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BK Polyomavirus Nephropathy in Kidney Transplantation: Balancing Rejection and Infection.


ABSTRACT: BK polyomavirus nephropathy (BKVN) and allograft rejection are two closely-associated diseases on opposite ends of the immune scale in kidney transplant recipients. The principle of balancing the immune system remains the mainstay of therapeutic strategy. While patient outcomes can be improved through screening, risk factors identification, and rapid reduction of immunosuppressants, a lack of standard curative therapy is the primary concern during clinical practice. Additionally, difficulty in pathological differential diagnosis and clinicopathology's dissociation pose problems for a definite diagnosis. This article discusses the delicate evaluation needed to optimize immunosuppression and reviews recent advances in molecular diagnosis and immunological therapy for BKVN patients. New biomarkers for BKVN diagnosis are under development. For example, measurement of virus-specific T cell level may play a role in steering immunosuppressants. The development of cellular therapy may provide prevention, even a cure, for BKVN, a complex post-transplant complication.

SUBMITTER: Shen CL 

PROVIDER: S-EPMC7998398 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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BK Polyomavirus Nephropathy in Kidney Transplantation: Balancing Rejection and Infection.

Shen Chia-Lin CL   Wu Bo-Sheng BS   Lien Tse-Jen TJ   Yang An-Hang AH   Yang Chih-Yu CY  

Viruses 20210316 3


BK polyomavirus nephropathy (BKVN) and allograft rejection are two closely-associated diseases on opposite ends of the immune scale in kidney transplant recipients. The principle of balancing the immune system remains the mainstay of therapeutic strategy. While patient outcomes can be improved through screening, risk factors identification, and rapid reduction of immunosuppressants, a lack of standard curative therapy is the primary concern during clinical practice. Additionally, difficulty in p  ...[more]

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