<< Вернуться к списку статей журнала

Том 12 №3 2010 год - Нефрология и диализ

Полиомавирус (BKV) у реципиентов с трансплантированной почкой (Обзор литературы)

Горбатенко Е.В. Момыналиев К.Т. Грибанов О.Г. Бабенко Н.Н. Каабак М.М.

Аннотация: Трансплантация почки является методом лечения пациентов с терминальной стадией хронической почечной недостаточности. Выживаемость реципиентов и трансплантата в последнее время значительно увеличилась за счет разработки новых протоколов иммуносупрессии, которые позволяют снизить количество случаев острого отторжения трансплантированного органа, однако на этом фоне большое значение приобретают пост-трансплантационные инфекции. Наибольшее значение в последнее время приобрел полиомавирус (BKV), который ассоциирован с нефропaтией (BKVAN). Приблизительно у 30-60% пациентов с BKV нефропатией наблюдаются потеря трансплантата. Диагноз BK инфекции базируется на комбинации показателей: обнаружения клеток с вирусными включениями («decoy cells») в моче, вируса в моче/крови и типичных гистологических изменений при интерстициальном нефрите. Лечение BKV нефропатий состоит в снижении доз иммуносупрессивной терапии и антивирусной терапии − цидофовиром или лефлуномидом или их комбинации. Раннее выявление полиомавируса и соответствующее снижение иммуносупрессивной терапии обеспечивает лучшую выживаемость почечного трансплантата.

Для цитирования: Горбатенко Е.В., Момыналиев К.Т., Грибанов О.Г., Бабенко Н.Н., Каабак М.М. Полиомавирус (BKV) у реципиентов с трансплантированной почкой (Обзор литературы). Нефрология и диализ. 2010. 12(3):164-173. doi:

Весь текст

Ключевые слова: Полиомавирус, трансплантация, нефропатия, иммуносупрессия, диагностика, polyoma virus BKV, transplantation, BKV-associated nephropathy, immunosuppression, diagnostic tools

Список литературы:

1. Суханов А. В. Полиомавирусная нефропатия трансплантата // Нефрология и диализ. Т. 3, 2001 г. №4.
2. Acott P.D. Polyoma virus in pediatric renal transplantation // Pediatr Transplant. 2006. Vol. 10. P. 856 - 860.
3. Ahuja M., Cohen E.P,. Dayer A.M. et al. Polyoma virus infection after renal transplantation. Use of immunostaining as a guide to diagnosis // Transplantation. 2001. Vol. 71. P. 896–899.
4. Akan I., Sariyer I.K., Biffi R. et al. Human polyomavirus JCV late leader peptide region contains important regulatory elements // Virology. 2006. Vol. 349. P. 66–78.
5. Andrews C.A., Shah K.V., Daniel R.W. et al. A serological investigation of BK virus and JC virus infections in recipients of renal allografts //J Infect Dis. 1988. Vol. 158. P. 176–181.
6. Atencio I.A., Shadan F.F., Zhou X.J. et al. Adult mouse kidneys become permissive to acute polyomavirus infection and reactivate persistent infections in response to cellular damage and regeneration // J Virol. 1993. Vol. 67. P. 1424–1432.
7. Awadalla Y., Randhawa P., Ruppert K. et al. HLA mismatching increases the risk of BK virus nephropathy in renal transplant recipients // Am J Transplant. 2004. Vol. 4. P. 1691–1696.
8. Babel N., Fendt J., Karaivanov S., Bold G. et al. Sustained BK viruria as an early marker for the development of BKV-associated nephropathy: analysis of 4128 urine and serum samples // Transplantation. 2009. Vol. 88. P. 89-95.
9. Babel N., Hammer M.H., Stele L. et al. Anti CD 20-mAb (rituximab) may prevent the progression of BKV-associated nephropathy in renal transplant recipients // Am J Transplant. 2007. Vol. 7 [Suppl 2]. P. 541.
10. Binet I., Nickeleit V., Hirsch H.H. et al. Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss // Transplantation. 1999. Vol. 67. P. 918–922.
11. Bohl D.L., Brennan D.C. BK virus nephropathy and kidney transplantation // Clin J Am Soc Nephrol. 2007. Vol. 2 Suppl 1. S36-46.
12. Bohl D.L., Storch G.A., Ryschkewitsch C. et al. Donor origin of BK virus in renal transplantation and role of HLA C7 in susceptibility to sustained BK viremia // Am J Transplant. 2005. Vol. 5. P. 2213–2221.
13. Boldorini R., Veggianii C., Barco D. et al. Kidney and urinary tract polyoma virus infection and distribution: molecular biology investigation of 10 consecutive autopsies // Arch Pathol Lab Med. 2005. Vol. 129. P. 69–73.
14. Bonvoisin C., Weekers L., Xhignesse P. et al. Polyomavirus in renal transplantation: A hot problem // Transplantation. 2008. Vol. 85(7 suppl). S42.
15. Boratynska M., Dubinski B., Rybka K. Et al. Immunocytological urinalysis and monocyte chemotactic peptide-1 in renal transplant recipients with polyomavirus replication // Transplant Proc. 2006. Vol. 38. P. 151–154.
16. Brennan D.C., Agha I., Bohl D.L, et al. Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction // Am J Transplant. 2005. Vol. 5. P. 582–594.
17. Bressollette-Bodin C., Coste-Burel M., Hourmant M. et al. A prospective longitudinal study of BK virus infection in 104 renal transplant recipients // Am J Transplant. 2005. Vol. 5. P. 1926–1933.
18. Buehrig C.K., Lager D.J., Stegall M.D. et al. Influence of surveillance renal allograft biopsy on diagnosis and prognosis of polyomavirus-associated nephropathy // Kidney Int. 2003. Vol. 64. P. 665–673.
19. Celik B., Randhawa P.S. Glomerular changes in BK virus nephropathy // Hum Pathol. 2004. V. 35. P. 367–370.
20. Celik B., Shapiro R., Vats A. et al. Polyomavirus allograft nephropathy: Sequential assessment of histologic viral load, tubulitis, and graft function following changes in immunosuppression // Am J Transplant. 2003. Vol. 3. P. 1378–1382.
21. Chandraker A., Ali S., Drachenberg C.B. et al. Use of fluoroquinolones to treat BK infection in renal transplant recipients // Am J Transplant. 2004. Vol. 4. P. 587.
22. Chen Y., Trofe J., Gordon J. et al. Interplay of cellular and humoral immune responses against BK virus in kidney transplant recipients with polyomavirus nephropathy // J Virol. 2006. Vol. 80. P. 3495–3505.
23. Comoli P., Azzi A., Maccario R. et al. Polyomavirus BK-specific immunity after kidney transplantation // Transplantation. 2004. Vol. 78. P. 1229–1232.
24. Ding R., Medeiros M., Dadhania D. et al. Noninvasive diagnosis of BK virus nephritis by measurement of messenger RNA for BK virus VP1 in urine // Transplantation. 2002. Vol. 74. P. 987–994.
25. Drachenberg C.B., Papadimitriou J.C., Hirsch H.H. et al. Histological patterns of polyomavirus nephropathy: correlation with graft outcome and viral load // Am J Transplant. 2004. Vol. 4. P. 2082–2092.
26. Drachenberg C.B., Papadimitriou J.C., Mann D. et al. Negative impact of human leukocyte antigen matching in the outcome of polyomavirus nephropathy //‘Transplantation. 2005. Vol. 80. P. 276–278.
27. Dugan A.S., Eash S., Atwood W.J. An N-linked glycoprotein with alpha(2,3)-linked sialic acid is a receptor for BK virus // J Virol. 2005. Vol. 79. P. 14442–14445.
28. Eash S., Querbes W., Atwood W.J. Infection of vero cells by BK virus is dependent on caveolae // J Virol. 2004. Vol. 78. P. 11583–11590.
29. Elphick G.F., Querbes W., Jordan J.A. et al. The human polyomavirus, JCV, uses serotonin receptors to infect cells // Science. 2004. Vol. 306. P. 1380-1383.
30. Funk G.A., Steiger J., Hans H.H. Rapid dynamics of polyomavirus type BK in renal transplant recipients // J Infect Dis. 2006. Vol. 193. P. 80–87.
31. Gardner S.D., Field A.M., Coleman D.V. et al. New human papovavirus (BK) isolated from urine after transplantation // Lancet. 1971. Vol. 1. P. 1253–1257.
32. Gee G.V., Dugan A.S., Tsomaia N. et al. The role of sialic acid in human polyomavirus infections // Glycoconj J. 2006. Vol. 23(1-2). P. 19-26.
33. Gee G.V., Tsomaia N., Mierke D.F. et al. Modeling a sialic acid binding pocket in the external loops of JC virus VP1 // J Biol Chem. 2004. Vol. 279. P. 49172–49176.
34. Ginevri F., De Santis R., Comoli P. et al. Polyomavirus BK infection in pediatric kidney-allograft recipients: A single- center analysis of incidence, risk factors, and novel therapeutic approaches // Transplantation. 2003. Vol. 75. P. 1266–1270.
35. Hammer M.H., Brestrich G., Andree H. et al. HLA type-independent method to monitor polyoma BK virus-specific CD4 and CD8 T-cell immunity // Am J Transplant. 2006. Vol. 6. P. 625–631.
36. Hariharan S. BK virus nephritis after renal transplantation // Kidney Int. 2006 Vol. 69(4) P. 655-662.
37. Hariharan S., Cohen E.P., Vasudev B. et al. BKV specific antibodies and BKV DNA in renal transplant recipients with BKV nephritis //Am J Transplant. 2005. Vol. 5. P. 2719–2724.
38. Herman J., Van Ranst M., Snoeck R. et al. Polyomavirus infection in pediatric renal transplant recipients: evaluation using a quantitative real-time PCR technique // Pediatr Transplant. 2004. Vol. 8. P. 485–492.
39. Hirsch H.H. Polyomavirus BK nephropathy: a (re-)emerging complication in renal transplantation. // Am J Transplant. 2002. Vol. 2. P. 25–30.
40. Hirsch H.H., Brennan D.C., Drachenberg C.B. et al. Polyoma-virus associated nephropathy in renal transplantation: Interdisciplinary analyses and recommendations // Transplantation 2005. Vol. 79. P. 1277 - 1286.
41. Hirsch H.H., Knowles W., Dickenmann M. et al. Prospective study of polyomavirus type BK replication and nephropathy in renaltransplant recipients // N Engl J Med. 2002. Vol. 347. P. 488–496.
42. Hirsch H.H., Mohaupt M., Klimkait T. Prospective monitoring of BK virus load after discontinuing sirolimus treatment in a renal transplant patient with BK virus nephropathy // J Infect Dis. 2001. Vol. 184. P. 1494–1495.
43. Hirsch H.H., Steiger J. Polyomavirus BK // Lancet Infect Dis. 2003. Vol. 3. P. 611 – 623.
44. Howell D.N., Smith S.R., Butterly D.W. et al. Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients // Transplantation. 1999. Vol. 68(9). P. 1279-88.
45. Hussain S., Bresnahan B.A., Cohen E.P. et al. Rapid kidney allograft failure in patients with polyoma virus nephritis with prior treatment with antilymphocyte agents // Clin Transplant. 2002. Vol. 16. P. 43–47.
46. Hussain S., Orentas R., Walczak J. et al. Prevention of BKV nephritis by monitoring BK viremia in renal transplant recipients: a prospective study // Graft. 2004. Vol. 7. P. 28–30.
47. Hymes L.C., Warshaw B.L. Polyomavirus (BK) in pediatric renal transplants: Evaluation of viremic patients with and without BK associated nephritis // Pediatr Transplant. 2006. Vol. 10. P. 920– 922.
48. Kadambi P.V., Josephson M.A., Williams J. et al. Treatment of refractory BK virus-associated nephropathy with cidofovir // Am J Transplant. 2003. Vol. 3. P. 186–191.
49. Kazory A., Ducloux D., Chalopin J.M. et al. The first case of JC virus allograft nephropathy //Transplantation. 2003. Vol. 76. P. 1653–1655.
50. Khalili K., White M.K., Sawa H. et al. The agnoprotein of polyomaviruses: A multifunctional auxiliary protein // J Cell Physiol. 2005. Vol. 204. P. 1–7.
51. Komagome R., Sawa H., Suzuki T. et al. Oligosaccharides as receptors for JC virus // J Virol. 2002. Vol. 76. P. 12992–13000.
52. Kuypers D.R., Vandooren A.K., Lerut E. et al. Adjuvant lowdose cidofovir therapy for BK polyomavirus interstitial nephritis in renal transplant recipients // Am J Transplant. 2005. Vol. 5. P. 1997–2004.
53. Lee E.D.H., Wang J., Dong Y. et al. Inability to clear polyoma virus in MHC disparate murine kidney transplant model results in accelerated graft rejection // Am J Kidney Dis. 2004. Vol. 4 [Suppl 8]. P. 599.
54. Leuenberger D., Andresen P.A., Gosert R. et al. Human polyomavirus type 1 (BK virus) agnoprotein is abundantly expressed but immunologically ignored // Clin Vaccine Immunol 2007. Vol. 14. P. 959–968.
55. Leung A.Y., Chan M.T., Yuen K.Y. et al. Ciprofloxacin decreased polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation // Clin Infect Dis. 2005. Vol. 40. P. 528–537.
56. Limaye A.P., Smith K.D., Cook L. et al. Polyoma virus nephropathy in native kidneys of non renal transplant recipients // Am J Transplant. 2005. Vol. 5. P. 614–620.
57. Lipshutz G.S., Flechner S.M., Govani M.V. et al. BK nephropathy in kidney transplant recipients treated with a calcineurin inhibitor-free immunosuppression regimen // Am J Transplant. 2004. Vol. 4. P. 2132–2134.
58. Low J.A., Magnuson B., Tsai B. et al. Identification of gangliosides GD1b and GT1b as receptors for BK virus // J Virol. 2006. Vol. 80. P. 1361–1366.
59. Mannon R.B., Hoffmann S.C., Kampen R.L. et al. Molecular evaluation of BK polyomavirus nephropathy // Am J Transplant. 2005. Vol. 5. P. 2883–2893.
60. Matas A.J., Kandaswamy R., Humar A. et al. Long-term immunosuppression, without maintenance prednisone, after kidney transplantation // Ann Surg. 2004. Vol. 240. P. 510–516.
61. Mathur V.S., Olson J.L., Darragh T.M. et al. Polyomavirus-induced interstitial nephritis in two renal transplant recipients: case reports and review of the literature // Am J Kidney Dis. 1997. Vol. 29. P. 754–758.
62. Medipalli R., Vasudev B., Zhu Y. et al. Improved outcomes of BKVN: Impact on BK virus surveillance protocol // Am J Transplant. 2007. Vol. 7 [Suppl 2]. P. 150.
63. Meier-Kriesche H.U., Li S., Gruessner R.W., et al. Immunosuppression: Evolution in practice and trends, 1994–2004 // Am J Transplant. 2006. Vol. 6. P. 1111–1131.
64. Mengel M., Marwedel M., Radermacher J. et al. Incidence of polyomavirus-nephropathy in renal allografts: Influence of modern immunosuppressive drugs // Nephrol Dial Transplant. 2003. Vol. 18. P. 1190– 1196.
65. Nickeleit V., Hirsch H.H., Binet I.F. et al. Polyomavirus infection of renal allograft recipients: From latent infection to manifest disease // J Am Soc Nephrol. 1999. Vol. 10. P. 1080–1089.
66. Nickeleit V., Klimkait T., Binet I.F. et al. Testing for polyomavirus type BK DNA in plasma to identify renal-allograft recipients with viral nephropathy //N Engl J Med. 2000. Vol. 342. P. 1309–1315.
67. Pho M.T., Ashok A., Atwood W.J. JC virus enters human glial cells by clathrin-dependent receptor-mediated endocytosis // J Virol. 2000. Vol. 74. P. 2288–2292.
68. Polo C., Perez J.L., Mielnichuck A. et al. Prevalence and patterns of polyomavirus urinary excretion in immunocompetent adults and children // Clin Microbiol Infect. 2004. Vol. 10. P. 640 – 644.
69. Prosser S.E., Orentas R.J., Jurgens L. et al. Recovery of BK virus large T-antigen-specific cellular immune response correlates with resolution of bk virus nephritis // Transplantation. 2008. Vol. 85. P. 185-192.
70. Provenzano M., Bracci L., Wyler S. et al. Characterization of highly frequent epitope-specific CD45RA/CCR7/- T lymphocyte responses against p53-binding domains of the human polyomavirus BK large tumor antigen in HLA-A*0201 BKV-seropositive donors // J Transl Med. 2006. Vol. 4. P. 47 – 62.
71. Purighalla R., Shapiro R., McCauley J. et al. BK virus infection in a kidney allograft diagnosed by needle biopsy // Am J Kidney Dis. 1995. Vol. 26. P. 671–673.
72. Ramos E., Drachenberg C.B., Papadimitriou J.C. et al. Clinical course of polyoma virus nephropathy in 67 renal transplant patients // J Am Soc Nephrol. 2002. Vol. 13. P. 2145–2151.
73. Ramos E., Vincenti F., Lu W.X. et al. Retransplantation in patients with graft loss caused by polyoma virus nephropathy // Transplantation. 2004. Vol. 77. P. 131–133.
74. Randhawa P.S., Finkelstein S., Scantlebury V. et al. Human polyoma virus-associated interstitial nephritis in the allograft kidney // Transplantation. 1999. Vol. 67. P. 103–109.
75. Randhawa P.S., Popescu I., Macedo C. et al. Detection of CD8 T cells sensitized to BK virus large T antigen in healthy volunteers and kidney transplant recipients // Hum Immunol. 2006. Vol. 67. P. 298–302.
76. Randhawa P.S: Anti-BK virus activity of ciprofloxacin and related antibiotics // Clin Infect Dis. 2005. Vol. 41. P. 1366–1367.
77. Reploeg M.D., Storch G.A., Clifford D.B. BK virus: a clinical review // Clin Infect Dis. 2001. Vol. 33. P. 191–202.
78. Rocha P.N., Plumb T.J., Miller S.E. et al. Risk factors for BK polyomavirus nephritis in renal allograft recipients // Clin Transplant. 2004. Vol. 18. P. 456–462.
79. Schmid H., Burg M., Kretzler M. et al. BK virus associated nephropathy in native kidneys of a heart allograft recipient // Am J Transplant. 2005. Vol. 5. P. 1562– 1568.
80. Sener A., House A.A., Jevnikar A.M. et al. Intravenous immunoglobulin as a treatment for BK virus associated nephropathy: One-year follow-up of renal allograft recipients // Transplantation. 2006. Vol. 81. P. 117–120.
81. Shah K.V. Human polyomavirus BKV and renal disease // Nephrol Dial Transplant. 2000. Vol. 15. P. 754–755.
82. Shah K.V., Daniel R.W., Warszawski R.M. High prevalence of antibodies to BK virus, an SV40-related papovavirus, in residents of Maryland // J Infect Dis. 1973. Vol. 128. P. 784–787.
83. Smith J.M., McDonald R.A., Finn L.S. et al. Polyomavirus nephropathy in pediatric kidney transplant recipients // Am J Transplant. 2004. Vol. 4. P. 2109–2117.
84. Stenlund A. Initiation of DNA replication: Lessons from viral initiator proteins // Nat Rev Mol Cell Biol. 2003. Vol. 4. P. 777–785.
85. Suzuki T., Okada Y., Semba S. et al. Identification of FEZ1 as a protein that interacts with JC virus agnoprotein and microtubules: Role of agnoproteininduced dissociation of FEZ1 from microtubules in viral propagation // J Biol Chem. 2005. Vol. 280. P. 24948–24956.
86. Teschner S., Geyer M., Wilpert J. et al. Remission of polyomavirus-induced graft nephropathy treated with low-dose leflunomide // Nephrol Dial Transplant. 2006. Vol. 21. P. 2039–2040.
87. Thamboo T.P., Jeffery K.J., Friend P.J. et al. Urine cytology screening for polyoma virus infection following renal transplantation: The Oxford experience // J Clin Pathol. 2006. Vol. 60. P. 927 -930.
88. Tong C.Y.W., Bakran A., Peiris J.S.M. et al. The association of viral infection and chronic allograft nephropathy with graft dysfunction after renal transplantation // Transplantation 2002. Vol. 74. P. 576–578.
89. Trofe J., Gaber L.W., Stratta R.J. et al. Polyomavirus in kidney and kidney-pancreas transplant recipients // Transpl Infect Dis. 2003. Vol. 5. P. 21–28.
90. Vasudev B., Hariharan S., Hussain S.A. et al. BK virus nephritis: Risk factors, timing, and outcome in renal transplant recipients // Kidney Int. 2005. Vol. 68. P. 1834– 1839.
91. Vats A., Shapiro R., Singh Randhawa P. et al. Quantitative viral load monitoring and cidofovir therapy for the management of BK virus-associated nephropathy in children and adults // Transplantation. 2003. Vol. 75. P. 105–112.
92. Vera-Sempere F.J., Rubio L., Felipe-Ponce V. et al. Renal donor implication in the origin of BK infection: Analysis of genomic viral subtypes // Transplant Proc. 2006. Vol. 38. P. 2378–2381.
93. Wadei H.M., Rule A.D., Lewin M. et al. Kidney transplant function and histological clearance of virus following diagnosis of polyomavirus-associated nephropathy (PVAN). // Am J Transplant. 2006. Vol. 6. P. 1025–1032.
94. Wen M.C., Wang C.L., Wang M. et al. Association of JC virus with tubulointerstitial nephritis in a renal allograft recipient // J Med Virol. 2004. Vol. 72. P. 675–678.
95. Williams J.W., Javaid B., Kadambi P.V. et al. Leflunomide for polyomavirus type BK nephropathy // N Engl J Med. 2005. Vol. 352. P. 1157– 1158.

Другие статьи по теме

• Опыт применения микофенолата натрия при трансплантации почки (промежуточные результаты 12 месячной мультицентровой открытой наблюдательной программы изучения безопасности, переносимости и эффективности препарата у реципиентов почечного трансплантата)
• Успешное лечение рака функционирующего почечного трансплантата
• Туберкулез в нефрологической практике (Клинические наблюдения)
• Роль ультразвукового исследования нефункционирующего почечного трансплантата в структуре обследования пациентов с синдромом непереносимости аллографта. Серия клинических наблюдений