Abstract: SA-PO491

Urinary Exosomal Viral miRNA as a Marker of BK Virus Nephropathy after Kidney Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Lee, Sang-Ho, Kyung Hee University Hospital at Gangdong, Seoul, Korea, Seoul, Korea (the Republic of)
  • Chung, Byung ha, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Lee, Yu ho, Kyung Hee University Hospital at Gangdong, Seoul, Korea, Seoul, Korea (the Republic of)
  • Jung-Woo, Seo, Kyung Hee University Hospital at Gangdong, Seoul, Korea, Seoul, Korea (the Republic of)
  • Kim, Jin sug, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Kim, Yang gyun, Division of Nephrology Department of internal medicine Kyung Hee University College of Medicine, Seoul, Korea (the Republic of)
  • Jeong, Kyung-hwan, Kyung Hee University, School of Medicine, Seoul, Korea (the Republic of)
  • Moon, Ju young, University of Southern California, Los Angeles, Alabama, United States
  • Ihm, Chun-Gyoo, None, Seoul, Korea (the Republic of)
  • Lee, Tae won, Kyung Hee Universitiy School of Medicine, Seoul, Korea (the Republic of)
Background

Recently, bkv-miR-B1-5p, one of the miRNAs encoded by BK virus, was reported to be elevated in the blood among the patients with BK virus nephropathy (BKVN). Urinary exosome was suggested to be a possible source of biomarker for kidney diseases, but it was unknown whether it could contain viral miRNA as well as human miRNAs.

Methods

In a cross sectional, observational study, we evaluated the prevalence of biopsy proven BKVN among 458 graft biopsies from 385 kidney transplant recipients at five transplantation centers from August 2013 to July 2015. For patients with BKVN (n=13) and 67 age, sex-matched renal transplant recipients, we measured BK viral miRNA B1-5p, 3p and human miRNA-16 in urinary exosomal fraction and compared the diagnostic value with viral DNA in plasma and urine.

Results

Pathology proven BKVN was diagnosed in 13 patients (2.8%). The prevalence of BKVN was significantly higher in patients who underwent indication biopsy than in patients who underwent protocol biopsy (4.8% vs. 0.5%). High levels of bkv-miR-B1-5p and bkv-miR-B1-3p were shown in all patients with BKVN. Plasma viral DNA assay (cut-off value of 1x104 copies/mL) showed false negative in 3 cases and urinary viral DNA assay (cut-off value of 1x107 copies/mL) showed false negative in 1 case among these 13 patients. When compared to 67 propensity score matching patients with other pathologic classification, the receiver operator characteristics (ROC) curve analysis for bkv-miR-B1-5p and bkv-miR-B1-5p/miR-16 showed excellent values of area under curve (AUC) for the diagnosis of BKVN.

Conclusion

This study suggests that urinary exosomal bkv-miR-B1-5p and bkv-miR-B1-5p/miR-16 also could be surrogate markers for the diagnosis of BKVN.

Funding

  • Government Support - Non-U.S.