在脏疾病中BK多重瘤病毒的流行:与免疫抑制剂和淋巴细胞子组的关联
Ziran Wang1, Jiawei Zhao2, Lingjun Kong1
1Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Infection and drug resistance
|October 6, 2025
概括
在患有脏疾病 (RD) 的患者中,经常检测到BK多重瘤病毒 (BKV) DNA,特别是在患有脏参与 (CTD-RI) 和泌尿瘤 (UT) 的结合组织疾病的患者中. 监测BKVDNA可以帮助指导免疫抑制剂的使用,并减少高风险RD患者的损伤.
科学领域:
- 病毒学 病毒学
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
背景情况:
- 乙基多瘤病毒 (BKV) 是一种潜伏的病原体,对免疫功能低下的个体构成风险,特别是在关联疾病 (RD) 中.
- 了解BKV的流行率及其对各种RD患者群体的影响,对于风险分层和管理至关重要.
研究的目的:
- 评估BKV-DNA定量聚合酶连锁反应 (qPCR) 检测套件的性能.
- 确定不同病患者队伍中BKV-DNA的流行率和病毒载荷.
- 研究CTD-RI患者的免疫抑制剂使用,BKV-DNA水平和淋巴细胞子集之间的关系.
主要方法:
- 招募了88名健康对照 (HC) 和271名RD患者 (CTD-RI,CKD,UT,KT).
- 评估了BKV-DNA qPCR套件的灵敏度,线性,准确性,精度和特异性.
- 分析了尿液,血清和血样本,以比较样本类型之间的检测灵敏度.
- 在各组中比较了BKV-DNA阳性率和负载,并分析了CTD-RI患者的免疫抑制剂使用和淋巴细胞子集相关性.
主要成果:
- 该BKV-DNA qPCR套件表现出令人满意的性能.
- 尿样对BKV-DNA检测比血清或血更敏感.
- 与HC (12.5%) 相比,CTD-RI (49.0%) 和UT (31.8%) 组观察到更高的BKV-DNA阳性率和负载.
- 菌酸莫菲提尔 (MMF) 的使用与BKV风险降低有关 (OR:0.27).
- 在BKV-DNA负载和CD19+B细胞,CD4+CD28+T细胞,CD45RA+CD4+T细胞和天真CD4+T细胞之间观察到负相关性.
结论:
- 建议在高风险RD患者中监测BKV-DNA,以指导免疫抑制疗法并减轻损伤.
- 需要进一步的长期多中心研究,以充分阐明BKV在R&D中的作用.
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