Kidney and urinary tract polyomavirus infection and distribution: molecular biology investigation of 10 consecutive autopsies.
BACKGROUND
Distinct human polyomavirus genotypes cause different diseases in patients with renal transplants: BK virus (BKV) causes tubulointerstitial nephritis and ureteral stenosis, whereas both JC virus (JCV) and BKV are responsible for hemorrhagic cystitis. These findings could result from a selective infection of kidney and urinary tract segments by JCV or BKV.


OBJECTIVE
To verify this hypothesis, 10 complete, unselected, consecutive autopsies from 9 immunocompetent patients and 1 patient affected by acquired immunodeficiency syndrome were investigated.


METHODS
Samples from kidneys (n = 80), renal pelvis (n = 20), ureter (n = 40), and urinary bladder (n = 30) obtained from 10 consecutive autopsies were investigated by means of multiplex nested polymerase chain reaction to detect polyomavirus DNA and to distinguish different species of the Polyomavirus genus. In situ hybridization and immunohistochemistry were also carried out to define the viral status of the infected tissues.


RESULTS
Polyomavirus DNA was detected in all of the subjects (positive samples ranging from 2 to 7 samples), for a total of 43 of 170 samples (25.3%), distributed as follows: urinary bladder (10/30, 33%), renal pelvis (6/20, 30%), ureter (10/40, 25%), and kidney tissue (17/80, 21%). We found that JCV was most frequently detected overall (23/43 samples, 53.5%) and was also detected most frequently within the kidney (8/17 positive samples, 47%), the renal pelvis (5/6 positive samples, 70%), and the ureter (7/10 positive samples, 70%), whereas BKV was found in 14 samples (32.5%), and it was the prevailing genotype in urinary bladder (6/10 positive samples, 60%). Coinfection of BKV-JCV was found in 6 samples (14%). Immunohistochemistry and in situ hybridization returned negative results.


CONCLUSIONS
The viruses JCV and BKV latently persist randomly in kidney and urinary tract. Distinct diseases induced by them could be related more closely to molecular viral rearrangements than to the topographic distribution of latent viruses.
Boldorini
Renzo
R
Department of Medical Science, University School of Medicine Amedeo Avogadro of Eastern Piedmont, Novara, Italy. renzo.boldorini@med.unipmn.it <renzo.boldorini@med.unipmn.it>
Veggiani
Claudia
C
Barco
Diana
D
Monga
Guido
G
D000163:Acquired Immunodeficiency Syndrome / Q000821:virology; D000368:Aged; D001344:Autopsy; D001739:BK Virus / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007577:JC Virus / Q000235:genetics / Q000302:isolation & purification; D007682:Kidney Pelvis / Q000473:pathology / Q000821:virology; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D008967:Molecular Biology / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000379:methods; D011120:Polyomavirus / Q000235:genetics / Q000302:isolation & purification*; D027601:Polyomavirus Infections / Q000473:pathology; D014412:Tumor Virus Infections / Q000473:pathology; D014513:Ureter / Q000473:pathology / Q000821:virology; D001743:Urinary Bladder / Q000473:pathology / Q000821:virology; D014552:Urinary Tract Infections / Q000821:virology
D004279:DNA, Viral