Davidson Lachlan A, Niessen Natalie M, Rowlandson Matthew, Myint Thida M, Trevillian Paul R, Hibberd Adrian D, Heer Munish K, Horvat Jay C, Baines Katherine J
School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia.
Immune Health Research Programme, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
Pathog Dis. 2025 Jan 30;83. doi: 10.1093/femspd/ftaf006.
BK polyomavirus (BKPyV) infection reactivates with immunosuppressive therapies and can lead to the development of BKPyV-associated nephropathy (BKPyVAN) in kidney transplant recipients. This scoping review assesses the use of transcriptomics to profile BKPyVAN in kidney transplant recipients. The following search strategy was employed in Medline and Embase: 'BK virus' or 'BK polyomavirus' or 'Polyomavirus' AND 'Kidney transplant' or 'Nephritis' or 'Nephropathy' AND 'Gene expression' or 'Transcriptomics' or 'mRNA'. The search identified 368 publications (264 EMBASE and 104 MEDLINE), and after removal of duplicates (92) and abstract/full-text screening, there were 11 eligible studies which included 7 original transcriptomic studies and 4 bioinformatic studies. There was consistent dysregulated expression of proinflammatory pathways (e.g. cytokines, chemokines, T- and B-cell-related pathways) in BKPyVAN compared with stable graft function. There was considerable overlap between the gene expression patterns identified in BKPyVAN and T-cell mediated rejection that require more exploration. This review highlights limitations including small sample sizes, lack of validation, and variation in technical platforms and study designs. Transcriptomics in BKPyVAN is currently underutilized and there is a genuine need for further research in larger cohorts to provide action in discovering novel therapeutic targets and discriminative gene expression signatures to guide individualized therapeutic strategies.
BK多瘤病毒（BKPyV）感染会因免疫抑制疗法而重新激活，并可能导致肾移植受者发生BK多瘤病毒相关性肾病（BKPyVAN）。本综述评估了转录组学在肾移植受者中对BKPyVAN进行分析的应用情况。在Medline和Embase中采用了以下检索策略：“BK病毒”或“BK多瘤病毒”或“多瘤病毒” 与 “肾移植” 或“肾炎”或“肾病” 与 “基因表达” 或“转录组学”或“mRNA”。检索共识别出368篇出版物（264篇来自EMBASE，104篇来自MEDLINE），在去除重复项（92篇）并经过摘要/全文筛选后，有11项符合条件的研究，其中包括7项原始转录组学研究和4项生物信息学研究。与移植肾功能稳定相比，BKPyVAN中促炎途径（如细胞因子、趋化因子、T细胞和B细胞相关途径）的表达持续失调。BKPyVAN中鉴定出的基因表达模式与T细胞介导的排斥反应之间存在相当大的重叠，这需要进一步探索。本综述强调了一些局限性，包括样本量小、缺乏验证以及技术平台和研究设计的差异。BKPyVAN中的转录组学目前未得到充分利用，确实需要在更大的队列中进行进一步研究，以便在发现新的治疗靶点和鉴别性基因表达特征以指导个体化治疗策略方面采取行动。
