title: Investigation of polyomaviruses replication in pediatric patients with nephropathy receiving rituximab.
abstract: Rituximab is a chimeric monoclonal antibody reacting with the CD20 antigen on B cells. It has been proposed as treatment for the idiopathic nephrotic syndrome, recurrent idiopathic nephropathy, and focal segmental glomerulosclerosis refractory to steroids. Rituximab influences T-cell immunity and may predispose the patients to opportunistic infections, such as progressive multifocal leukoencephalopathy caused by the polyomavirus JC (JCV). The risk of latent viruses infections/reactivations in pediatric patients receiving monoclonal antibodies is not well known yet. In this longitudinal 6-month study, the effects of rituximab on JCV and BK virus (BKV) replication have been investigated. Blood, serum, and urine samples have been collected monthly from 11 pediatric patients (mean age: 11 years) with the idiopathic nephrotic syndrome and recurrent idiopathic nephropathy, under rituximab therapy. JCV and BKV real-time PCRs and sequencing of the viral protein 1 and the non-coding control region have been conducted. The same investigations have been undertaken on samples collected from eight pediatric patients (controls, mean age: 6 years), with idiopathic nephrotic syndrome or focal segmental glomerulosclerosis, treated with conventional chemotherapy. JCV was detected in the urine of one patient (9%), and one control (12.5%); BKV was found in the urine of 7/11 patients (63.6%) and 2/8 controls (25%) and in blood samples from four patients. No significant difference was found in the mean viral loads and in the viral molecular characterizations between the two groups. The polyomaviruses replication was not associated with rituximab therapy in children.
authors: Foundation Ettore Sansavini, Health Science Foundation, Lugo, Ravenna, Italy.
authors: Serena
authors: S
authors: Delbue
authors: Mariano
authors: M
authors: Ferraresso
authors: Francesca
authors: F
authors: Elia
authors: Mirco
authors: M
authors: Belingheri
authors: Camilla
authors: C
authors: Carloni
authors: Lucia
authors: L
authors: Signorini
authors: Silvia
authors: S
authors: Carluccio
authors: Simone
authors: S
authors: Dallari
authors: Luciana
authors: L
authors: Ghio
authors: Pasquale
authors: P
authors: Ferrante
mesh_terms: D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000494:pharmacology* / Q000627:therapeutic use; D001739:BK Virus / Q000235:genetics / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood / Q000652:urine; D005260:Female; D005838:Genotype; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use; D007577:JC Virus / Q000235:genetics / Q000502:physiology*; D016030:Kidney Transplantation / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D058889:Molecular Typing; D009404:Nephrotic Syndrome / Q000097:blood* / Q000652:urine / Q000821:virology; D027601:Polyomavirus Infections / Q000097:blood / Q000652:urine / Q000821:virology; D012045:Regulatory Sequences, Nucleic Acid; D000069283:Rituximab; D017422:Sequence Analysis, DNA; D014412:Tumor Virus Infections / Q000097:blood / Q000652:urine / Q000821:virology; D014764:Viral Proteins / Q000235:genetics; D014775:Virus Activation; D014779:Virus Replication
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D004279:DNA, Viral; D007155:Immunologic Factors; D014764:Viral Proteins; D000069283:Rituximab