Do BKPyV genomic features underlie clinical divergence between kidney and hematopoietic transplant recipients?

This study explores whether viral determinants of BK polyomavirus (BKPyV) may contribute to the distinct clinical manifestations observed in kidney transplant recipients (KTR) and hematopoietic stem cell transplant recipients (HSCT). Although BKPyV reactivation is typically attributed to graft type and immunosuppression—resulting mainly in nephropathy in KTR and hemorrhagic cystitis in HSCT—the potential impact of viral genotype or specific SNPs on renal versus bladder tropism remains poorly defined. By analyzing BKPyV genotypes and whole-genome sequences from KTR and HSCT, we assessed whether particular viral lineages or mutational signatures were associated with either graft type or clinical outcomes. While overall genotype distribution was similar across groups, we observed a higher frequency of SNPs within the small t antigen gene among KTRs, suggesting a possible but modest viral contribution that merits further investigation.

本研究旨在探究BK多瘤病毒（BK polyomavirus, BKPyV）的病毒决定因素是否与肾移植受者（kidney transplant recipients, KTR）及造血干细胞移植受者（hematopoietic stem cell transplant recipients, HSCT）中观察到的不同临床表现存在关联。尽管BKPyV再激活通常被归因于移植器官类型与免疫抑制状态，进而主要使肾移植受者出现肾病、造血干细胞移植受者发生出血性膀胱炎，但病毒基因型或特定单核苷酸多态性（single nucleotide polymorphisms, SNPs）对肾脏与膀胱组织嗜性的潜在影响仍尚未明确。本研究通过分析两类受者体内的BKPyV基因型及全基因组序列，评估了特定病毒谱系或突变特征是否与移植器官类型或临床结局相关。尽管各组间总体基因型分布相似，但我们观察到肾移植受者群体中，小T抗原基因（small t antigen gene）内的SNPs出现频率更高，这提示病毒可能存在一定程度的贡献，但该作用较为有限，有待进一步研究验证。