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Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement

BACKGROUND: This study aimed to investigate the pathological characteristics of BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) with glomerular involvement in kidney transplant recipients. METHODS: Forty-four patients with glomerular BKPyV infection were retrospectively included for analysi...

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Autores principales: Chen, Xu-Tao, Deng, Rong-Hai, Yang, Shi-Cong, Hou, Xiao-Tao, Li, Jun, Chen, Yan-Yang, Yang, Hui-Fei, Wang, Ze-Yuan, Wang, Chang-Xi, Qiu, Jiang, Chen, Li-Zhong, Chen, Wen-Fang, Huang, Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475425/
https://www.ncbi.nlm.nih.gov/pubmed/32953723
http://dx.doi.org/10.21037/atm-20-1879
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author Chen, Xu-Tao
Deng, Rong-Hai
Yang, Shi-Cong
Hou, Xiao-Tao
Li, Jun
Chen, Yan-Yang
Yang, Hui-Fei
Wang, Ze-Yuan
Wang, Chang-Xi
Qiu, Jiang
Chen, Li-Zhong
Chen, Wen-Fang
Huang, Gang
author_facet Chen, Xu-Tao
Deng, Rong-Hai
Yang, Shi-Cong
Hou, Xiao-Tao
Li, Jun
Chen, Yan-Yang
Yang, Hui-Fei
Wang, Ze-Yuan
Wang, Chang-Xi
Qiu, Jiang
Chen, Li-Zhong
Chen, Wen-Fang
Huang, Gang
author_sort Chen, Xu-Tao
collection PubMed
description BACKGROUND: This study aimed to investigate the pathological characteristics of BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) with glomerular involvement in kidney transplant recipients. METHODS: Forty-four patients with glomerular BKPyV infection were retrospectively included for analysis. Immunohistochemical (IHC) staining was performed on paraffin sections using monoclonal mouse anti-SV40 large T antigen antibody. RESULTS: In BKPyV-infected glomeruli, the glomerular parietal epithelial cells (GPECs) were swollen, hyperchromatic, and enlarged, with an increased nuclear to cytoplasm (N/C) ratio and smudgy basophilic intra-nuclear viral inclusions. IHC staining revealed the distribution of BKPyV involvement in GPECs, podocytes, and shedding cells within Bowman’s space. Notably, BKPyV affected GPEC proliferation and caused crescent formation (7 biopsies, 15.9%). Three biopsies exhibited fibrous crescents and the absence of viral inclusions. The other 4 biopsies exhibited cellular and fibro-cellular crescents, with viral cytopathic changes and positive IHC staining in the proliferative GPECs. Electron microscopy showed viral particles in both GPECs and podocytes. BKPyV-infected GPECs were degenerative, with mitochondrial swelling, endoplasmic reticulum expansion, and multi-layered membranous structure formation. Twelve (27.3%) patients received repeat biopsies within 1.6 to 39.5 months (median: 13.5 months), but none revealed persistent glomerular BKPyV infection. CONCLUSIONS: Distinct glomerular changes in BKPyVAN biopsies should raise the possibility of glomerular involvement.
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spelling pubmed-74754252020-09-17 Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement Chen, Xu-Tao Deng, Rong-Hai Yang, Shi-Cong Hou, Xiao-Tao Li, Jun Chen, Yan-Yang Yang, Hui-Fei Wang, Ze-Yuan Wang, Chang-Xi Qiu, Jiang Chen, Li-Zhong Chen, Wen-Fang Huang, Gang Ann Transl Med Original Article BACKGROUND: This study aimed to investigate the pathological characteristics of BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) with glomerular involvement in kidney transplant recipients. METHODS: Forty-four patients with glomerular BKPyV infection were retrospectively included for analysis. Immunohistochemical (IHC) staining was performed on paraffin sections using monoclonal mouse anti-SV40 large T antigen antibody. RESULTS: In BKPyV-infected glomeruli, the glomerular parietal epithelial cells (GPECs) were swollen, hyperchromatic, and enlarged, with an increased nuclear to cytoplasm (N/C) ratio and smudgy basophilic intra-nuclear viral inclusions. IHC staining revealed the distribution of BKPyV involvement in GPECs, podocytes, and shedding cells within Bowman’s space. Notably, BKPyV affected GPEC proliferation and caused crescent formation (7 biopsies, 15.9%). Three biopsies exhibited fibrous crescents and the absence of viral inclusions. The other 4 biopsies exhibited cellular and fibro-cellular crescents, with viral cytopathic changes and positive IHC staining in the proliferative GPECs. Electron microscopy showed viral particles in both GPECs and podocytes. BKPyV-infected GPECs were degenerative, with mitochondrial swelling, endoplasmic reticulum expansion, and multi-layered membranous structure formation. Twelve (27.3%) patients received repeat biopsies within 1.6 to 39.5 months (median: 13.5 months), but none revealed persistent glomerular BKPyV infection. CONCLUSIONS: Distinct glomerular changes in BKPyVAN biopsies should raise the possibility of glomerular involvement. AME Publishing Company 2020-08 /pmc/articles/PMC7475425/ /pubmed/32953723 http://dx.doi.org/10.21037/atm-20-1879 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Chen, Xu-Tao
Deng, Rong-Hai
Yang, Shi-Cong
Hou, Xiao-Tao
Li, Jun
Chen, Yan-Yang
Yang, Hui-Fei
Wang, Ze-Yuan
Wang, Chang-Xi
Qiu, Jiang
Chen, Li-Zhong
Chen, Wen-Fang
Huang, Gang
Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title_full Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title_fullStr Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title_full_unstemmed Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title_short Pathological characteristics of BK polyomavirus-associated nephropathy with glomerular involvement
title_sort pathological characteristics of bk polyomavirus-associated nephropathy with glomerular involvement
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475425/
https://www.ncbi.nlm.nih.gov/pubmed/32953723
http://dx.doi.org/10.21037/atm-20-1879
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