PMID- 27047803
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160406
LR  - 20200930
IS  - 2251-8363 (Print)
IS  - 2251-8819 (Electronic)
IS  - 2251-8363 (Linking)
VI  - 5
IP  - 1
DP  - 2016 Jan
TI  - Place of mTOR inhibitors in management of BKV infection after kidney 
      transplantation.
PG  - 1-7
LID - 10.15171/jnp.2016.01 [doi]
AB  - CONTEXT: BK virus (BKV) viremia and BKV-associated nephropathy (BKVAN) have 
      become a serious nuisance to kidney transplant (KT) patients since the 
      mid-nineties, when the incidence of this disease has increased significantly. 
      EVIDENCE ACQUISITION: Directory of open access journals (DOAJ), EMBASE, Google 
      Scholar, PubMed, EBSCO, and Web of Science have been searched. RESULTS: Many 
      hypothesis have been made as to why this phenomenon has developed; it is of 
      general opinion that a more potent immunosuppression is at the core of the 
      problem. The use of the association of tacrolimus (TAC) with mycophenolic acid 
      (MPA) has gained momentum in the same years as the increase in BKV viremia 
      incidence making it seem to be the most likely culprit. m-TOR inhibitors 
      (m-TORIs) have been shown to have antiviral properties in vitro and this fact has 
      encouraged different transplant teams to use these agents when confronted with 
      BKV infection (viremia or nephropathy). However, the results are mitigated. There 
      had been conflicting results for example when converting from TAC-to 
      sirolimus-based immunosuppression in the setting of established BKVAN. 
      CONCLUSIONS: In order to prevent BKV infection we have to minimize to some extent 
      immunosuppression, but it is not always possible, e.g. in high immunological risk 
      patients. Conversely, we could use m-TORIs associated with low-dose calcineurin 
      inhibitors (CNIs). This could be actually the key to a safe immunosuppression 
      regimen both from the immunological stand point and from the viral one.
FAU - Jouve, Thomas
AU  - Jouve T
AD  - Clinique Universitaire de Nephrologie, CHU Grenoble, France ; Universite Grenoble 
      Alpes, Grenoble, France.
FAU - Rostaing, Lionel
AU  - Rostaing L
AD  - Clinique Universitaire de Nephrologie, CHU Grenoble, France ; Universite Grenoble 
      Alpes, Grenoble, France ; Department of Nephrology and Organ Transplantation, CHU 
      Rangueil, Universite Paul Sabatier, Toulouse, France ; INSERM U563, IFR-BMT, CHU 
      Purpan, Toulouse, France.
FAU - Malvezzi, Paolo
AU  - Malvezzi P
AD  - Clinique Universitaire de Nephrologie, CHU Grenoble, France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151220
PL  - Iran
TA  - J Nephropathol
JT  - Journal of nephropathology
JID - 101611182
PMC - PMC4790181
OTO - NOTNLM
OT  - BK virus infection
OT  - BKV-associated nephropathy
OT  - Everolimus
OT  - Immunosuppression
OT  - Kidney transplantation
OT  - Sirolimus
EDAT- 2016/04/06 06:00
MHDA- 2016/04/06 06:01
PMCR- 2016/01/01
CRDT- 2016/04/06 06:00
PHST- 2015/11/17 00:00 [received]
PHST- 2015/12/14 00:00 [accepted]
PHST- 2016/04/06 06:00 [entrez]
PHST- 2016/04/06 06:00 [pubmed]
PHST- 2016/04/06 06:01 [medline]
PHST- 2016/01/01 00:00 [pmc-release]
AID - 10.15171/jnp.2016.01 [doi]
PST - ppublish
SO  - J Nephropathol. 2016 Jan;5(1):1-7. doi: 10.15171/jnp.2016.01. Epub 2015 Dec 20.