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人多瘤病毒与疾病,重点介绍临床 BK 和 JC。

Human polyoma viruses and disease with emphasis on clinical BK and JC.

机构信息

Barnes-Jewish Hospital, St. Louis, MO, United States.

出版信息

J Clin Virol. 2010 Apr;47(4):306-12. doi: 10.1016/j.jcv.2009.12.006. Epub 2010 Jan 8.

Abstract

Polyoma viruses are ubiquitous infecting many different mammalian species including humans. There are five known human polyoma viruses. JC virus and BK virus are two polyoma viruses identified nearly three decades ago. Recently WU, KI and Merkel cell polyoma viruses have been isolated from humans. The exact role of these three newly discovered viruses in human disease is not known. Most human polyoma disease is caused by BK and JC viruses which are usually acquired in childhood. Approximately 50-80% of humans have seropositivity to these viruses. Clinically apparent diseases in immunocompetent hosts are extremely rare. These viruses remain latent possibly in the lymphoid organs, neuronal tissue, and kidney and under the circumstances of severe immunosuppression both these viruses reactivate. Neurotropic JC virus reaches the brain and causes progressive multifocal leukoencephalopathy, a demyelinating disease of the central nervous system with a high mortality rate. BK virus is urotheliotropic and its reactivation causes a form of interstitial nephritis, known as BK or polyoma virus associated nephropathy which is associated with high graft loss if not recognized early. There are no known effective antiviral agents for any of the polyoma viruses.

摘要

多瘤病毒广泛存在,感染多种不同的哺乳动物物种,包括人类。已知有五种人类多瘤病毒。JC 病毒和 BK 病毒是近三十年前发现的两种多瘤病毒。最近,从人类中分离出了 WU、KI 和 Merkel 细胞多瘤病毒。这三种新发现的病毒在人类疾病中的确切作用尚不清楚。大多数人类多瘤病毒疾病是由 BK 和 JC 病毒引起的,这些病毒通常在儿童时期获得。大约 50-80%的人对这些病毒呈血清阳性。免疫功能正常的宿主中,临床上明显的疾病极为罕见。这些病毒潜伏在可能的淋巴器官、神经元组织和肾脏中,在严重免疫抑制的情况下,这两种病毒都会重新激活。亲神经的 JC 病毒到达大脑,导致进行性多灶性白质脑病,这是一种中枢神经系统脱髓鞘疾病,死亡率很高。BK 病毒是尿路上皮亲嗜性的,其重新激活会导致间质性肾炎,称为 BK 或多瘤病毒相关肾病,如果不能早期发现,会导致移植物丢失率很高。目前还没有针对任何一种多瘤病毒的有效抗病毒药物。

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