Hacettepe University, Faculty of Medicine, Ankara.
Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara.
Int J Antimicrob Agents. 2024 Nov;64(5):107333. doi: 10.1016/j.ijantimicag.2024.107333. Epub 2024 Sep 7.
Polyomaviruses are a group of small, non-enveloped, double-stranded DNA viruses that can infect various hosts, including humans. BKPyV causes conditions such as human polyomavirus-associated nephropathy (HPyVAN), human polyomavirus-associated haemorrhagic cystitis (HPyVHC), and human polyomavirus-associated urothelial cancer (HPyVUC). JC polyomavirus (JCPyV), on the other hand, is the causative agent of progressive multifocal leukoencephalopathy (PML), a severe demyelinating disease of the central nervous system. PML primarily affects immunocompromised individuals, including those with HIV, recipients of certain immunosuppressive therapies, and transplant patients. The treatment options for HPyV infections have been limited, but recent developments in virus-specific T cell (VST) therapy have shown promise. Although VST therapy has shown potential in treating both BKPyV and JCPyV infections, several challenges remain. These include the time-consuming and costly preparation of VSTs, the need for sophisticated production facilities, and uncertainties regarding the optimal cell type and infusion frequency. To the best of our knowledge, 85 patients with haemorrhagic cystitis, 27 patients with BKPyV viremia, 2 patients with BKPyV nephritis, 14 patients with haemorrhagic cystitis and BKPyV viremia, and 32 patients with PML have been treated with VST in the literature. The overall response results were 82 complete response, 33 partial response, 35 no response, and 10 no-outcome-reported. This review underscores the importance of VST therapy as a promising treatment approach for polyomavirus infections, emphasising the need for continued research and clinical trials to refine and expand this innovative immunotherapeutic strategy.
多瘤病毒是一组小的、无包膜的、双链 DNA 病毒，可感染多种宿主，包括人类。BKPyV 可引起人类多瘤病毒相关性肾病 (HPyVAN)、人类多瘤病毒相关性出血性膀胱炎 (HPyVHC) 和人类多瘤病毒相关性尿路上皮癌 (HPyVUC) 等疾病。另一方面，JC 多瘤病毒 (JCPyV) 是进行性多灶性白质脑病 (PML) 的病原体，PML 是一种严重的中枢神经系统脱髓鞘疾病。PML 主要影响免疫功能低下的个体，包括 HIV 感染者、接受某些免疫抑制治疗的患者和移植患者。HPyV 感染的治疗选择有限，但最近病毒特异性 T 细胞 (VST) 治疗的发展显示出了希望。尽管 VST 治疗在治疗 BKPyV 和 JCPyV 感染方面显示出了潜力，但仍存在一些挑战。这些挑战包括 VST 的制备耗时且昂贵、需要复杂的生产设施以及关于最佳细胞类型和输注频率的不确定性。据我们所知，文献中有 85 例出血性膀胱炎患者、27 例 BKPyV 血症患者、2 例 BKPyV 肾炎患者、14 例出血性膀胱炎和 BKPyV 血症患者以及 32 例 PML 患者接受了 VST 治疗。总体反应结果为 82 例完全缓解、33 例部分缓解、35 例无反应和 10 例未报告结果。本综述强调了 VST 治疗作为一种有前途的多瘤病毒感染治疗方法的重要性，强调需要继续进行研究和临床试验，以完善和扩展这种创新的免疫治疗策略。
