Azzi A, Cesaro S, Laszlo D, Zakrzewska K, Ciappi S, De Santis R, Fanci R, Pesavento G, Calore E, Bosi A
Department of Public Health, University of Florence, Italy.
J Clin Virol. 1999 Oct;14(2):79-86. doi: 10.1016/s1386-6532(99)00055-4.
Several observations suggest an association between long-lasting haemorrhagic cystitis (HC) in bone marrow transplantation (BMT) recipients and human polyomavirus BK (BKV) reactivation, but no conclusive evidence has been obtained so far. The amount of BKV measured in the urine of BMT patients during an episode of HC was compared with that detected in the urine of BMT patients without HC and of immunocompetent individuals in order to better assess the association of BKV reactivation with HC. For this purpose a quantitative competitive PCR was developed. The application of this assay to clinical samples allowed us to distinguish asymptomatic reactivation both in healthy individuals and in immunocompromised patients from reactivation associated with HC, in almost all cases. Low levels, below the sensitivity of the quantitative assay, were shown in asymptomatic healthy individuals and in about 50% of immunocompromised patients. A significantly higher viral load than in the urine of asymptomatic immunocompromised patients was detected in the urine of patients with HC. These data strengthen the hypothesis that BKV reactivation can cause, together with other factors, the majority of late HC in BMT recipients as well as in patients treated for acute refractory lymphoblastic leukemia.
多项观察结果提示，骨髓移植（BMT）受者的持久性出血性膀胱炎（HC）与人类多瘤病毒BK（BKV）激活之间存在关联，但目前尚未获得确凿证据。为了更好地评估BKV激活与HC的关联，对BMT患者发生HC期间尿液中检测到的BKV量与未发生HC的BMT患者及免疫功能正常个体尿液中检测到的BKV量进行了比较。为此开发了一种定量竞争性聚合酶链反应（PCR）。该检测方法应用于临床样本后，几乎在所有情况下，我们都能够区分健康个体和免疫功能低下患者的无症状激活与HC相关的激活。无症状健康个体及约50%的免疫功能低下患者的病毒载量较低，低于定量检测的灵敏度。HC患者尿液中检测到的病毒载量明显高于无症状免疫功能低下患者尿液中的病毒载量。这些数据强化了这样一种假设，即BKV激活与其他因素一起，可导致BMT受者以及接受急性难治性淋巴细胞白血病治疗的患者中大多数迟发性HC的发生。
