Haasnoot
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | - E W van Zwet
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - E C J Claas
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J W de Fijter
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - A C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | - F Arnold
- UMR INRA 1282 ISP Université François Rabelais, Tours, France
| | - A Touzé
- UMR INRA 1282 ISP Université François Rabelais, Tours, France
| | - F H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | - J I Rotmans
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - M C W Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
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Vigil D, Konstantinov NK, Barry M, Harford AM, Servilla KS, Kim YH, Sun Y, Ganta K, Tzamaloukas AH. BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection. World J Transplant 2016; 6:472-504. [PMID: 27683628 PMCID: PMC5036119 DOI: 10.5500/wjt.v6.i3.472] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/25/2016] [Accepted: 09/08/2016] [Indexed: 02/05/2023] Open
Abstract
Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs. Renal biopsy is required for the diagnosis of BKN. Quantitation of the BK viral load in blood and urine are surrogate diagnostic methods. The treatment of BKN is based on reduction of the immunosuppressive medications. Several compounds have shown antiviral activity, but have not consistently shown to have beneficial effects in BKN. In addition to BKN, BK viral infection can cause severe urinary bladder cystitis, ureteritis and urinary tract obstruction as well as manifestations in other organ systems including the central nervous system, the respiratory system, the gastrointestinal system and the hematopoietic system. BK viral infection has also been implicated in tumorigenesis. The spectrum of clinical manifestations from BK infection and infection from other members of the Papoviridae family is widening. Prevention and treatment of BK infection and infections from other Papovaviruses are subjects of intense research.
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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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Atyabi SR, Bouzari M, Kardi MT. John Cunningham (JC) virus genotypes in kidney transplant recipients, rheumatoid arthritis patients and healthy individuals in Isfahan, Iran. J Med Virol 2016; 89:337-344. [PMID: 27391167 DOI: 10.1002/jmv.24626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 11/11/2022]
Abstract
In healthy individuals John Cunningham virus is latent without any clinical signs, but in the cases of the use of immunosuppressive drugs in graft recipients, autoimmune diseases and also increasing of age, that the immune system is suppressed it may cause disease in reactivation. Progressive multifocal leukoencephalopathy (PML) is the well-known disease caused by the virus. It has also been associated with nephropathy and tumorogensis. At present, based on vp1 capsid gene 7 genotypes have been detected. Genetic variations of JC virus in different geographical areas and the presence of different subtypes is a useful tool for reconstructing of the genetic information of JC virus and understanding of its evolution. The aim of this study was to investigate different genotypes of the JC virus in the urine of 100 kidney transplant recipients, 43 rheumatoid arthritis patients, and 100 healthy individuals as control group in Isfahan. DNA was extracted by phenol-chloroform method and subjected to a nested PCR using specific primer for vp1 capsid gene designed by Oligo 7 software. Fisher's exact test was used for statistical analyses. Using MEGA 6 software the sequences were aligned using Clustal W tool and phylogenetic trees were constructed by neighbor joining method. Thirty-one positive samples were sequenced. Genotypes 1, 3, and 4 of the virus were detected for the first time in Iran. For the first time genotype 3 was reported as the dominant genotype in Iran. For the first time in the world, genotype 4 was detected in rheumatoid arthritis patients. J. Med. Virol. 89:337-344, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Majid Bouzari
- Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, Iran
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Chon WJ, Aggarwal N, Kocherginsky M, Kane B, Sutor J, Josephson MA. High-level viruria as a screening tool for BK virus nephropathy in renal transplant recipients. Kidney Res Clin Pract 2016; 35:176-81. [PMID: 27668162 PMCID: PMC5025461 DOI: 10.1016/j.krcp.2016.05.005] [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: 01/26/2016] [Revised: 05/10/2016] [Accepted: 05/25/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although early monitoring of BK virus infection in renal transplant patients has led to improved outcomes over the past decade, it remains unclear whether monitoring for viremia is the best screening tool for BK virus nephropathy (BKVN). METHODS We conducted a retrospective review of the medical records of 368 renal transplant recipients who had a minimum of 18 months of posttransplantation follow-up. The relationship between the presence of BK viruria and a composite end point of BK viremia/BKVN was established, and the predictive value of high-grade BK viruria for development of viremia/BKVN was determined. RESULTS High grade of BK viruria was present in 110 (30.1%) of the renal transplant recipients. BK viremia/BKVN was present in 64 (17.4%) patients and was 50 times more likely to be present in patients with high-grade BK viruria. The risk of developing BK viremia/BKVN was 3 times higher in high-grade viruria patients, and viruria preceded viremia by nearly 7 weeks. CONCLUSION The presence of high-grade viruria is an early marker for developing BK viremia/BKVN. Detection of high-grade viruria should prompt early allograft biopsy and/or preemptive reduction in immunosuppression.
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Affiliation(s)
- W James Chon
- Division of Nephrology & Hypertension, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nidhi Aggarwal
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Brenna Kane
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Jozefa Sutor
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Michelle A Josephson
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA
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BK and JC virus infections in healthy patients compared to kidney transplant recipients in Tunisia. Microb Pathog 2016; 97:204-8. [PMID: 27317859 DOI: 10.1016/j.micpath.2016.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/14/2022]
Abstract
The human polyomaviruses BKPyV and JCPyV are members of Polyomaviridae family and after primary infections they persist as latent infection especially in the kidneys. BKVPy reactivation is mainly related to a renal nephropathy and JCV reactivation can induce the progressive multifocal leukoencephalopathy. The aim of this study was to investigate and to compare the presence of BKPyV and JCPyV in urine and plasma samples from immunocompromised and immunocompetent groups. The viral detection and quantification was done by a real time PCR from 100 healthy individuals and from 72 kidney transplanted patients (KTx) enrolled in a prospective study. Polyomavirus DNA urinary shedding was identified in 19% of healthy person, BKPyV in 6%; JCPyV more frequent in 13%. No individuals in this group developed polyomavirus viremia. BKPyV and JCPyV viruria was seen in 36% and 28% of KTx respectively, and 11% had a concomitant BKPyV and JCPyV viruria. Only BKPy viremia was detected in 5.5% of the KTx. In healthy persons, JCPyV shedding was associated with older individuals. However, in KTx, BKPyV was associated with younger age and male gender. No significant association was found between the patient's origin and BKPyV or JCPyV infection. In conclusion and consisting with previous reports, BKPyV and JCPyV prevalence and urinary loads were significantly higher in immunosuppressed compared to non-immunosuppressed individuals. In Addition and by contrast to KTx, JCPyV was more frequent than BKPyV in healthy individuals. Furthermore, the shedding of both polyomaviruses was differently associated with the age and the sex according to each population.
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Bicalho CS, Oliveira RR, Pierrotti LC, Fink MCDS, Urbano PRP, Nali LHS, Luna EJA, Romano CM, David DR, David-Neto E, Pannuti CS. Pre-transplant shedding of BK virus in urine is unrelated to post-transplant viruria and viremia in kidney transplant recipients. Clin Transplant 2016; 30:796-801. [DOI: 10.1111/ctr.12752] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 01/16/2023]
Affiliation(s)
- C. S. Bicalho
- Department of Infectious and Parasitic Diseases; University of São Paulo School of Medicine; Hospital das Clínicas; São Paulo Brazil
| | - R. R. Oliveira
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - L. C. Pierrotti
- Department of Infectious and Parasitic Diseases; University of São Paulo School of Medicine; Hospital das Clínicas; São Paulo Brazil
| | - M. C. D. S. Fink
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - P. R. P. Urbano
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - L. H. S. Nali
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - E. J. A. Luna
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - C. M. Romano
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - D. R. David
- Department of Pathology; University of São Paulo School of Medicine; São Paulo Brazil
| | - E. David-Neto
- Renal Transplant Division; University of São Paulo School of Medicine Hospital das Clínicas; São Paulo Brazil
| | - C. S. Pannuti
- Virology Laboratory; São Paulo Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
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Loutfy SA, Moneer MM, Salem SE, El-Moniem Abada EA, El-Moniem Ahmed EA, Ibrahim LH, Mohamed ECB. Polyomavirus infections and its clinical relevance in cancer patients: A Prospective Study. J Infect Public Health 2016; 10:22-30. [PMID: 26965455 DOI: 10.1016/j.jiph.2016.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/23/2015] [Accepted: 01/04/2016] [Indexed: 11/19/2022] Open
Abstract
BK and JC polyomaviruses (PyV) have been demonstrated to be associated with the pathogenesis of various human cancers. We aimed to investigate the impact of BK and JC polyomavirus infections on several clinical parameters in different human cancers. A total of 150 cancer patients were included in the study (51 patients with solid tumors, 48 patients with lymphomas and 51 patients with leukemias). Amplification of PyV DNA was performed using a semi-nested version of Polymerase chain reaction targeting the T genomic region of PyV. The polyomavirus load was determined using real-time PCR assay. The clinical data were collected. Polyomavirus DNA could be detected in 84 (56%) of 150 of all cancerous patients. The solid tumors had the lowest proportion of JCV (6 (11.8%) of 51), whereas had the highest proportion of JCV (200copies/μl). JCV was more frequent among NHL patients (30%) and absent in HL patients (0%). During follow-up, PyV positivity decreased significantly (p=0.004) in lymphoma patients (n=28). Although PyV positivity decreased significantly from 39% to 7% in 28 of 48 lymphoma patients after treatment, it significantly persisted in leukemic patients after treatment (from 22% to 38%). JC was more frequent among leukemic patients with leukopenia. The presence of JC polyomavirus was more frequent among leukemic patients without any significant impact on their overall survival.
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Affiliation(s)
- Samah A Loutfy
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Egypt.
| | - Manar M Moneer
- Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Egypt
| | - Salem E Salem
- Medical Oncology Department, National Cancer Institute, Cairo University, Egypt
| | | | | | - Lamiaa H Ibrahim
- Botany & Microbiology Department, Faculty of Science, Helwan University, Egypt
| | - El-Chaimaa B Mohamed
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Egypt
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31
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Winter BJ, O'Connell HE, Bowden S, Carey M, Eisen DP. A Case Control Study Reveals that Polyomaviruria Is Significantly Associated with Interstitial Cystitis and Vesical Ulceration. PLoS One 2015; 10:e0137310. [PMID: 26325074 PMCID: PMC4556646 DOI: 10.1371/journal.pone.0137310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 08/14/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate whether polyomaviruses contribute to interstitial cystitis pathogenesis. Subjects and Methods A prospective study was performed with 50 interstitial cystitis cases compared with 50 age-matched, disease-free controls for the frequency of polyomaviruria. Associations between polyomaviruria and disease characteristics were analysed in cases. Polyomavirus in urine and bladder tissue was detected with species (JC virus vs. BK virus) specific, real-time PCR. Results Case patients were reflective of interstitial cystitis epidemiology with age range from 26–88 years (median 58) and female predominance (41/50 F). There was a significant increase in the frequency of polyomavirus shedding between cases and controls (p<0.02). Polyomavirus shedding, in particular BK viruria, was associated with vesical ulceration, a marker of disease severity, among interstitial cystitis cases after adjustment for age and sex (OR 6.8, 95% CI 1.89–24.4). There was a significant association among cases between the presence of BK viruria and response to intravesical Clorpactin therapy (OR 4.50, 95% CI 1.17–17.4). Conclusion The presence of polyomaviruria was found to be associated with the ulcerative form of interstitial cystitis. Clorpactin, which has anti-DNA virus activity, was more likely to improve symptoms in the presence of BK viruria. These data from this pilot study suggest associations between polyomaviruria and interstitial cystitis warranting further investigation.
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Affiliation(s)
- Benjamin J. Winter
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Helen E. O'Connell
- Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Scott Bowden
- Victorian Infectious Diseases Reference Laboratory, Wreckyn St, North Melbourne, Victoria, Australia
| | - Marcus Carey
- Department of Urogynaecology, Royal Women’s Hospital, Flemington Rd, Parkville, Victoria, Australia
| | - Damon P. Eisen
- Victorian Infectious Diseases Service at the Doherty Institute, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
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Gagneux-Brunon A, Pillet S, Laurent B, Mariat C, Michalet M, Lucht F, Botelho-Nevers E. A case of BK virus nephropathy in a stem cell transplant recipient: a rare or under-recognized cause for Acute Kidney injury. Med Mal Infect 2015; 45:331-4. [PMID: 26144286 DOI: 10.1016/j.medmal.2015.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/18/2015] [Accepted: 06/03/2015] [Indexed: 11/29/2022]
Affiliation(s)
- A Gagneux-Brunon
- Service de Maladies Infectieuses et Tropicales, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France.
| | - S Pillet
- Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France; Laboratoire de Bactériologie et Virologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - B Laurent
- Laboratoire de Cytologie et Histologie rénale, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - C Mariat
- Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France; Service de Néphrologie, Dialyse, Transplantation et Hypertension, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - M Michalet
- Service d'Hématologie, Hôpitaux Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - F Lucht
- Service de Maladies Infectieuses et Tropicales, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France
| | - E Botelho-Nevers
- Service de Maladies Infectieuses et Tropicales, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France
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Boobes Y, Bernieh B, Hussain Q, Al Omary H, Al Hakim M, Abayechi F, El Jack H, Khan I, Ahmed M. Prevalence of Polyomavirus Among United Arab Emirates Kidney Transplant Recipients: Results From a Single Center. Transplant Proc 2015; 47:1143-5. [DOI: 10.1016/j.transproceed.2014.11.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/19/2014] [Indexed: 12/11/2022]
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Funahashi Y, Kato M, Fujita T, Takai S, Kimura Y, Gotoh M. Prevalence of polyomavirus positivity in urine after renal transplantation. Transplant Proc 2014; 46:564-6. [PMID: 24656013 DOI: 10.1016/j.transproceed.2013.09.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 09/20/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Little is known about the timing of polyomavirus reactivation and its presence in urine after renal transplantation. The purpose of this study was to investigate the prevalence of positive polyomavirus in urine at various time points after renal transplantation. METHODS From November 2008 to August 2013, 279 renal transplant patients from our institution were included in this study. One urine sample was collected at 0-3, 4-6, 7-12, 13-24, 25-60, and ≥ 61 months after renal transplantation. A total of 394 urine samples were assessed for the presence of the BK and JC viruses with the use of a real-time polymerase chain reaction assay. RESULTS BK virus was detected in the urine of one-third of patients during the first 6 months. Thereafter, the positivity rate decreased gradually to 12% >5 years after transplantation. The positivity rate for the JC virus in urine was 33%-49% regardless of the post-transplantation phase. CONCLUSIONS BK virus was detected more frequently in urine during the early phase after renal transplantation, whereas the JC virus was detected more consistently.
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Affiliation(s)
- Y Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - M Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Fujita
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Takai
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Kimura
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yamamoto Y, Morooka M, Ihira M, Yoshikawa T. The kinetics of urinary shedding of BK virus in children with renal disease. Microbiol Immunol 2014; 59:37-42. [PMID: 25399670 DOI: 10.1111/1348-0421.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/14/2014] [Accepted: 11/12/2014] [Indexed: 11/24/2022]
Abstract
Children with renal diseases are typically treated with immunosuppressive drugs, which place them at high risk of reactivation of the BK virus (BKV). Currently, little is known about the impact of immunosuppressive drugs on the kinetics of urinary shedding of BKV and viral reactivation in pediatric patients with renal diseases. Urine samples were collected monthly for 1 year from 20 children (median age, 9 years; range, 4-15 years) with renal diseases and subjected to real-time PCR. Urinary shedding of BKV was detected in 35% (7/20) of the patients, three of these patients having persistent viral DNA excretion (two cases, twelve times; one case, four times) and four having intermittent viral DNA excretion. Thirty-four of the 240 urine samples contained BKV DNA (median copy numbers, 5.66 log copies/mL; range, 2.45-7.69 log copies/mL). In two of the cases with persistent viral shedding, high copy numbers (range, 4.57-7.69 log copies/mL) of BKV DNA were detected in all 12 urine samples collected. In the other case with persistent viral excretion, a range of 2.45-3.98 log copies/mL of BKV DNA was detected in the four urine samples collected between the 9th and 12th sampling time points. Additionally, high copy numbers (range, 3.12-4.36 log copies/mL) of BKV DNA were detected intermittently in the urine samples of the other four cases. No remarkable correlations were found between the kinetics of BKV DNA loads and urinary findings such as proteinuria and hematuria. The present data demonstrate the kinetics of urinary BKV shedding in pediatric patients with renal diseases. Additionally, no pathogenic role for BKV infection was identified.
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Affiliation(s)
- Yasuto Yamamoto
- Departments of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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High frequency of Merkel cell polyomavirus DNA in the urine of kidney transplant recipients and healthy controls. J Clin Virol 2014; 61:565-70. [PMID: 25467862 DOI: 10.1016/j.jcv.2014.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 10/17/2014] [Accepted: 10/19/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Polyomavirus (PyV) infection is common, ranging from 60% to 100% depending on the virus. The urinary excretion rates of JC virus (JCV) and BK virus (BKV) have been extensively studied, but less is known about the more recently discovered PyVs. OBJECTIVES To investigate the urinary excretion of Merkel cell PyV (MCPyV), which is associated with Merkel cell carcinoma (MCC), in kidney transplant recipients and healthy subjects, as well as those of lymphotropic polyomavirus (LPV), which was isolated from the B-cells of African green monkeys but has also been found in human blood, JCV and BKV. STUDY DESIGN Urine samples were collected from 62 adult (ATP) and 46 pediatric (PTP) kidney transplant recipients and from 67 adult (AHC) and 40 pediatric (PHC) healthy controls. DNA was isolated and analyzed using real-time PCR (Q-PCR) to determine the viral loads of MCPyV, LPV, JCV and BKV. RESULTS MCPyV DNA was more frequently detected (p<0.05) in the PTP (36.9%) and PHC (30.0%) groups compared to JCV (8.7% in PTP, 12.5% in PHC), BKV (6.5% in PTP, 2.5% in PHC), and LPV (2.2% in PTP, 5% in PHC) and in the AHC (47.8%) group compared to BKV (13.4%) and LPV (0%). CONCLUSIONS Based on the results, it could be concluded that: (a) Despite the rarity of MCC, MCPyV is a common infection; (b) MCPyV demonstrates an excretion pattern similar to those of JCV and BKV, persisting in the kidney and infecting skin cells upon reactivation, with subsequent integration and transformation.
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Schmidt T, Adam C, Hirsch HH, Janssen MWW, Wolf M, Dirks J, Kardas P, Ahlenstiel-Grunow T, Pape L, Rohrer T, Fliser D, Sester M, Sester U. BK polyomavirus-specific cellular immune responses are age-dependent and strongly correlate with phases of virus replication. Am J Transplant 2014; 14:1334-45. [PMID: 24726000 DOI: 10.1111/ajt.12689] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 01/22/2014] [Accepted: 01/29/2014] [Indexed: 01/25/2023]
Abstract
BK polyomavirus (BKPyV) infection is widespread and typically asymptomatic during childhood, but may cause nephropathy in kidney transplant recipients. However, there is only limited knowledge on BKPyV-specific immunity in children and adults, and its role in BKPyV-replication and disease posttransplant. We therefore characterized BKPyV-specific immunity from 122 immunocompetent individuals (1-84 years), 38 adult kidney recipients with (n = 14) and without BKPyV-associated complications (n = 24), and 25 hemodialysis (HD) patients. Blood samples were stimulated with overlapping peptides of BKPyV large-T antigen and VP1 followed by flow-cytometric analysis of activated CD4 T cells expressing interferon-γ, IL-2 and tumor necrosis factor-α. Antibody-levels were determined using enzyme-linked immunosorbent assay. Both BKPyV-IgG levels and BKPyV-specific CD4 T cell frequencies were age-dependent (p = 0.0059) with maximum levels between 20 and 30 years (0.042%, interquartile range 0.05%). Transplant recipients showed a significantly higher BKPyV-specific T cell prevalence (57.9%) compared to age-matched controls (21.7%) or HD patients (28%, p = 0.017). Clinically relevant BKPyV-replication was associated with elevated frequencies of BKPyV-specific T cells (p = 0.0002), but decreased percentage of cells expressing multiple cytokines (p = 0.009). In conclusion, BKPyV-specific cellular immunity reflects phases of active BKPyV-replication either after primary infection in childhood or during reactivation after transplantation. Combined analysis of BKPyV-specific T cell functionality and viral loads may improve individual risk assessment.
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Affiliation(s)
- T Schmidt
- Department of Transplant and Infection Immunology, Institute of Virology, Saarland University, Homburg, Germany
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Satyanarayana G, Marty FM, Tan CS. The polyomavirus puzzle: is host immune response beneficial in controlling BK virus after adult hematopoietic cell transplantion? Transpl Infect Dis 2014; 16:521-31. [PMID: 24834968 DOI: 10.1111/tid.12233] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 01/22/2014] [Accepted: 02/08/2014] [Indexed: 12/14/2022]
Abstract
BK virus (BKV), a ubiquitous human polyomavirus, usually does not cause disease in healthy individuals. BKV reactivation and disease can occur in immunosuppressed individuals, such as those who have undergone renal transplantation or hematopoietic cell transplantation (HCT). Clinical manifestations of BKV disease include graft dysfunction and failure in renal transplant recipients; HCT recipients frequently experience hematuria, cystitis, hemorrhagic cystitis (HC), and renal dysfunction. Studies of HCT patients have identified several risk factors for the development of BKV disease including myeloablative conditioning, acute graft-versus-host disease, and undergoing an umbilical cord blood (uCB) HCT. Although these risk factors indicate that alterations in the immune system are necessary for BKV pathogenesis in HCT patients, few studies have examined the interactions between host immune responses and viral reactivation in BKV disease. Specifically, having BKV immunoglobulin-G before HCT does not protect against BKV infection and disease after HCT. A limited number of studies have demonstrated BKV-specific cytotoxic T cells in healthy adults as well as in post-HCT patients who had experienced HC. New areas of research are required for a better understanding of this emerging infectious disease post HCT, including prospective studies examining BK viruria, viremia, and their relationship with clinical disease, a detailed analysis of urothelial histopathology, and laboratory evaluation of systemic and local cellular and humoral immune responses to BKV in patients receiving HCT from different sources, including uCB and haploidentical donors.
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Affiliation(s)
- G Satyanarayana
- Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Infectious Disease, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA; Center for Virology and Vaccine Research, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Lee SH, Hong SH, Lee JY, Hwang TK, Kim KS, Lee H, Choi YJ. Asymptomatic hematuria associated with urinary polyomavirus infection in immunocompetent patients. J Med Virol 2013; 86:347-53. [PMID: 24127261 DOI: 10.1002/jmv.23724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 12/16/2022]
Abstract
Unlike the case for immunodeficient patients, little is known about polyomavirus (PV) infection in immunocompetent patients. PV infection in immunocompetent individuals has been reported sporadically, but little is known about asymptomatic hematuria. To determine the clinical significance and prevalence of urinary PV infection in immunocompetent patients, a total of 95 individuals admitted to Seoul St. Mary's hospital were investigated. Sixty-four patients were enrolled for evaluation of asymptomatic hematuria, and 31 healthy individuals served as controls. Clinical screening for PV infection was performed by urine cytology analysis by liquid-based preparation and urine RT-PCR for BK virus (BKV) and JC virus (JCV), respectively. The average age of the patients in the PV(+) - and PV(-) -groups with asymptomatic hematuria were 60 years and 46 years, respectively. Urine cytology analysis revealed decoy cells in 37/64 hematuria patients (38.9%), but not in healthy controls. They were more prevalent in male patients. Eighty-two patients (86.3%) had PV viruria, viz., 54/64 patients in the hematuria group and 28/31 in the control group. Interestingly, 28/31 (90.3%) cases in the healthy control group were positive for PV viruria, which exceeded the number in the hematuria group (84.4%). PV viruria was associated primarily with JCV, rather than BKV. PV viruria, including JCV viruria, correlated with urine decoy cells and increased age. In conclusion, urinary PV infection is common in immunocompetent patients with asymptomatic hematuria and is age-related. These data may provide an insight into the pathogenesis and future treatment of asymptomatic hematuria associated with urinary PV infection in immunocompetent patients.
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Affiliation(s)
- Sung Hak Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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40
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Pastrana DV, Ray U, Magaldi TG, Schowalter RM, Çuburu N, Buck CB. BK polyomavirus genotypes represent distinct serotypes with distinct entry tropism. J Virol 2013; 87:10105-13. [PMID: 23843634 PMCID: PMC3754014 DOI: 10.1128/jvi.01189-13] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/01/2013] [Indexed: 12/21/2022] Open
Abstract
BK polyomavirus (BKV) causes significant urinary tract pathogenesis in immunosuppressed individuals, including kidney and bone marrow transplant recipients. It is currently unclear whether BKV-neutralizing antibodies can moderate or prevent BKV disease. We developed reporter pseudoviruses based on seven divergent BKV isolates and performed neutralization assays on sera from healthy human subjects. The results demonstrate that BKV genotypes I, II, III, and IV are fully distinct serotypes. While nearly all healthy subjects had BKV genotype I-neutralizing antibodies, a majority of subjects did not detectably neutralize genotype III or IV. Surprisingly, BKV subgenotypes Ib1 and Ib2 can behave as fully distinct serotypes. This difference is governed by as few as two residues adjacent to the cellular glycan receptor-binding site on the virion surface. Serological analysis of mice given virus-like particle (VLP)-based BKV vaccines confirmed these findings. Mice administered a multivalent VLP vaccine showed high-titer serum antibody responses that potently cross-neutralized all tested BKV genotypes. Interestingly, each of the neutralization serotypes bound a distinct spectrum of cell surface receptors, suggesting a possible connection between escape from recognition by neutralizing antibodies and cellular attachment mechanisms. The finding implies that different BKV genotypes have different cellular tropisms and pathogenic potentials in vivo. Individuals who are infected with one BKV serotype may remain humorally vulnerable to other BKV serotypes after implementation of T cell immunosuppression. Thus, prevaccinating organ transplant recipients with a multivalent BKV VLP vaccine might reduce the risk of developing posttransplant BKV disease.
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Affiliation(s)
- Diana V Pastrana
- Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
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41
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Ma Y, Fang M. Immunosenescence and age-related viral diseases. SCIENCE CHINA-LIFE SCIENCES 2013; 56:399-405. [PMID: 23633071 PMCID: PMC7089158 DOI: 10.1007/s11427-013-4478-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/01/2013] [Indexed: 12/15/2022]
Abstract
Immunosenescence is described as a decline in the normal functioning of the immune system associated with physiologic ageing. Immunosenescence contributes to reduced efficacy to vaccination and increased susceptibility to infectious diseases in the elderly. Extensive studies of laboratory animal models of ageing or donor lymphocyte analysis have identified changes in immunity caused by the ageing process. Most of these studies have identified phenotypic and functional changes in innate and adaptive immunity. However, it is unclear which of these defects are critical for impaired immune defense against infection. This review describes the changes that occur in innate and adaptive immunity with ageing and some age-related viral diseases where defects in a key component of immunity contribute to the high mortality rate in mouse models of ageing.
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Affiliation(s)
- YongChao Ma
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101 China
| | - Min Fang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101 China
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Robaina TF, Mendes GS, Benati FJ, Pena GA, Silva RC, Montes MAR, Janini MER, Câmara FP, Santos N. Shedding of polyomavirus in the saliva of immunocompetent individuals. J Med Virol 2013; 85:144-8. [PMID: 23154878 DOI: 10.1002/jmv.23453] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to investigate and compare the frequency of BKV, JCV, WUV, and KIV in the saliva of healthy individuals. Samples were analyzed for the presence of polyomaviruses (BKV, JCV, WUV, and KIV) DNA by real-time PCR. Of the 291 samples tested, 71 (24.3%) were positive for at least one of the screened polyomaviruses. Specifically, 12.7% (37/291) were positive for WUV, 7.2% (21/291) positive for BKV, 2.4% (7/291) positive for KIV, and 0.3% (1/291) positive for JCV. BKV and WUV co-infections were detected in 1.7% (5/291) of individuals. No other co-infection combinations were found. The mean number of DNA copies was high, particularly for WUV and BKV, indicating active replication of these viruses. Polyomavirus detection was higher among individuals 15-19 years of age (46.0%; 23/50) and ≥50 years of age (33.3%; 9/27). However, the detection rate in the first group was almost 1.7× greater than the latter. WUV infections were more frequent in individuals between the ages of 15 and 19 years and the incidence decreased with age. By contrast, BKV excretion peaked and persisted during the third decade of life and KIV infections were detected more commonly in subjects ≥50 years old. These findings reinforced the previous hypotheses that saliva may be a route for BKV transmission, and that the oral cavity could be a site of virus replication. These data also demonstrated that JCV, WUV, and KIV may be transmitted in a similar fashion.
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Affiliation(s)
- Tatiana F Robaina
- Microbiology Institute, Federal University of Rio of Janeiro, Rio de Janeiro, RJ, Brazil
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Rianthavorn P, Posuwan N, Payungporn S, Theamboonlers A, Poovorawan Y. Polyomavirus reactivation in pediatric patients with systemic lupus erythematosus. TOHOKU J EXP MED 2013; 228:197-204. [PMID: 23076257 DOI: 10.1620/tjem.228.197] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Polyomavirus (PyV) infection usually persists without any symptoms in normal individuals. In immunocompromised patients including patients with systemic lupus erythematosus (SLE), PyV reactivation occurs with a high prevalence and can cause severe clinical complications. In this study, reactivation of six PyV [JC, BK, WU, KI, merkel cell (MC) and trichodysplasia spinulosa (TS)] was investigated in terms of prevalence, clinical implications and correlation with urine transforming growth factor (TGF)-β1 expression in 50 SLE patients aged less than 18 years. Clinical characteristics were obtained from medical record review. PyV viruria was assessed by nested polymerase chain reaction. Urine TGF-β1 was measured with ELISA. The mean age was 13 ± 2.8 years. The prevalence of JC and BK viruria was 16% and 32%, respectively. WU, KI, MC and TS were not isolated from any urine specimens. Co-reactivation of 2 PyV was not detected. Urine TGF-β1 levels in patients with JC viruria, with BK viruria and without PyV viruria were 0.27 ± 0.09, 0.10 ± 0.05 and 0.13 ± 0.09 ng/mg of urine creatinine, respectively. Cumulative doses of cyclophosphamide per body weight and urine TGF-β1 levels were higher in JC viruria than in other groups (p < 0.05). The prevalence of JC and BK reactivation was higher in pediatric patients with SLE than in the normal population. JC reactivation in pediatric patients with SLE was correlated with the administration of high-dose cyclophosphamide and increased urine TGF-β1 levels. Surveillance of JC reactivation is recommended in pediatric patients with chronic and severe SLE receiving high-dose cyclophosphamide.
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Affiliation(s)
- Pornpimol Rianthavorn
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Zhong S, Suzuki M, Peng X, Shen ZJ, Wang XJ, Xu TY, Li T, Yogo Y, Homma Y. BK polyomavirus from patients with tissue-derived prostate adenocarcinoma. Future Virol 2013. [DOI: 10.2217/fvl.13.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim: To explore the potential role of BK polyomavirus (BKV) in prostate tumorigenesis. Materials & methods: A total of 82 patients (no immunosuppression history) were divided into two groups. Group 1 included 32 patients receiving radical prostatectomy due to prostate adenocarcinoma. Group 2 consisted of 50 patients receiving transurethral resection of prostate or incision of prostate (TUIP) due to benign prostatic hyperplasia. Prostate tissue specimens of group 1 were obtained from two regions of the prostate: one was from the peripheral section of the prostate or proximal to the region where adenocarcinoma was confirmed by the preoperative needle biopsies (mark A region), the other was from the central section of the prostate or distal from the region where adenocarcinoma was confirmed by the needle biopsies (mark B region). If BKV alone was detected in either of the two regions, that case was regarded as BKV-positive prostate cancer. Those of group 2 were obtained from transrectal prostate biopsy before transurethral resection of prostate or transurethral incision of the prostate. Total DNA was extracted from each of the tissues and subjected to single or nested PCR using the β-globin system to detect targeted sequences within: the LTag gene; the VP1 gene and the transcriptional control region (TCR). Results: In group 1, BKV DNA sequences were detected in six cases (18.8%, 6/32), which were all in the A regions. Among the six cases, there were four cases with all of LTag, VP1 and TCR amplified, one case with LTag and TCR amplified, and one case with only the LTag amplified. In group 2, there was only one case (2.0%, 1/50) in which BKV DNA sequences were detected, and the only amplified fragment was VP1. The difference between the two groups was statistically significant (p = 0.008). Conclusion: BKV is often detected in the prostate cancer tissue and may be associated with progression of prostate cancer.
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Affiliation(s)
- Shan Zhong
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai 200025, China
| | - Makoto Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Xu Peng
- Department of Systems Biology & Translational Medicine, College of Medicine, Texas A&M Healthy Science Center, Temple, TX, USA
| | - Zhou-Jun Shen
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai 200025, China.
| | - Xian-Jin Wang
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai 200025, China
| | - Tian-Yuan Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai 200025, China
| | - Tao Li
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai 200025, China
| | - Yoshiaki Yogo
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Nali LHDS, Centrone CDC, Urbano PRP, Penalva-de-Oliveira AC, Vidal JE, Miranda EP, Pannuti CS, Fink MCDDS. High prevalence of the simultaneous excretion of polyomaviruses JC and BK in the urine of HIV-infected patients without neurological symptoms in São Paulo, Brazil. Rev Inst Med Trop Sao Paulo 2012; 54:201-5. [PMID: 22850991 DOI: 10.1590/s0036-46652012000400004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/25/2012] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate the prevalence of the urinary excretion of BKV and JCV in HIV-infected patients without neurological symptoms. METHODS Urine samples from HIV-infected patients without neurological symptoms were tested for JC virus and BK virus by PCR. Samples were screened for the presence of polyomavirus with sets of primers complementary to the early region of JCV and BKV genome (AgT). The presence of JC virus or BK virus were confirmed by two other PCR assays using sets of primers complementary to the VP1 gene of each virus. Analysis of the data was performed by the Kruskal-Wallis test for numerical data and Pearson or Yates for categorical variables. RESULTS A total of 75 patients were included in the study. The overall prevalence of polyomavirus DNA urinary shedding was 67/75 (89.3%). Only BKV DNA was detected in 14/75 (18.7%) urine samples, and only JCV DNA was detected in 11/75 (14.7%) samples. Both BKV and JCV DNA were present in 42/75 (56.0%) samples. CONCLUSION In this study we found high rates of excretion of JCV, BKV, and simultaneous excretion in HIV+ patients. Also these results differ from the others available on the literature.
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Affiliation(s)
- Luiz Henrique da Silva Nali
- Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
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Bárcena-Panero A, Echevarría JE, Van Ghelue M, Fedele G, Royuela E, Gerits N, Moens U. BK polyomavirus with archetypal and rearranged non-coding control regions is present in cerebrospinal fluids from patients with neurological complications. J Gen Virol 2012; 93:1780-1794. [PMID: 22552944 DOI: 10.1099/vir.0.042143-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BK polyomavirus (BKPyV) has recently been postulated as an emerging opportunistic pathogen of the human central nervous system (CNS), but it is not known whether specific strains are associated with the neurotropic character of BKPyV. The presence of BKPyV large T-antigen DNA was examined in 2406 cerebrospinal fluid (CSF) samples from neurological patients with suspected JC polyomavirus infection. Twenty patients had a large T-antigen DNA-positive specimen. The non-coding control region (NCCR) of the BKPyV strains amplified from CSF from these 20 patients, strains circulating in renal and bone marrow transplant recipients and from healthy pregnant women was sequenced. The archetypal conformation was the most prevalent in all groups and 14 of the neurological patients harboured archetypal strains, while the remaining six patients possessed BKPyV with rearranged NCCR similar to previously reported variants from non-neurological patients. Transfection studies in Vero cells revealed that five of six early and four of six late rearranged promoters of these CSF isolates showed significantly higher activity than the corresponding archetypal promoter. From seven of the neurological patients with BKPyV DNA-positive CSF, paired serum samples were available. Five of them were negative for BKPyV DNA, while serum from the remaining two patients harboured BKPyV strains with archetypal NCCR that differed from those present in their CSF. Our results suggest that NCCR rearrangements are not a hallmark for BKPyV neurotropism and the dissemination of a rearranged NCCR from the blood may not be the origin of BKPyV CNS infection.
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Affiliation(s)
- Ana Bárcena-Panero
- Network of Biomedical Investigation Centres in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway.,Viral Isolation and Detection Laboratory, Microbiology Diagnostic Service, National Microbiology Centre, Carlos III Health Institute, 28220 Majadahonda, Madrid, Spain
| | - Juan E Echevarría
- Network of Biomedical Investigation Centres in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Viral Isolation and Detection Laboratory, Microbiology Diagnostic Service, National Microbiology Centre, Carlos III Health Institute, 28220 Majadahonda, Madrid, Spain
| | - Marijke Van Ghelue
- Department of Medical Genetics, University Hospital of Northern-Norway, N-9038 Tromsø, Norway
| | - Giovanni Fedele
- Department of Diagnosis Orientation, National Microbiology Centre, Carlos III Health Institute, 28220 Majadahonda, Madrid, Spain
| | - Enrique Royuela
- Network of Biomedical Investigation Centres in Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Viral Isolation and Detection Laboratory, Microbiology Diagnostic Service, National Microbiology Centre, Carlos III Health Institute, 28220 Majadahonda, Madrid, Spain
| | - Nancy Gerits
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway
| | - Ugo Moens
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway
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Bárcena-Panero A, Echevarría JE, Romero-Gómez MP, Royuela E, Castellanos A, González I, Fedele G. Development and validation with clinical samples of internally controlled multiplex real-time PCR for diagnosis of BKV and JCV infection in associated pathologies. Comp Immunol Microbiol Infect Dis 2012; 35:173-9. [PMID: 22261266 DOI: 10.1016/j.cimid.2011.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 11/28/2011] [Accepted: 12/19/2011] [Indexed: 11/17/2022]
Abstract
This article describes the development and validation with clinical samples of an internally controlled multiplex quantitative real-time PCR (QRT-PCR) for human polyomaviruses BK (BKV) and JC (JCV). Blood and urine samples from renal transplant recipients with suspected nephropathy, and cerebrospinal fluid (CSF) specimens from AIDS, natalizumab-treated and HIV-negative patients with suspected progressive multifocal leukoencephalopathy, previously checked for BKV and JCV by conventional PCR, were tested by QRT-PCR. All samples positive by conventional PCR were confirmed by QRT-PCR. Four cases of JCV-associated neurological infection, including all those detected in natalizumab-treated patients, and one case of BKV-related neurological infection were only identified by QRT-PCR. BKV was quantified in the CSF of neurological patients for the first time. Analyses of the Quality Control for Molecular Diagnostics 2010 panel were "highly satisfactory" for BKV and "satisfactory" for JCV. The QRT-PCR is specific and reproducible. It improves the sensitivity of conventional PCR for the diagnosis of BKV and JCV infection in various diseases.
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Affiliation(s)
- Ana Bárcena-Panero
- Viral Isolation and Detection Laboratory, Microbiology Diagnostic Service, National Microbiology Centre, Carlos III Health Institute, Majadahonda, Madrid, Spain.
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Detection of polyomavirus BK reactivation after renal transplantation using an intensive decoy cell surveillance program is cost-effective. Transplantation 2011; 92:1018-23. [PMID: 21946172 DOI: 10.1097/tp.0b013e318230c09b] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Reactivation of polyomavirus BK (BKV) after renal transplantation can lead to allograft dysfunction or loss with early detection improving outcomes. Current guidelines recommend quantitative polymerase chain reaction for surveillance; however, urinary decoy cell detection is a potentially cost-effective alternative. We present the outcomes from an early intensive BKV surveillance program using decoy cell detection for initial screening starting 2 weeks after transplantation. METHODS Records for all recipients of kidney (n=211) or simultaneous kidney and pancreas (n=102) transplants performed over 2 years in a single center were reviewed. Follow-up was for a minimum of 1 year. Urine cytology screening was performed fortnightly from 0 to 3 months after transplantation, monthly from 3 to 6 months then every 2 months from 6 to 12 months. RESULTS Decoy cell positivity occurred in 56 of 313 patients (17.9%) with sustained decoy cell positivity (≥2 positive urine samples >2 weeks apart) present in 32 patients (10.2%). Twenty-four patients (7.6%) became viremic and three patients (1%) developed polyoma virus nephropathy. The median time after transplantation until decoy cell positivity was 78 days, decreasing to 67 days for patients with sustained positivity and 57 days for patients who developed polyoma virus nephropathy. No grafts were lost due to BKV during the study period. Decoy cell screening resulted in savings of approximately £135,000 over 2 years, when compared with routine surveillance by quantitative polymerase chain reaction. CONCLUSIONS Clinically significant BKV reactivation occurs early after transplantation and can be reliably detected by decoy cell screening. A surveillance strategy for detecting BKV reactivation based on urine cytology is cost-effective.
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Matos A, Duque V, Luxo C, Meliço-Silvestre A, Major EO. Individuals infected with JC polyomavirus do not present detectable JC virus DNA in oropharyngeal fluids. J Gen Virol 2011; 93:692-697. [PMID: 22158878 DOI: 10.1099/vir.0.036798-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
JC virus (JCV) is ubiquitous in the human population. Primary infection normally occurs during childhood and is followed by a lifelong persistent infection. The main mode of transmission remains unknown. Several authors have hypothesized that JCV transmission occurs through the respiratory route, and that respiratory secretions could represent a possible source of viral particles. The present study intended to evaluate oropharyngeal fluids from patients infected with JCV, in order to ascertain if respiratory secretions could indeed constitute a source of exposure to this polyomavirus. Oropharyngeal washing samples from 25 patients co-infected with JCV and human immunodeficiency virus type 1 were evaluated for the presence of JCV DNA. Regardless of the titre of antibodies or the presence of viral urinary excretion, JCV genome was not detected in oropharyngeal samples collected from any of the patients infected with JCV included in this study, which may suggest that oropharyngeal fluids are an unlikely source for JCV infection.
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Affiliation(s)
- Ana Matos
- Center for Pharmaceutical Studies, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Vitor Duque
- Laboratory of Virology, Infectious Diseases Department, Coimbra's University Hospital, Coimbra, Portugal
| | - Cristina Luxo
- Center for Pharmaceutical Studies, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - António Meliço-Silvestre
- Laboratory of Virology, Infectious Diseases Department, Coimbra's University Hospital, Coimbra, Portugal
| | - Eugene O Major
- Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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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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