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https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#1
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
May 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28536123/randomized-controlled-trial-of-mineralocorticoid-receptor-blockade-in-children-with-chronic-kidney-allograft-nephropathy
#2
Mara Medeiros, Luis Velásquez-Jones, Ana M Hernández, Guillermo Ramón-García, Saúl Valverde, Yolanda Fuentes, Arindal Vargas, Mauricio Patiño, Rosalba Pérez-Villalva, Juan Antonio Ortega-Trejo, Jonatan Barrera-Chimal, Norma A Bobadilla
BACKGROUND AND OBJECTIVES: We showed that mineralocorticoid receptor blockade (MRB) prevented acute and chronic cyclosporine nephropathy (CsA-Nx) in the rat. The aim of this translational study was to investigate the effect of long-term eplerenone administration on renal allograft function in children with biopsy-proven chronic allograft nephropathy (CAN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Renal transplant children <18 years, biopsy-proven CAN, and a GFR>40 ml/min per 1...
May 23, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28535782/bk-polyomavirus-nephropathy-in-two-kidney-transplant-patients-with-distinct-diagnostic-strategies-for-bk-virus-and-similar-clinical-outcomes-two-case-reports
#3
Ana Luisa Figueira Gouvêa, Rachel Ingrid Juliboni Cosendey, Ana Lucia Rosa Nascimento, Fabiana Rabe Carvalho, Andrea Alice Silva, Heleno Pinto de Moraes, Mayra Carrijo Rochael, Rafael Brandão Varella, Stephanie Gomes Almeida, Jorge Reis Almeida, Jocemir Ronaldo Lugon
BACKGROUND: BK polyomavirus-associated nephropathy is an important cause of post-transplantation renal failure. We present two cases of BK polyomavirus-associated nephropathy who were submitted to contrasting strategies of clinical follow-up to BK polyomavirus reactivation, but progressed to a similar final outcome. CASE PRESENTATION: Case 1 is a 37-year-old white man whose graft had never presented a good glomerular filtration rate function, with episodes of tacrolimus nephrotoxicity, and no urinary monitoring for BK polyomavirus; stage B BK polyomavirus-associated nephropathy was diagnosed by biopsy at 14 months post-transplant...
May 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28516112/hemorrhagic-cystitis-in-a-liver-transplant-recipient-secondary-to-bk-virus
#4
Faisal Kamal, Bilal Ali, Matthew Barnes, Sehrish Kamal, Satheesh Nair, Humberto Gonzalez
The association between BK virus infection and hemorrhagic cystitis (HC) in hematopoietic stem cell transplant (HSCT) recipients is well established. However, BK virus-associated HC has not been described in liver transplant (LT) recipients. We present a case of BK virus-associated HC in a LT recipient. Our patient presented with worsening liver function tests 2 years after transplantation and was found to have acute cellular rejection. He was treated with increased immunosuppression and subsequently developed hematuria...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28512328/tacrolimus-blood-level-fluctuation-predisposes-to-coexisting-bk-virus-nephropathy-and-acute-allograft-rejection
#5
Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28510315/bk-virus-nephropathy-revisited
#6
EDITORIAL
Michael Mengel
More than 20 years after its first description and increased morbidity under powerful immunosuppression, the understanding of the pathogenesis of BK polyomavirus induced allograft nephropathy (BKVN) has changed clinical practice in renal transplantation. Screening programs were introduced at most transplant centers causing the prevalence of BKVN to decrease. However, BK viremia is still found in 10-30% of renal allograft recipients with 1-10% developing BKVN. This article is protected by copyright. All rights reserved...
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#7
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28492728/evaluation-of-the-predisposition-and-clinical-impact-of-bk-virus-replication-in-kidney-transplant-patients
#8
Elviani B Moura, Silvia V Petzhold, Augusto R Amaral, Luciane M Deboni, Paulo H C DE França
The BK virus (BKV) produces a subclinical kidney infection in immunocompetent individuals. However, viremia may occur in kidney transplant patients with ongoing immunosuppression. BKV-associated nephropathy (BKVN) has no specific treatment and is a leading cause of organ transplant loss. In this study, we evaluated the predisposition and the clinical impact of BKV replication in kidney transplant patients during post-transplant monitoring in a reference institution in Brazil. Demographic, clinical and laboratory data generated during routine outpatient follow-up were retrospectively collected...
May 4, 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28480121/alchemy-a-web-2-0-real-time-quality-assurance-platform-for-human-immunodeficiency-virus-hepatitis-c-virus-and-bk-virus-quantitation-assays
#9
Emmanuel Agosto-Arroyo, Gina M Coshatt, Thomas S Winokur, Shuko Harada, Seung L Park
BACKGROUND: The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/28472480/characterizing-the-cellular-immune-response-to-parainfluenza-virus-3
#10
Paibel I Aguayo-Hiraldo, Reuben J Arasaratnam, Ifigeneia Tzannou, Manik Kuvalekar, Premal Lulla, Swati Naik, Caridad A Martinez, Pedro A Piedra, Juan F Vera, Ann M Leen
Parainfluenza virus (PIV) 3 infections are a major cause of morbidity and mortality in immunocompromised individuals with no approved therapies. Our group has demonstrated the safety and efficacy of adoptively transferred virus-specific T cells for the prevention and treatment of a broad range of viral infections including BK virus, cytomegalovirus, adenovirus, human herpesvirus 6 and Epstein-Barr virus. However, this approach is restricted to well-characterized viruses with known immunogenic/protective T cell target antigens, precluding extension to PIV-3...
May 2, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28460546/an-update-on-chemical-pharmacotherapy-options-for-the-prevention-of-kidney-transplant-rejection-with-a-focus-on-costimulation-blockade
#11
Florian Kälble, Matthias Schaier, Sebastian Schäfer, Caner Süsal, Martin Zeier, Claudia Sommerer, Christian Morath
The introduction of calcineurin inhibitors (CNI) has greatly improved graft survival in the past three decades. However, long-term graft survival is still limited due to chronic allograft injury and side-effects of immunosuppressive medication. Areas covered: The present overview gives an update on pharmacotherapeutic strategies after kidney transplantation. The main focus is on CNI-sparing regimens using co-stimulatory blockade and on new substances on the horizone. Expert opinion: CNI sparing regimens are well-established...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28452096/kidney-transplant-after-hematopoietic-cell-transplant-in-pediatrics-infectious-and-immunosuppressive-considerations
#12
Christen L Ebens, Angela R Smith, Priya S Verghese
Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis...
April 27, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28443094/serum-igg-antibodies-from-pregnant-women-reacting-to-mimotopes-of-simian-virus-40-large-t-antigen-the-viral-oncoprotein
#13
Elisa Mazzoni, Mariantonietta Di Stefano, Josè R Fiore, Federica Destro, Marco Manfrini, John Charles Rotondo, Maria V Casali, Fortunato Vesce, Pantaleo Greco, Gennaro Scutiero, Fernanda Martini, Mauro G Tognon
Simian virus 40 (SV40) large T antigen (LT) coding sequences were revealed in different human samples, whereas SV40 antibodies (Ab) were detected in human sera of cancer patients and healthy individuals, although with a lower prevalence. Previous studies carried out by the neutralization assay gave a SV40 seroprevalence, in the general population, up to 8%, although higher rates, 12%, were detected in kidney transplant children, in a group of HIV-positive patients, and in healthy females. In this study, serum samples from pregnant women, together with those from non-pregnant women, were analyzed to check the prevalence of IgG Ab reacting to SV40 LT antigens...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28438210/specific-and-quantitative-detection-of-human-polyomaviruses-bkpyv-and-jcpyv-in-the-healthy-pakistani-population
#14
Iqra Hussain, Fareeda Tasneem, Muhammed Umer, Ayesha Pervaiz, Muslim Raza, Muhammad Imran Arshad, Naveed Shahzad
BACKGROUND: The BK Polyomavirus (BKPyV) and JC polyomavirus (JCPyV) infections are widespread in human population and have been associated with severe kidney and brain disorders, respectively. The viruses remain latent primarily in reno-urinary tract, reactivating only in case of a compromised immune system. The seroepidemiology and molecular prevalence of BKPyV and JCPyV have been widely studied both in healthy and immunocompromised patients worldwide. However, data regarding the prevalence of these viruses in the immunocompetent or apparently healthy Pakistani population is lacking...
April 24, 2017: Virology Journal
https://www.readbyqxmd.com/read/28422412/histological-evolution-of-bk-virus-associated-nephropathy-importance-of-integrating-clinical-and-pathological-findings
#15
Cinthia B Drachenberg, John C Papadimitriou, Muhammad R Chaudhry, Richard Ugarte, Manju Mavanur, Beje Thomas, Charles Cangro, Nadiesda Costa, Emilio Ramos, Matthew R Weir, Abdolreza Haririan
Long term clinicopathological studies of BK-associated nephropathy (PyVAN) are not available. We studied 206 biopsies (71 patients), followed 3.09±1.46y after immunosuppression reduction. The biopsy features (% SV40+staining and inflammation +/- acute rejection) were correlated with viral load dynamics and serum creatinine to define the clinicopathological status (PyVCPS). Incidence of acute rejection was 28% in the 2(nd) biopsy and 50% subsequently (25% mixed TCMR+AMR; rejection overall affected 38% of patients (>50% AMR)...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28419633/bk-virus-in-solid-organ-transplantation-pretransplant-screening-of-recipients-and-risk-factors-for-disease
#16
EDITORIAL
Arnaud G L'Huillier, Upton D Allen
No abstract text is available yet for this article.
April 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28415933/incidence-risk-factors-and-the-effect-of-polyomavirus-infection-in-hematopoietic-stem-cell-transplant-recipients
#17
Jianhua Hu, Siying Li, Meifang Yang, Lichen Xu, Xuan Zhang, Hong Zhao, Huihui Dong, Yaping Huang, Jun Fan, Lanjuan Li
Objective The effect of polyomavirus infection in HSCT recipients is poorly understood. Methods We evaluated 38 HSCT recipients. Polyomavirus was detected by nested qualitative polymerase chain reaction (PCR) assays of urine. The risk factors for BK virus and JC virus were analysed. The kidney and liver functions of infected and uninfected patients were compared. Results BK virus, JC virus, and simian virus 40 were detected in 21%, 42%, and 0% of HSCT recipients respectively. HCMV infection was found to be an independent risk factor for JC virus infection (odds ratio (OR): 8...
April 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28405598/clearance-of-bk-virus-nephropathy-by-combination-antiviral-therapy-with-intravenous-immunoglobulin
#18
Kathy Kable, Carmen D Davies, Philip J O'connell, Jeremy R Chapman, Brian John Nankivell
BACKGROUND: Reactivation of BK polyoma virus causes a destructive virus allograft nephropathy (BKVAN) with graft loss in 46%. Treatment options are limited to reduced immunosuppression and largely ineffective antiviral agents. Some studies suggest benefit from intravenous immunoglobulin (IVIG). METHODS: We evaluated effectiveness of adjuvant IVIG to eliminate virus from blood and tissue, in a retrospective, single-center cohort study, against standard-of-care controls...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28399927/bk-viruria-and-viremia-in-children-with-systemic-lupus-erythematosus
#19
Nirupama Gupta, Cuong Q Nguyen, Renee F Modica, Melissa E Elder, Eduardo H Garin
BACKGROUND: BK virus (BKV) is a ubiquitous polyoma virus that lies dormant in the genitourinary tract once acquired in early childhood. In states of cellular immunodeficiency, the virus can reactivate to cause hemorrhagic cystitis and nephritis. Children with systemic lupus erythematosus (SLE) have an increased risk of developing infectious complications secondary to their immunocompromised state from the administration of several immuno-modulatory drugs. Currently, there are no data regarding the prevalence of BK viruria or viremia in children with SLE...
April 11, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28392330/viral-reactivations-and-associated-outcomes-in-context-of-immune-reconstitution-after-pediatric-hematopoietic-cell-transplantation
#20
Rick Admiraal, Coco de Koning, Caroline A Lindemans, Marc B Bierings, Annemarie M J Wensing, A Birgitta Versluys, Tom F W Wolfs, Stefan Nierkens, Jaap Jan Boelens
BACKGROUND: Viral reactivations (VR) following hematopoietic cell transplantation (HCT) contribute to significant morbidity and mortality. Timely immune reconstitution (IR) is suggested to prevent VR. OBJECTIVES: We studied the relation between IR (as a continuous over-time-predictor) and VR (as time-varying-predictor), and the relation between VR and other clinical outcomes. METHODS: In this retrospective analysis, all patients receiving a first HCT between January-2004 and September-2014 were included...
April 6, 2017: Journal of Allergy and Clinical Immunology
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