期刊
VIRUSES-BASEL
卷 13, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/v13030487
关键词
BK polyomavirus nephropathy; kidney transplant; acute rejection; immunosuppressants; tacrolimus
类别
资金
- Yin Yen-Liang Foundation Development and Construction Plan of the School of Medicine, National Yang-Ming University, Taipei, Taiwan [107F-M01-0504]
- Ministry of Science and Technology (MOST), Taiwan [MOST 105-2628-B-075-008-MY3, MOST 108-2633-B-009-001, MOST 109-2314-B-010-053-MY3, MOST 109-2811-B-010-532, MOST 109-2321-B-009-007]
- Taipei Veterans General Hospital, Taipei, Taiwan [V106D25-003-MY3, VGHUST107-G5-3-3, VGHUST109-V5-1-2, V110C-194]
- Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B) from The Featured Areas Research Center Program within Ministry of Education (MOE) in Taiwan
BK polyomavirus nephropathy (BKVN) and allograft rejection are two closely-associated diseases in kidney transplant recipients, requiring a balanced immune system for treatment. While there is currently no standard curative therapy, patient outcomes can be improved through screening and reduction of immunosuppressants. New biomarkers and cellular therapy are being developed for the diagnosis and treatment of BKVN.
BK polyomavirus nephropathy (BKVN) and allograft rejection are two closely-associated diseases on opposite ends of the immune scale in kidney transplant recipients. The principle of balancing the immune system remains the mainstay of therapeutic strategy. While patient outcomes can be improved through screening, risk factors identification, and rapid reduction of immunosuppressants, a lack of standard curative therapy is the primary concern during clinical practice. Additionally, difficulty in pathological differential diagnosis and clinicopathology's dissociation pose problems for a definite diagnosis. This article discusses the delicate evaluation needed to optimize immunosuppression and reviews recent advances in molecular diagnosis and immunological therapy for BKVN patients. New biomarkers for BKVN diagnosis are under development. For example, measurement of virus-specific T cell level may play a role in steering immunosuppressants. The development of cellular therapy may provide prevention, even a cure, for BKVN, a complex post-transplant complication.
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