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Pre-transplant immune factors may be associated with BK polyomavirus reactivation in kidney transplant recipients
Journal article   Open access   Peer reviewed

Pre-transplant immune factors may be associated with BK polyomavirus reactivation in kidney transplant recipients

David DeWolfe, Jinal Gandhi, Matthew R Mackenzie, Thomas A Broge Jr, Evelyn Bord, Amaara Babwah, Didier A Mandelbrot, Martha Pavlakis, Francesca Cardarelli, Raphael Viscidi, …
PloS one, Vol.12(5), pp.e0177339-e0177339
2017
DOI: 10.1371/journal.pone.0177339
PMCID: PMC5451008
PMID: 28562595
url
https://doi.org/10.1371/journal.pone.0177339View
Published (Version of record) Open Access

Abstract

BK polyomavirus (BKPyV) reactivation in kidney transplant recipients can lead to allograft damage and loss. The elements of the adaptive immune system that are permissive of reactivation and responsible for viral control remain incompletely described. We performed a prospective study evaluating BKPyV-specific T-cell response, humoral response and overall T-cell phenotype beginning pre-transplant through one year post-transplant in 28 patients at two centers. We performed an exploratory analysis of risk factors for the development of viremia and viruria as well as compared the immune response to BKPyV in these groups and those who remained BK negative. 6 patients developed viruria and 3 developed viremia. BKPyV-specific CD8+ T-cells increased post-transplant in viremic and viruric but not BK negative patients. BKPyV-specific CD4+ T-cells increased in viremic, but not viruric or BK negative patients. Anti-BKPyV IgG antibodies increased in viruric and viremic patients but remained unchanged in BK negative patients. Viremic patients had a greater proportion of CD8+ effector cells pre-transplant and at 12 months post-transplant. Viremic patients had fewer CD4+ effector memory cells at 3 months post-transplant. Exploratory analysis demonstrated lower CD4 and higher total CD8 proportions, higher anti-BKPyV antibody titers and the cause of renal failure were associated BKPyV reactivation. In conclusion, low CD4, high CD8 and increased effector CD8 cells were found pre-transplant in patients who became viremic, a phenotype associated with immune senescence. This pre-transplant T-cell senescence phenotype could potentially be used to identify patients at increased risk of BKPyV reactivation.
Adult Aged Antibodies, Viral - biosynthesis BK Virus - genetics BK Virus - immunology BK Virus - physiology CD4-Positive T-Lymphocytes - immunology CD8-Positive T-Lymphocytes - immunology DNA, Viral - analysis Female Humans Immunophenotyping Kidney Diseases - immunology Kidney Diseases - surgery Kidney Transplantation Male Middle Aged Prospective Studies Virus Activation

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