Clinical and immunological characteristics for BK polyomavirus-associated nephropathy after kidney transplantation
Issued Date
2023-08-01
Resource Type
eISSN
20504527
DOI
Scopus ID
2-s2.0-85169166727
Journal Title
Immunity, Inflammation and Disease
Volume
11
Issue
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Immunity, Inflammation and Disease Vol.11 No.8 (2023)
Suggested Citation
Siripoon T., Apiwattanakul N., Mongkolrattanakul P., Tongsook C., Unwanatham N., Hongeng S., Kantachuvesiri S., Bruminhent J. Clinical and immunological characteristics for BK polyomavirus-associated nephropathy after kidney transplantation. Immunity, Inflammation and Disease Vol.11 No.8 (2023). doi:10.1002/iid3.956 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/89379
Title
Clinical and immunological characteristics for BK polyomavirus-associated nephropathy after kidney transplantation
Other Contributor(s)
Abstract
Introduction: BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) can cause a significant risk of allograft impairment after kidney transplantation (KT). Intact BKPyV-specific immunity is associated with viral containment. This study investigated BKPyV-specific immunological factors among KT recipients. Methods: This prospective study in a single transplant center from January 2019 to August 2019 assessed associations between clinical and immunological characteristics, with a focus on BKPyV-cell-specific immunity and BKPyVAN, among KT recipients aged ≥15 years. The numbers of interferon-gamma (IFN-γ)-producing CD4+ T, CD8+ T, natural killer (NK), and natural killer T (NKT) cells were measured after stimulation with large T antigen and viral capsid protein 1 (VP1). Results: In total, 100 KT recipients were included (mean age ± SD, 42 ± 11 years); 35% of the recipients were female patients, and 70% had received induction immunosuppressive therapy. The 1-year cumulative incidence of high-level BKPyV DNAuria (possible BKPyVAN) and (presumptive BKPyVAN) was 18%. Among 40 patients with immunological factor data, pre-KT %NK cells (hazard ratio [HR], 1.258; 95% confidence interval [CI], 1.077–1.469; p =.004) and %VP1-specific NK cells (HR, 1.209; 95% CI, 1.055–1.386; p =.006) were factors independently associated with possible and presumptive BKPyVAN. KT recipients with possible and presumptive BKPyVAN were more likely to exhibit significant mean coefficients of %NK, %VP1-specific NK, and %NKT cells at 1 month after KT than before KT (all p <.05). Conclusion: Individuals with nonspecific and VP1-specific NK cells before KT and increasing numbers of these cells after KT may be at risk for high-level BKPyV DNAuria and presumptive BKPyVAN. Further studies are needed to determine the utility of BKPyV-specific innate immune surveillance in predicting the occurrence of BKPyVAN.