title: Genomics of BK viremia in kidney transplant recipients.
abstract: BACKGROUND
  This study aimed to investigate global gene expression profiles of BK viremia and nephropathy (BKVN) samples using microarrays to investigate the immunologic response to BK virus.
  
  
  METHODS
  Patients were monitored for BK viremia in the blood monthly for 6 months, then at 9 and 12 months after kidney transplantation. BKVN and normal transplant kidney biopsy samples, and whole blood samples of patients with and without BK viremia were analyzed by Affymetrix Human Gene 1.0 ST Arrays.
  
  
  RESULTS
  During a mean follow-up of 917±325 days, 61 of the 289 patients (21%) developed BK viremia at a median 149 (27, 1,113) days after transplantation with a median peak PCR titers of 35,900 (1,000, 2,677,000). The only significant risk factor for development of BK viremia was induction with anti-thymocyte globulin (P=0.03). Only four patients developed BKVN (1.3%). Pathogenesis-based transcript analysis revealed a significant increased expression of interferon-gamma and rejection induced (GRIT), quantitative cytotoxic T-cell (QCAT), quantitative constitutive and alternate macrophage, B-cell and natural killer cell-associated transcripts (NKAT), indicating an active inflammatory immune response in BKVN biopsies (n=3) compared to normal transplant kidney biopsies with (n=3) and without BK viremia (n=11). The whole blood gene expression profiles of 19 BK viremia patients revealed significant increased expression of GRIT, QCAT, and NKAT compared to 14 patients without viremia.
  
  
  CONCLUSIONS
  The results showed increased activity of cytotoxic T cells and natural killer cells in BKVN and viremia samples resembling acute rejection and suggested the involvement of both adaptive and innate immunity.
authors: 1 Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, NY. 2 Renal Division, Montefiore Medical Center, The University Hospital for, Albert Einstein College of Medicine, Bronx, NY. 3 Department of Genetics, Division of Computational Genetics, Albert Einstein College of Medicine, Bronx, NY. 4 Address correspondence to: Enver Akalin, M.D., Montefiore Einstein Center for Transplantation, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467.
authors: Michelle
authors: M
authors: Lubetzky
authors: Yi
authors: Y
authors: Bao
authors: Pilib
authors: P
authors: O Broin
authors: Kwaku
authors: K
authors: Marfo
authors: Maria
authors: M
authors: Ajaimy
authors: Aws
authors: A
authors: Aljanabi
authors: Graciela
authors: G
authors: de Boccardo
authors: Aaron
authors: A
authors: Golden
authors: Enver
authors: E
authors: Akalin
mesh_terms: D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000737:chemistry; D001402:B-Lymphocytes / Q000166:cytology; D001739:BK Virus / Q000378:metabolism*; D001706:Biopsy; D005260:Female; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D015894:Genome, Human; D023281:Genomics; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D016030:Kidney Transplantation / Q000009:adverse effects*; D007694:Killer Cells, Natural / Q000166:cytology; D008264:Macrophages / Q000166:cytology; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis; D027601:Polyomavirus Infections / Q000235:genetics* / Q000276:immunology / Q000821:virology; D051437:Renal Insufficiency / Q000150:complications* / Q000235:genetics / Q000821:virology; D012307:Risk Factors; D013602:T-Lymphocytes, Cytotoxic / Q000166:cytology; D014412:Tumor Virus Infections / Q000235:genetics* / Q000276:immunology / Q000821:virology; D014766:Viremia / Q000235:genetics*
chemical_list: D000961:Antilymphocyte Serum; D007371:Interferon-gamma