title: Immunophenotyping in BK virus allograft nephropathy distinct from acute rejection.
abstract: Differentiating BK virus nephropathy (BKVN) from acute rejection (AR) is crucial in clinical practice, as both of them have interstitial inflammation in the grafts. The purpose of the study is to describe the inflammatory cellular constituents of BKVN and to determine the clinical utility of immunophenotyping findings in distinguishing BKVN from AR. In addition, the expression of the HLA-DR was investigated. Sixty-five renal allograft recipients were included in this study, including 22 cases of BKVN, 31 cases of AR, and 12 cases of stable allograft. Immunostaining for infiltrating lymphocytes showed that the number of CD20 cells (P < 0.001) and the percentages of CD3 (P < 0.001), CD4 (P = 0.004), CD8 (P = 0.005), and CD20 (P = 0.002) cells were all significantly different between BKVN and AR. Moreover, there were no statistically significant differences in tubule cell HLA-DR expression (P = 0.156). This observation suggests that the number of CD20 cells and the percentages of CD3, CD4, CD8, and CD20 cells in renal biopsies would aid the distinction between BKVN and AR. On the other hand, the presence of HLA-DR upregulation may not only be specific for acute rejection but also be a response to BKVN.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing University Clinical School of Medicine, 305 East Zhong Shan Road, Nanjing 210002, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.forename: Qiquan
authors.initials: Q
authors.lastname: Sun
authors.forename: Jinsong
authors.initials: J
authors.lastname: Chen
authors.forename: Shuming
authors.initials: S
authors.lastname: Ji
authors.forename: Jiqiu
authors.initials: J
authors.lastname: Wen
authors.forename: Dongrei
authors.initials: D
authors.lastname: Cheng
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D064591:Allografts / Q000276:immunology / Q000378:metabolism* / Q000821:virology*; D001739:BK Virus; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D016130:Immunophenotyping; D007249:Inflammation / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000821:virology; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000821:virology; D007674:Kidney Diseases / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism* / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000276:immunology / Q000378:metabolism*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006684:HLA-DR Antigens