移植后BK多重病毒相关病的临床和免疫学特征
Tanaya Siripoon1,2, Nopporn Apiwattanakul3, Pannawat Mongkolrattanakul4
1Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Immunity, inflammation and disease
|August 30, 2023
概括
移植前和移植后具有特定自然杀手 (NK) 细胞水平的移植接受者有BK多重瘤病毒相关病 (BKPyVAN) 的风险. 监测这些NK细胞可能有助于预测BKPyVAN的发展.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 病毒学 病毒学
背景情况:
- 在移植后,BK多瘤病毒 (BKPyV) 相关性病 (BKPyVAN) 对合移植功能构成重大风险.
- 保持完整的BKPyV特异性免疫对于脏移植接受者的病毒制至关重要.
研究的目的:
- 调查BKPyV特异性免疫因子与BKPyVAN在移植 (KT) 接受者的发展之间的关联.
- 为了确定可预测BKPyVAN.风险的免疫标记.
主要方法:
- 进行了一项前性研究,涉及100名KT接受者 (年龄≥15岁).
- 产生干扰素- (IFN-γ) 的CD4+ T,CD8+ T,自然杀手 (NK) 和自然杀手T (NKT) 细胞被量化后刺激与BKPyV大T抗原和病毒囊蛋白1 (VP1).
主要成果:
- 高水平BKPyVDNAuria (可能的BKPyVAN) 的1年累积发病率为18%.
- 移植前的NK细胞水平和VP1特异性NK细胞水平独立地与发展可能和推定BKPyVAN的风险有关.
- 与KT前水平相比,接受BKPyVAN的患者在KT后1个月内增加了NK,VP1特异性NK和NKT细胞数量.
结论:
- 在KT之前,NK细胞水平的升高,包括非特异性和VP1特异性,以及KT后水平的增加,可能表明BKPyVDNAuria和BKPyVAN的风险更高.
- 需要进行进一步的研究,以探索BKPyV特定的BKPyV发生的先天免疫监测的预测价值.
相关概念视频
01:16Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39
01:28Kidney Transplant I: Introduction
28
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
28
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:29Acute Kidney Injury III: Clinical Manifestations
29
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
29
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
34
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
34
01:24Chronic Kidney Disease II: Clinical Manifestations
29
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
29