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https://www.readbyqxmd.com/read/28298471/bk-polyomavirus-clinical-aspects-immune-regulation-and-emerging-therapies
#1
REVIEW
George R Ambalathingal, Ross S Francis, Mark J Smyth, Corey Smith, Rajiv Khanna
BK polyomavirus (BKV) causes frequent infections during childhood and establishes persistent infections within renal tubular cells and the uroepithelium, with minimal clinical implications. However, reactivation of BKV in immunocompromised individuals following renal or hematopoietic stem cell transplantation may cause serious complications, including BKV-associated nephropathy (BKVAN), ureteric stenosis, or hemorrhagic cystitis. Implementation of more potent immunosuppression and increased posttransplant surveillance has resulted in a higher incidence of BKVAN...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28295760/variability-in-assessing-for-bk-viremia-whole-blood-is-not-reliable-and-plasma-is-not-above-reproach-a-retrospective-analysis
#2
Neerja Agrawal, Ignacio A Echenique, Shane M Meehan, Ajit P Limaye, Linda Cook, Anthony Chang, Robert C Harland, Basit Javaid, Pradeep V Kadambi, Scott Matushek, James Williams, Michelle A Josephson
Polyomavirus nephropathy (PVN) is a major complication of kidney transplantation. Most reports describe polyomavirus viremia either precedes or is detectable at the time of diagnosis of PVN. This association is the basis of current screening recommendations. We retrospectively reviewed the PCR results of blood and urine samples from 29 kidney transplant recipients with biopsy proven PVN. Biopsies were performed for a rise in serum creatinine or persistent high-level BK viruria. All biopsies had polyoma virus large T-antigen expression in tubular epithelium by immunohistochemistry...
March 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28280692/influence-of-tacrolimus-metabolism-rate-on-renal-function-after-solid-organ-transplantation
#3
REVIEW
Gerold Thölking, Hans Ulrich Gerth, Katharina Schuette-Nuetgen, Stefan Reuter
The calcineurin inhibitor (CNI) tacrolimus (TAC) is an integral part of the immunosuppressive regimen after solid organ transplantation. Although TAC is very effective in prevention of acute rejection episodes, its highly variable pharmacokinetic and narrow therapeutic window require frequent monitoring of drug levels and dose adjustments. TAC can cause CNI nephrotoxicity even at low blood trough levels (4-6 ng/mL). Thus, other factors besides the TAC trough level might contribute to CNI-related kidney injury...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28265581/impact-of-desensitization-on-antiviral-immunity-in-hla-sensitized-kidney-transplant-recipients
#4
Mieko Toyoda, Bong-Ha Shin, Shili Ge, James Mirocha, David Thomas, Maggie Chu, Edgar Rodriguez, Christine Chao, Anna Petrosyan, Odette A Galera, Ashley Vo, Jua Choi, Alice Peng, Joseph Kahwaji, Stanley C Jordan
Viral infections represent significant morbidity and mortality factors in kidney transplant recipients, with CMV, EBV, and BKV infections being most common. Desensitization (DES) with IVIg and rituximab with/without plasma exchange followed by kidney transplantation with alemtuzumab induction increased successful transplant rates in HLA-sensitized patients but may represent an increased risk for viral infections due to severe lymphocyte depletion. Here, we report on the posttransplant viral infection status in 372 DES versus 538 non-DES patients...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28247238/clinical-pharmacokinetic-monitoring-of-leflunomide-in-renal-transplant-recipients-with-bk-virus-reactivation-a-review-of-the-literature
#5
REVIEW
Joan C Y Ng, Marianna Leung, Alissa J Wright, Mary H H Ensom
Leflunomide is an immunosuppressive drug with in vitro and initial observational evidence of antiviral activity against BK virus (BKV), a pathogen that causes opportunistic infection upon reactivation in renal transplant recipients. Leflunomide is considered an ancillary option to immunosuppression reduction in the management of BKV reactivation. Plasma or blood concentrations of teriflunomide, the active metabolite of leflunomide, are commonly monitored because of high leflunomide doses being used, known inter-individual variability in pharmacokinetics, and hepatotoxicity risk...
February 28, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28221173/new-developments-in-transplant-proteomics
#6
Julie Ho, Patricia Hirt-Minkowski, John A Wilkins
PURPOSE OF REVIEW: Despite modern immunosuppression, renal allograft rejection remains a major contributor to graft loss. Novel biomarkers may help improve posttransplant outcomes through the early detection and treatment of rejection. Our objective is to provide an overview of proteomics, review recent discovery-based rejection studies, and explore innovative approaches in biomarker development. RECENT FINDINGS: Urine MMP7 was identified as a biomarker of subclinical and clinical rejection using two-dimensional liquid chromatography tandem-mass spectrometry (LC-MS/MS) and improved the overall diagnostic discrimination of urine CXCL10 : Cr alone for renal allograft inflammation...
February 17, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28209721/the-cumulative-burden-of-double-stranded-dna-virus-detection-after-allogeneic-hct-is-associated-with-increased-mortality
#7
Joshua A Hill, Bryan T Mayer, Hu Xie, Wendy M Leisenring, Meei-Li Huang, Terry Stevens-Ayers, Filippo Milano, Colleen Delaney, Mohamed L Sorror, Brenda M Sandmaier, Garrett Nichols, Danielle M Zerr, Keith R Jerome, Joshua T Schiffer, Michael Boeckh
Strategies to prevent active infection with certain double-stranded DNA (dsDNA) viruses after allogeneic hematopoietic cell transplantation (HCT) are limited by incomplete understanding of their epidemiology and clinical impact. We retrospectively tested weekly plasma samples from allogeneic HCT recipients at our center from 2007-2014. We used quantitative PCR to test for cytomegalovirus (CMV), BK polyomavirus (BKV), human herpesvirus 6B (HHV-6B), HHV-6A, adenovirus (AdV), and Epstein-Barr virus (EBV) between days 0-100 post-HCT...
February 16, 2017: Blood
https://www.readbyqxmd.com/read/28207975/stabilization-of-renal-function-after-the-first-year-of-follow-up-in-kidney-transplant-recipients-treated-for-significant-bk-polyomavirus-infection-or-bk-polyomavirus-associated-nephropathy
#8
Marie-Christine Simard-Meilleur, Paule Bodson-Clermont, Gilles St-Louis, Michel R Pâquet, Catherine Girardin, Marie-Chantal Fortin, Héloïse Cardinal, Marie-Josée Hébert, Reneé Lévesque, Edith Renoult
BACKGROUND: BK polyomavirus virus (BKPyV) screening and immunosuppression reduction effectively prevent graft loss due to BKPyV-associated nephropathy (BKPVAN) during the first year after transplantation. The aim of our study was to evaluate the impact of this infection during longer follow-up periods. METHODS: We reviewed the outcome of our screening and immunosuppression reduction protocol in 305 patients who received a kidney transplant between March 2008 and January 2013...
February 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28191298/asymptomatic-epstein-barr-virus-shedding-in-the-urine-of-kidney-transplant-recipients-case-reports-and-review-of-the-literature
#9
Maryam Rahbar, Gholamreza Poormand, Masoud Karkhaneh Mahmoodi, Aboozar Jazayeri, Seyed Mohammad Jazayeri
Epstein-Barr virus (EBV) is associated with a wide range of malignancies and complications like post-transplant lymphoproliferative disorder (PTLD). To suppress active EBV infection in transplant recipients, who are at a heightened risk of developing PTLD, EBV DNAemia monitoring has been recommended. Quantitative multiplex real time polymerase chain reaction (QMRTPCR) offered the advantage of detection of more than one target in the same sample. We present four cases of kidney transplant recipient who were admitted for rising serum creatinine between 9 and 20 months post-transplant with a suspicion of BKV-associated nephropathy...
December 31, 2016: Infectious Disease Reports
https://www.readbyqxmd.com/read/28160729/comparison-of-emag%C3%A2-versus-nuclisens-%C3%A2-easymag-%C3%A2-performance-on-clinical-specimens
#10
Magali Garcia, Céline Chessa, Anne Bourgoin, Geneviève Giraudeau, Chloé Plouzeau, Gérard Agius, Nicolas Lévêque, Agnès Beby-Defaux
BACKGROUND: eMAG™ (bioMerieux) is a new nucleic acid extraction platform based on magnetic silica technology, like its predecessor, NucliSENS(®) easyMAG(®) (bioMerieux). Using the same reagents and disposables, eMAG™ adds further automation, allowing simultaneous extraction of 48 samples directly from primary tubes, and distribution of nucleic acid extracts on PCR strips or in tubes at the end of the extraction process. OBJECTIVE: To compare the performance of eMAG™ and easyMAG(®) on various clinical specimens...
March 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28151406/a-simple-and-reliable-strategy-for-bk-virus-subtyping-and-subgrouping
#11
Virginie Morel, Elodie Martin, Catherine François, François Helle, Justine Faucher, Thomas Mourez, Gabriel Choukroun, Gilles Duverlie, Sandrine Castelain, Etienne Brochot
BK virus-associated diseases in transplant recipients is an emerging issue. However, identification of the various BK virus subtypes/subgroups is a long and delicate process on the basis of the currently available data. We therefore wanted to define a simple and effective one-step strategy to characterize all BK virus strains from the VP1 gene sequence. Based on the analysis of 199 available complete DNA VP1 sequences, phylogenetic trees, alignments and isolated polymorphisms were used to define an effective strategy to distinguish the twelve different BK virus subtypes/subgroups...
February 1, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28129450/viral-encephalitis-after-haplo-identical-hematopoietic-stem-cell-transplantation-causative-viral-spectrum-characteristics-and-risk-factors
#12
Xiao-Hui Zhang, Jia-Min Zhang, Wei Han, Huan Chen, Yu-Hong Chen, Feng-Rong Wang, Jing-Zhi Wang, Yuan-Yuan Zhang, Xiao-Dong Mo, Yao Chen, Yu Wang, Ying-Jun Chang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang
OBJECTIVE: To retrospectively identify characteristics and risk factors of viral encephalitis (VE) in patients who underwent a haplo-identical hematopoietic stem cell transplant (HSCT). METHODS: A nested case-control study was designed. Cases with VE and controls were identified from a cohort composed of 1274 patients who underwent a haplo-identical HSCT from 2012 to 2015. RESULTS: VE was identified in 30 patients (2.4%).The median time from HSCT to diagnosis was 144...
January 27, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28100494/quantification-of-bk-virus-standards-by-quantitative-real-time-pcr-and-droplet-digital-pcr-is-confounded-by-multiple-virus-populations-in-the-who-bkv-international-standard
#13
Allen C Bateman, Alexander L Greninger, Ederlyn E Atienza, Ajit P Limaye, Keith R Jerome, Linda Cook
BACKGROUND: The WHO recently released a BK virus (BKV) international standard. This study evaluated the WHO international standard and commercially available BKV standards by quantitative real-time PCR (qPCR) and droplet digital PCR (ddPCR). METHODS: WHO, Exact Diagnostics, Acrometrix, and Zeptometrix BKV standards were tested by qPCR and ddPCR. Two preparations of NIST BKV clones were also tested. Nucleic acid was extracted with the Roche MP96 and MPLC, followed by quantification in duplicate...
January 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28053213/calibration-of-bk-virus-nucleic-acid-amplification-testing-to-the-1st-who-international-standard-for-bk-virus
#14
Susanna K Tan, Stephen Milligan, Malaya K Sahoo, Nathaniel Taylor, Benjamin A Pinsky
Significant interassay variability in the quantification of BK virus (BKV) DNA precludes establishing broadly applicable thresholds for the management of BKV infection in transplantation. The 1st WHO International Standard for BKV (primary standard) was introduced in 2016 as a common calibrator for improving the harmonization of BKV nucleic acid amplification testing (NAAT) and enabling comparisons of biological measurements worldwide. Here, we evaluated the Altona RealStar BKV assay (Altona) and calibrated the results to the international unit (IU) using the Exact Diagnostics BKV verification panel, a secondary standard traceable to the primary standard...
March 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27982631/quantum-critical-scaling-in-the-disordered-itinerant-ferromagnet-uco_-1-x-fe_-x-ge
#15
K Huang, S Eley, P F S Rosa, L Civale, E D Bauer, R E Baumbach, M B Maple, M Janoschek
The Belitz-Kirkpatrick-Vojta (BKV) theory shows in excellent agreement with experiment that ferromagnetic quantum phase transitions (QPTs) in clean metals are generally first order due to the coupling of the magnetization to electronic soft modes, in contrast to the classical analogue that is an archetypical second-order phase transition. For disordered metals the BKV theory predicts that the second-order nature of the QPT is restored because the electronic soft modes change their nature from ballistic to diffusive...
December 2, 2016: Physical Review Letters
https://www.readbyqxmd.com/read/27925350/a-kidney-transplant-recipient-with-renal-medullary-viral-cytopathic-changes
#16
Poornima Ramanan, Elizabeth A Timmerman, Mary E Fidler, Hatem Amer, Bobbi S Pritt, Dale A Schwab, Hollis J Batterman, Matthew J Binnicker
We present a case of JC polyomavirus (JCV)-associated nephropathy (PyVAN) in an asymptomatic deceased-donor kidney transplant recipient. Despite the presence of viral cytopathic effect in the kidney biopsy and positive BK polyomavirus (BKV) in situ hybridization (ISH), BKV real-time polymerase chain reaction (PCR) results of plasma and urine were negative. JCV ISH was performed and was found to be positive. JCV real-time PCR on urine, plasma, and the kidney biopsy tissue was positive. Reduction in immunosuppression resulted in resolution of JCV viremia...
December 7, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27910187/ureteral-stent-duration-and-the-risk-of-bk-polyomavirus-viremia-or-bacteriuria-after-kidney-transplantation
#17
Jonathan T Wingate, Jared Brandenberger, Andrew Weiss, Lauren G Scovel, Christian S Kuhr
OBJECTIVES: Ureteral stents are used in kidney transplantation (KTX) to decrease post-operative complications, but they are associated with BK polyomavirus viremia (BKV). Our primary outcome was to determine the association between ureteral stent duration and BKV. Secondary outcome measures were the association between bacteriuria and stent duration or use of ureteral stent strings. METHODS: Between January 2010 and January 2015, 403 patients underwent KTX at the Virginia Mason Medical Center and met inclusion criteria...
December 2, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27872831/outcomes-of-renal-transplant-recipients-with-bk-virus-infection-and-bk-virus-surveillance-in-the-auckland-region-from-2006-to-2012
#18
Chun-Yuan Hsiao, Helen L Pilmore, Lifeng Zhou, Janak R de Zoysa
AIM: To evaluate incidence, risk factors and treatment outcome of BK polyomavirus nephropathy (BKVN) in a cohort of renal transplant recipients in the Auckland region without a formal BK polyomavirus (BKV) surveillance programme. METHODS: A cohort of 226 patients who received their renal transplants from 2006 to 2012 was retrospectively reviewed. RESULTS: Seventy-six recipients (33.6%) had a BK viral load (BKVL) test and 9 patients (3.9%) developed BKVN...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27854236/correlation-of-bk-virus-neutralizing-serostatus-with-the-incidence-of-bk-viremia-in-kidney-transplant-recipients
#19
Johanna R Abend, Marguerite Changala, Atul Sathe, Fergal Casey, Amy Kistler, Sindhu Chandran, Abigail Howard, David Wojciechowski
BACKGROUND: BK virus (BKV)-associated nephropathy is the second leading cause of graft loss in kidney transplant recipients. Due to the high prevalence of persistent infection with BKV in the general population, it is possible that either the transplant recipient or donor may act as the source of virus resulting in viruria and viremia. Although several studies suggest a correlation between donor-recipient serostatus and the development of BK viremia, specific risk factors for BKV-related complications in the transplant setting remain to be established...
June 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27852673/progress-in-quantitative-viral-load-testing-variability-and-impact-of-the-who-quantitative-international-standards
#20
R T Hayden, Y Sun, L Tang, G W Procop, D R Hillyard, B A Pinsky, S A Young, A M Caliendo
It has been hoped that the recent availability of WHO quantitative standards would improve interlaboratory agreement for viral load testing; however, insufficient data are available to evaluate whether this has been the case. Results from 554 laboratories participating in proficiency testing surveys for quantitative PCR assays of cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK virus (BKV), adenovirus (ADV), and human herpesvirus 6 (HHV6) were evaluated to determine overall result variability and then were stratified by assay manufacturer...
February 2017: Journal of Clinical Microbiology
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