F. Helle, Aurélien Aubry, V. Morel, V. Descamps, Baptiste Demey, E. Brochot
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引用次数: 0
摘要
世界上大多数成年人都潜伏感染了 BK 多瘤病毒。它可导致健康人无症状感染,但由于免疫抑制疗法导致的病毒相关性肾病,它已成为肾移植受者的一个威胁。在这些情况下,当细胞功能反应因免疫抑制而受损时,中和抗体可能会发挥重要作用,因为它们可以通过与病毒颗粒结合,直接阻止靶细胞感染,而不受细胞介导免疫的影响。长期以来,由于缺乏方便的体外模型,研究抗 BK 病毒中和抗体在病毒控制中的作用一直受到阻碍,但在过去十年中取得了重大进展。四种 BK 病毒基因型已被证明表现为不同的血清型。肾移植前受体针对供体血清型的中和抗体滴度低与移植后 BK 病毒复制有很大关系。已有研究描述了 BK 病毒逃避中和抗体的不同机制。最近的研究也支持将静脉注射免疫球蛋白或单克隆中和抗体作为一种治疗策略的潜在益处,更有趣的是,这也可以在肾脏出现晚期损伤之前作为预防性或先发制人的治疗。此外,还可以通过接种疫苗诱导中和抗体。在这篇综述中,我们总结了抗 BK 病毒中和抗体方面积累的知识及其对肾移植受者的临床重要性和治疗潜力。
The majority of the world’s adult population is latently infected by the BK polyomavirus. It causes asymptomatic infection in healthy individuals but emerged as a threat to kidney transplant recipients because of virus associated nephropathy caused by immunosuppressive therapy. In these conditions, when a functional cellular response is impaired by immunosuppression, neutralizing antibodies may play a major role, since they can directly prevent infection of target cells, independently of cell mediated immunity, by binding to the viral particles. Studying the contribution of anti-BK virus neutralizing antibodies in viral control has long been hampered by the lack of convenient in vitro models but major progress has been made in the last decade. The four BK virus genotypes have been demonstrated to behave as distinct serotypes. A low recipient neutralizing antibody titer against the donor’s serotype before kidney transplant has been significantly associated with BK virus replication after transplant. Different mechanisms exploited by the BK virus to evade neutralizing antibodies have been described. Recent studies also support the potential benefit of administering intravenous immunoglobulins or monoclonal neutralizing antibodies as a therapeutic strategy and, more interestingly, this could also be used as preventive or pre-emptive therapy, before advanced kidney damage has occurred. Besides, neutralizing antibodies could be induced by vaccination. In this review, we summarize accumulated knowledge on anti-BK virus neutralizing antibodies as well as their clinical importance and therapeutic potential for kidney transplant recipients.
期刊介绍:
The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews.
Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication.
JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.