{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:35Z","timestamp":1760146895995,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Compagnia San Paolo","award":["ROL: 20760","RF-2019-12371492","08069119","08045823","08071519","MM2109"],"award-info":[{"award-number":["ROL: 20760","RF-2019-12371492","08069119","08045823","08071519","MM2109"]}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["ROL: 20760","RF-2019-12371492","08069119","08045823","08071519","MM2109"],"award-info":[{"award-number":["ROL: 20760","RF-2019-12371492","08069119","08045823","08071519","MM2109"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Polyomavirus BK (BKPyV)-associated nephropathy (BKPyV-nephropathy) remains a significant cause of premature kidney allograft failure. In the absence of effective antiviral treatments, current therapeutic approaches rely on immunosuppression (IS) reduction, possibly at the risk of inducing alloimmunity. Therefore, we sought to explore the long-term effects of a tailored viro-immunologic surveillance and treatment program for BKPyV on the development of alloimmunity and kidney graft outcome. Forty-five pediatric kidney transplant recipients were longitudinally monitored for BKPyV replication, virus-specific immunity, and donor-specific HLA antibodies (DSAs). DNAemia developed in 15 patients who were treated with stepwise IS reduction. Among the other 30 patients, 17 developed DNAuria without DNAemia and 13 always resulted as BKPyV-negative. All patients with DNAemia cleared BKPyV after having mounted a virus-specific cellular immune response, and no biopsy-proven BKPyV-nephropathy was observed. The presence of cytotoxic populations directed to the BKPyV Large-T (LT) antigen early after transplantation protected kidney recipients from developing BKPyV replication, and the appearance of LT-specific T cells in viruric patients prevented the development of BKPyV-DNAemia. In our cohort, no significant correlation was observed between BKPyV-DNAemia and the development of DSA and antibody-mediated rejection. However, patients who experienced and cleared BKPyV-DNAemia had a worse allograft survival at a median follow-up of 18.9 years (p = 0.048). These data need to be confirmed in larger cohorts.<\/jats:p>","DOI":"10.3390\/microorganisms13010048","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T14:21:12Z","timestamp":1735654872000},"page":"48","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Control of BKPyV-DNAemia by a Tailored Viro-Immunologic Approach Does Not Lead to BKPyV-Nephropathy Progression and Development of Donor-Specific Antibodies in Pediatric Kidney Transplantation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6827-2876","authenticated-orcid":false,"given":"Michela","family":"Cioni","sequence":"first","affiliation":[{"name":"Fondazione Malattie Renali del Bambino, IRCCS G. Gaslini Institute, 16147 Genova, Italy"},{"name":"Transfusion Service, IRCCS G. Gaslini Institute, 16147 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Muscianisi","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marica","family":"De Cicco","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Basso","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-0423","authenticated-orcid":false,"given":"Hans H.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, 4009 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris","family":"Fontana","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Department, Kidney Transplant Surgery Unit, Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Catenacci","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7608-8091","authenticated-orcid":false,"given":"Jessica","family":"Bagnarino","sequence":"additional","affiliation":[{"name":"Microbiology and Virology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-9132","authenticated-orcid":false,"given":"Mariangela","family":"Siciliano","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"Montana Lampo","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Acquafredda","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lou Tina Diana","family":"Boti","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Rotella","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Bozza","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Zumelli","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristiana","family":"Mebelli","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Baldanti","sequence":"additional","affiliation":[{"name":"Microbiology and Virology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Cardillo","sequence":"additional","affiliation":[{"name":"Transplantation Immunology, Fondazione Ca\u2019 Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-1744","authenticated-orcid":false,"given":"Marco","family":"Zecca","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arcangelo","family":"Nocera","sequence":"additional","affiliation":[{"name":"Fondazione Malattie Renali del Bambino, IRCCS G. Gaslini Institute, 16147 Genova, Italy"},{"name":"Nephrology, Dialysis and Transplantation Unit, IRCCS G. Gaslini Institute, 16147 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Luppi","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Verrina","sequence":"additional","affiliation":[{"name":"Fondazione Malattie Renali del Bambino, IRCCS G. Gaslini Institute, 16147 Genova, Italy"},{"name":"Nephrology, Dialysis and Transplantation Unit, IRCCS G. Gaslini Institute, 16147 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Ginevri","sequence":"additional","affiliation":[{"name":"Fondazione Malattie Renali del Bambino, IRCCS G. Gaslini Institute, 16147 Genova, Italy"},{"name":"Nephrology, Dialysis and Transplantation Unit, IRCCS G. Gaslini Institute, 16147 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5964-0553","authenticated-orcid":false,"given":"Patrizia","family":"Comoli","sequence":"additional","affiliation":[{"name":"Cell Factory, Department of Mother and Child Health, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"},{"name":"Pediatric Hematology\/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"ref_1","unstructured":"Morris, M.I., Kotton, C.N., and Wolfe, C. (2020). BK Polyomavirus After Solid Organ and Hematopoietic Cell Transplantation: One Virus \u2013Three Diseases. 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