Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czechia.
National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czechia.
Front Immunol. 2022 Jul 25;13:929946. doi: 10.3389/fimmu.2022.929946. eCollection 2022.
BK polyomavirus (BKPyV) often reactivates after kidney transplantation, causing BKPyV-associated nephropathy (BKPyVAN) in 1%-10% of cases with a potential detrimental effect on allograft survival. Kidney transplant recipients are regularly screened for BKPyV DNA in plasma. As this strategy may not always reduce the risk of BKPyVAN, other predictive markers are needed. To evaluate the role of pretransplant BKPyV-specific antibody, 210 kidney transplant recipients and 130 donors were screened for BKPyV DNA and BKPyV-specific antibodies. We found that the donor BKPyV immunoglobulin G (IgG) seroprevalence and antibody level were strongly associated with BKPyV-DNAemia and BKPyVAN, although multivariant analysis found the presence of anti-BKPyV-specific antibodies as a predictive factor only for BKPyV-DNAemia. The pretransplant recipient status had no effect on posttransplant BKPyV-DNAemia and BKVAN. BKPyV IgG levels remained stable in BKPyV-negative recipients during 1-year follow-up, while a considerable increase was observed in BKPyV-positive patients. The presence of anti-BKPyV-specific antibodies in kidney allograft donors is a good and reliable predictive marker for posttransplant BKPyV replication with relevance to risk stratification in transplant recipients.
BK 多瘤病毒（BKPyV）在肾移植后常发生再激活，导致 1%-10%的病例出现 BKPyV 相关性肾病（BKPyVAN），从而对移植物的存活产生潜在的不利影响。肾移植受者定期进行血浆 BKPyV DNA 筛查。由于这种策略并不总能降低 BKPyVAN 的风险，因此需要其他预测标志物。为了评估移植前 BKPyV 特异性抗体的作用，对 210 名肾移植受者和 130 名供者进行了 BKPyV DNA 和 BKPyV 特异性抗体筛查。我们发现，供体 BKPyV 免疫球蛋白 G（IgG）血清阳性率和抗体水平与 BKPyV-DNA 血症和 BKPyVAN 密切相关，尽管多变量分析发现存在抗 BKPyV 特异性抗体仅可预测 BKPyV-DNA 血症。移植前受者状态对移植后 BKPyV-DNA 血症和 BKVAN 无影响。在 1 年的随访中，BKPyV 阴性受者的 BKPyV IgG 水平保持稳定，而 BKPyV 阳性患者的水平则显著升高。供体肾中存在抗 BKPyV 特异性抗体是移植后 BKPyV 复制的良好且可靠的预测标志物，与移植受者的风险分层有关。
