Challenges and opportunities in research on BK virus infection after renal transplantation

• Published in: International immunopharmacology Vol. 141; p. 112793
• Main Authors: Tang, Yukun, Wang, Zipei, Du, Dunfeng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.11.2024
• Subjects: Animals; Antiviral Agents - therapeutic use; BK Virus; BK virus-associated nephropathy; BKV reactivation; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - adverse effects; Polyomavirus Infections - diagnosis; Polyomavirus Infections - immunology; Renal transplantation; Tumor Virus Infections - drug therapy; Tumor Virus Infections - immunology; Tumor Virus Infections - virology; Virus Activation; Renal transplantation; BK virus-associated nephropathy; BK virus; BKV reactivation
• ISSN: 1567-5769; 1878-1705; 1878-1705
• DOI: 10.1016/j.intimp.2024.112793

[Display omitted] •We captures BKV research status, advances, and offers new perspectives for future challenges.•Focus on improving transplant prevention, clinical education, and medical compliance until effective antivirals emerge.•New preventive, diagnostic, and therapeutic measures in our paper bring new insights  to clinicians. Renal transplantation is one of the primary approaches for curing end-stage kidney disease. With advancements in immunosuppressive agents, the short-term and long-term survival rates of transplanted kidneys have significantly improved. However, infections associated with potent immunosuppression have remained a persistent challenge. Among them, BK virus (BKV) reactivation following renal transplantation leading to BK virus-associated nephropathy (BKVAN) is a major cause of graft dysfunction. However, we still face significant challenges in understanding the pathogenesis, prevention, diagnosis, and treatment of BKVAN. These challenges include: 1. The mechanism of BKV reactivation under immunosuppressive conditions has not been well elucidated, leading to difficulties in breakthroughs in clinical research on prevention, diagnosis, and treatment. 2. Lack of proper identification of high-risk individuals, and effective personalized clinical management strategies. 3.Lack of early and sensitive diagnostic markers. 4. Lack of direct and effective treatment options due to the absence of specific antiviral drugs. The purpose of this review is to summarize the current status and cutting-edge advancements in BKV-related research, providing new methods and perspectives to address future research challenges.