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Review
. 2013:2013:256923.
doi: 10.1155/2013/256923. Epub 2013 Aug 13.

Immunity to Polyomavirus BK Infection: Immune Monitoring to Regulate the Balance between Risk of BKV Nephropathy and Induction of Alloimmunity

Patrizia Comoli  1 , Michela Cioni, Sabrina Basso, Chiara Gagliardone, Leonardo Potenza, Enrico Verrina, Mario Luppi, Marco Zecca, Gian Marco Ghiggeri, Fabrizio Ginevri
Affiliations
Review

Immunity to Polyomavirus BK Infection: Immune Monitoring to Regulate the Balance between Risk of BKV Nephropathy and Induction of Alloimmunity

Patrizia Comoli et al. Clin Dev Immunol. 2013.

Abstract

Polyomavirus BK-associated nephropathy (PyVAN) is the main infectious cause of allograft damage after kidney transplantation. A number of studies revealed an association between the presence of BKV-specific cellular immunity and BK viral clearance, with patients failing to recover specific T cells progressing to PyVAN. Evolution to allograft dysfunction can be prevented by restoration of BKV-specific immunity through a stepwise reduction of maintenance immunosuppressive drugs. Prospective monitoring of BK viral load and specific immunity, together with B-cell alloimmune surveillance, may allow a targeted modification/reduction of immunosuppression, with the aim of obtaining viral clearance while preventing graft injury due to deposition of de novo donor-specific HLA antibodies and late/chronic antibody-mediated allograft injury. Innovative, immune-based therapies may further contribute to BKV infection prevention and control.

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