title: BK Polyomavirus and the Transplanted Kidney: Immunopathology and Therapeutic Approaches.
abstract: BK polyomavirus is ubiquitous, with a seropositivity rate of over 75% in the adult population. Primary infection is thought to occur in the respiratory tract, but asymptomatic BK virus latency is established in the urothelium. In immunocompromised host, the virus can reactivate but rarely compromises kidney function except in renal grafts, where it causes a tubulointerstitial inflammatory response similar to acute rejection. Restoring host immunity against the virus is the cornerstone of treatment. This review covers the virus-intrinsic features, the posttransplant microenvironment as well as the host immune factors that underlie the pathophysiology of polyomavirus-associated nephropathy. Current and promising therapeutic approaches to treat or prevent this complication are discussed in relation to the complex immunopathology of this condition.
authors.affiliation: 1 Centre de Recherche de l'Hôpital Maisonneuve-Rosemont (CRHMR), Montreal, Canada. 2 Division of Nephrology, Department of Medicine, Hôpital Maisonneuve-Rosemont (HMR), Université de Montréal, Montreal, Quebec, Canada. 3 Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montreal, Quebec, Canada. 4 Division of Nephrology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, Quebec, Canada. 5 Faculty of Medicine, Institute of Infection, Immunity and Inflammation, University of Calgary, Calgary, AB, Canada. 6 Division of Hematology, Department of Medicine, Hôpital Maisonneuve-Rosemont (HMR), Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lamarche
authors.forename: Julie
authors.initials: J
authors.lastname: Orio
authors.forename: Suzon
authors.initials: S
authors.lastname: Collette
authors.forename: Lynne
authors.initials: L
authors.lastname: Senécal
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Hébert
authors.forename: Édith
authors.initials: É
authors.lastname: Renoult
authors.forename: Lee Anne
authors.initials: LA
authors.lastname: Tibbles
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Delisle
mesh_terms: D001739:BK Virus / Q000472:pathogenicity; D003713:Dendritic Cells / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D007674:Kidney Diseases / Q000188:drug therapy / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D027601:Polyomavirus Infections / Q000150:complications* / Q000276:immunology; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications* / Q000276:immunology; D014764:Viral Proteins / Q000502:physiology; D014775:Virus Activation; D017735:Virus Latency
chemical_list: D014764:Viral Proteins