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Role of BK Virus-Specific T Cell Immune Monitoring for BK Virus-Associated Nephropathy in Kidney Transplant Recipients

J. Bruminhent,1 S. Srisala,2 C. Klinmalai,3 S. Pinsai,1 S. Watcharananan,1 S. Kantachuvessiri,5 S. Hongeng,4 N. Apiwattanakul.3

1Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
3Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4Division of Hematology and Oncology, Department of Pediatrics Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
5Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Meeting: 2018 American Transplant Congress

Abstract number: C190

Keywords: Kidney transplantation, Monitoring, Polyma virus, T cells

Session Information

Session Name: Poster Session C: Kidney: Polyoma

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Background: Reduced immunosuppression in a key therapy for BK virus (BKV)-associated nephropathy (BKVAN) in kidney transplant (KT) recipients. A study of immune monitoring against BKV is scarce. We investigated BKV-specific T cell immunity in KT recipients at our institution.

Methods: All adult KT recipients with BKVAN (January to November2017) were included. Laboratory-developed intracellular cytokine assay measuring %IFN-γ producing CD4+&CD8+ Tcells, using large-T antigen (LT) & viral capsid protein 1 (VP1), at diagnosis & 3 months after reduction of immunosuppression were assessed.

Results: We included 12 KT recipients with BKVAN [(proven (n=7), presumptive (n=4), possible (n=1)]. Those with presumptive BKVAN had a median plasma BKV load of 5.9log10 cps/mL (IQR 4.9-6.1). Mycophenolate mofetil was discontinued in all patients. Four(33%) patients achieved BKV clearance & 8(67%) patients remained with persistent BKV DNAemia. There was a significant increase in mean of %IFN-γ producing CD4+T cells to LT after reduction of immunosuppression compared to at diagnosis [0.004vs.0.015 (p= 0.047)]. A trend of increasing in mean of %IFN-γ producing CD4+ T cells to VP1 and CD8+ T cells to LT&VP1 was also observed (P= NS).

Mean IFN-γ producing T-cells (%) P value
At diagnosis After reduction of immunosuppression
CD4+ LT 0.004 0.015 0.047
CD8+ LT 0.009 0.066 0.54
CD4+ VP1 0.015 0.02 0.98
CD8+ VP1 0.044 0.112 0.19

Conclusions: Our pilot study showed a trend of increased BKV-specific T cell immunity after reduction of immunosuppression. A larger study is needed to assess specific immunity as a potential tool to manage BKVAN.

CITATION INFORMATION: Bruminhent J., Srisala S., Klinmalai C., Pinsai S., Watcharananan S., Kantachuvessiri S., Hongeng S., Apiwattanakul N. Role of BK Virus-Specific T Cell Immune Monitoring for BK Virus-Associated Nephropathy in Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Bruminhent J, Srisala S, Klinmalai C, Pinsai S, Watcharananan S, Kantachuvessiri S, Hongeng S, Apiwattanakul N. Role of BK Virus-Specific T Cell Immune Monitoring for BK Virus-Associated Nephropathy in Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/role-of-bk-virus-specific-t-cell-immune-monitoring-for-bk-virus-associated-nephropathy-in-kidney-transplant-recipients/. Accessed May 24, 2025.

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