title: Immunity to Polyomavirus BK Infection: Immune Monitoring to Regulate the Balance between Risk of BKV Nephropathy and Induction of Alloimmunity.
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.
authors.affiliation: Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Comoli
authors.forename: Michela
authors.initials: M
authors.lastname: Cioni
authors.forename: Sabrina
authors.initials: S
authors.lastname: Basso
authors.forename: Chiara
authors.initials: C
authors.lastname: Gagliardone
authors.forename: Leonardo
authors.initials: L
authors.lastname: Potenza
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
authors.forename: Mario
authors.initials: M
authors.lastname: Luppi
authors.forename: Marco
authors.initials: M
authors.lastname: Zecca
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Ghiggeri
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ginevri
mesh_terms: D000818:Animals; D000920:Antibody-Dependent Cell Cytotoxicity; D001739:BK Virus / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007157:Immunologic Surveillance; D007167:Immunotherapy; D007674:Kidney Diseases / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control / Q000628:therapy / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control / Q000628:therapy; D014184:Transplantation, Homologous