Table 1.
Clinical characteristics of patients with BK virus nephropathy and other kidney transplant recipients.
Fig 1.
Comparison of the levels of viral microRNAs between urinary supernatant and exosomal fraction.
(A) The levels of total RNA in urinary exosomal fraction and urinary supernatant. (B) and (C) The levels of bkv-miR-5p in patients without BKVN and those with BKVN. (B) indicates the levels of bkv-miR-5p in urinary exosomal fraction, and (C) indicates those in urinary supernatant. (D) The levels of miR-16 in urinary exosomal fraction of patients with BKVN and those without BKVN.
Table 2.
Clinical characteristics, BK viral load and urinary exosomal BK virus microRNA in 13 patients with BKVN and 67 age, sex-matched kidney transplant recipients.
Fig 2.
Plasma BK viral load, urinary BK viral load, urinary exosomal bkv-miR-B1-5p, and bkv-miR-B1-5p/miR-16 levels according to renal allograft status.
(A) and (B) Plasma and urinary BK viral load was elevated in patients with BKVN. However, two patients with BKVN showed negative plasma BK viral load, and one patient showed negative urinary BK viral load (C) and (D) Patients with BKVN also showed highest levels of bkv-miR-B1-5p and bkv-miR-B1-5p/miR-16 (p<0.001). All patients in this group revealed positive urinary BK viral microRNA levels. Abbreviations; TCMR, T-cell mediated rejection; aABMR, acute antibody-mediated rejection; cABMR, chronic active antibody-mediated rejection; BKVN, BK virus nephropathy.
Fig 3.
Correlation analyses between urinary exosomal bkv-miR-B1-5p, bkv-miR-B1-5p/miR-16 and BK viral load.
(A) and (B) A significant positive correlation between bkv-miR-B1-5p and plasma BK viral load was shown. (C) and (D) There was also a positive correlation between bkv-miR-B1-5p and urinary BK viral load. Open circles represent patients with BKVN and closed circles represent the remaining patients. Dotted lines signify the cut-off values for each test in this study (5.9 log10 copies/mL for bkv-miR-B1-5p, 1.2 log10 copies/mL for bkv-miR-B1-5p/miR-16, 4.0 log10 copies/mL for plasma BK viral load, and 7.0 log10 copies/mL for urinary BK viral load).
Fig 4.
Receiver operating characteristic (ROC) curves for the diagnosis of BK virus nephropathy (BKVN) using (A) bkv-miR-B1-5p, (B) bkv-miR-B1-5p/miR-16, (C) plasma BK viral load, and (D) urinary BK viral load. ROC curves demonstrating diagnostic accuracy for detecting patients with BKVN by area under the curve (AUC). The AUC for bkv-miR-B1-5p, bkv-miR-B1-5p/miR-16, plasma BK viral load, and urinary BK viral load are 0.989, 0.985, 0.914, and 0.932, respectively.