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Investigation of polyomaviruses replication in pediatric patients with nephropathy receiving rituximab.

Abstract
Rituximab is a chimeric monoclonal antibody reacting with the CD20 antigen on B cells. It has been proposed as treatment for the idiopathic nephrotic syndrome, recurrent idiopathic nephropathy, and focal segmental glomerulosclerosis refractory to steroids. Rituximab influences T-cell immunity and may predispose the patients to opportunistic infections, such as progressive multifocal leukoencephalopathy caused by the polyomavirus JC (JCV). The risk of latent viruses infections/reactivations in pediatric patients receiving monoclonal antibodies is not well known yet. In this longitudinal 6-month study, the effects of rituximab on JCV and BK virus (BKV) replication have been investigated. Blood, serum, and urine samples have been collected monthly from 11 pediatric patients (mean age: 11 years) with the idiopathic nephrotic syndrome and recurrent idiopathic nephropathy, under rituximab therapy. JCV and BKV real-time PCRs and sequencing of the viral protein 1 and the non-coding control region have been conducted. The same investigations have been undertaken on samples collected from eight pediatric patients (controls, mean age: 6 years), with idiopathic nephrotic syndrome or focal segmental glomerulosclerosis, treated with conventional chemotherapy. JCV was detected in the urine of one patient (9%), and one control (12.5%); BKV was found in the urine of 7/11 patients (63.6%) and 2/8 controls (25%) and in blood samples from four patients. No significant difference was found in the mean viral loads and in the viral molecular characterizations between the two groups. The polyomaviruses replication was not associated with rituximab therapy in children.
AuthorsSerena Delbue, Mariano Ferraresso, Francesca Elia, Mirco Belingheri, Camilla Carloni, Lucia Signorini, Silvia Carluccio, Simone Dallari, Luciana Ghio, Pasquale Ferrante
JournalJournal of medical virology (J Med Virol) Vol. 84 Issue 9 Pg. 1464-70 (Sep 2012) ISSN: 1096-9071 [Electronic] United States
PMID22825826 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
CopyrightCopyright © 2012 Wiley Periodicals, Inc.
Chemical References
  • Antibodies, Monoclonal, Murine-Derived
  • DNA, Viral
  • Immunologic Factors
  • Viral Proteins
  • Rituximab
Topics
  • Adolescent
  • Antibodies, Monoclonal, Murine-Derived (pharmacology, therapeutic use)
  • BK Virus (genetics, physiology)
  • Child
  • Child, Preschool
  • DNA, Viral (blood, urine)
  • Female
  • Genotype
  • Humans
  • Immunologic Factors (pharmacology, therapeutic use)
  • JC Virus (genetics, physiology)
  • Kidney Transplantation (adverse effects)
  • Longitudinal Studies
  • Male
  • Molecular Typing
  • Nephrotic Syndrome (blood, urine, virology)
  • Polyomavirus Infections (blood, urine, virology)
  • Regulatory Sequences, Nucleic Acid
  • Rituximab
  • Sequence Analysis, DNA
  • Tumor Virus Infections (blood, urine, virology)
  • Viral Proteins (genetics)
  • Virus Activation
  • Virus Replication

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