Le polyomavirus BK (ou BKPyV) est un virus ubiquitaire qui infecte plus de 80% de la population adulte. Asymptomatique chez le sujet immunocompétent, il peut être la cause de cystites hémorragiques chez les greffés de cellules souches hématopoïétiques ou de néphropathies interstitielles après transplantation rénale. Parmi les facteurs de risques impliqués dans le développement des néphropathies à BKPyV, nous nous sommes intéressés à l’étude de la variabilité de la région régulatrice non codante (NCCR) du génome viral et à la réponse immunitaire cellulaire spécifique anti- BKPyV en post-greffe. La région NCCR du BKPyV est caractérisée par l’apparition de réarrangements (rrNCCR) chez certains patients présentant une virémie intense et prolongée. Ces réarrangements sont également observés in vitro au cours de la multiplication virale sur cellules permissives. Dans le but de caractériser les rrNCCR et d’étudier leur impact sur la réplication virale, nous avons étudié l’émergence de ces réarrangements in vitro et in vivo sur des échantillons cliniques d’une cohorte de transplantés du rein du CHU de Nantes. Par ailleurs, nous avons étudié la réponse spécifique anti-BKPyV dans les premiers mois postgreffe dans une cohorte prospective de patients adultes transplantés de rein. Nos résultats montrent une augmentation du taux des anticorps au cours de l’infection, et l’absence de valeur prédictive de la réponse médiée par les lymphocytes T sur la survenue d’une infection active à BKPyV. L’ensemble de ces résultats contribue à une meilleure compréhension des mécanismes en jeu au cours des infections à BKPyV en transplantation rénale. / The BK polyomavirus is ubiquitous and infects the majority of the adult population. It is not associated with any specific disease in immunocompetent individuals, but can be responsible for hemorrhagic cystitis after stem cell transplantation or interstitial nephropathy after kidney transplantation. Among the different risk factors involved in the development of such opportunistic diseases, we focused on the genetic polymorphism of the non coding control region of the viral genome (NCCR) and on the specific immune responses directed against BKPyV after kidney transplantation. The NCCR region is characterized by the emergence of rearrangements in vitro on permissive cells, and in vivo in case of prolonged infection and high viral loads. We described the emergence of such rearranged strains in vitro, correlated them with increased viral replication and transcription, and compared these sequences with clinical strains obtained from kidney transplanted patients. Our second objective was to study the specific immune responses in the first months following kidney transplantation. We showed that the active infection was associated with an increase in the anti-BKPyV IgG levels, and that the detection of a CD4+ or CD8+ mediated response was not predictive of a protection toward viral reactivation. Our results contribute to a better understanding of the different factors involved in the pathogenesis of BKPyV infections.

The main structural protein VP1 is the product of late polyomaviral genes and it is the largest and the most abundant protein of the whole polyomaviral capsid. Because of the low coding capacity of the polyomaviral genomes, it is considered that in addition to its structural role the VP1 protein might have some additional functions in the late phase of the infectious cycle. This diploma thesis is exactly on these additional functions. In the case of the VP1 protein of mouse polyomavirus, it was observed that the protein is capable of binding to the structure of cellular microtubules. The first objective of this work was to test whether pentamers of the VP1 protein are able of this binding without the participation of other cellular (or viral) proteins. Based on an in vitro experiment, we showed that protein VP1 binds to the structure of microtubules very inefficiently. The second objective of this work was to prepare a detection system that would allow an identification of potential interaction partners of BK polyomavirus VP1 protein. Therefore, expression plasmids producing the N and C-terminally tagged VP1 protein were prepared. These tagged proteins had the property of being biotinylated whilst being produced in the transfected cells. By using affinity chromatography, the entire protein complexes...

BK polyomavirus (BKV) is associated with urinary apparatus pathogenesis in kidney transplant recipient. Immune suppression triggers BKV reactivation that potentially causes polyomavirus associated nephropathy (PVAN), a major post-transplant problem causes graft rejection. Antiviral immunity plays the key role in limiting the viral replication but selection by the immune system or antivirals may cause the evolvement of escape variants with higher fitness. Mutation in VP1, the major capsid protein can allow BKV to escape neutralizing antibodies. In an attempt to detect co-infection and minor variants, BKV VP1 genomic region was amplified by PCR and analysed by deep sequencing from plasma samples of four kidney transplant recipients. BKV genotype I and IV was identified in patients and each patient was detected with one BKV genotype. Multiple point mutations and subsequent changes in amino acid were detected in majority, three out of four, of the patients.

Le polyomavirus BK est un virus très prévalent qui demeure normalement en phase de latence dans l’uroépithélium sans entrainer de complications. Chez les greffés rénaux, il peut cependant se réactiver et mener à une néphropathie pouvant nuire à la survie du greffon. L’immunité du receveur est la pierre angulaire de la prévention et du traitement de cette néphropathie, puisque le seul traitement démontré efficace est une diminution de l’immunosuppression. Cependant, une augmentation non spécifique de l’immunité augmente également le risque de rejet. Notre objectif était donc d’adapter et de valider un protocole transférable en clinique d’immunothérapie adoptive antivirale nous permettant de produire des lignées de lymphocytes T BKvirus spécifiques à partir du sang de patients greffés virémiques, afin de prévenir et traiter ces néphropathies. Nous avons tout d’abord comparé les lignées cellulaires produites à partir de donneurs sains à celles de patients immunosupprimés soumis à une immunosuppression chronique. Par la suite, nous avons adapté le protocole en ajoutant une stimulation à l’aide de cellules dendritiques afin de maximiser l’expansion cellulaire, le statut de différentiation et la spécificité. Bien que les lignées étaient polyclonales, elles n’ont pas démontré de potentiel alloréactif in vivo et in vitro, et ce, malgré une persistance et une prolifération in vivo. Nous avons donc élaboré un protocole qui est prêt à être transféré en étude clinique de phase I/II et qui pourrait nous permettre de prévenir et traiter la néphropathie associée au polyomavirus BK, sans augmenter le risque de rejet. / More than 75% of the population has been exposed to BK polyomavirus and carries latent virus in the uroepithelium without any complications. However, it can reactivates in kidney transplant recipients (KTR) and lead to a nephropathy affecting graft survival. Recipient anti-viral immunity is the cornerstone of BK-virus associated nephropathy prevention and treatment and thus, reduction of immunosuppression is the only well-accepted treatment. Adoptive immunotherapy is a promising solution to this problem, allowing a specific T cell mediated response against this virus without the alloreactive risk. It was demonstrated efficacious for other viral infections in immunocompromised hosts but it has not been used in this specific context. Our objective was to adapt and validate a clinical-compliant protocol to obtain BK-specific T cell lines from viremic KTR and to compare their expansion, differentiation and specificity to ones obtained from healthy donors. Although comparable specificity and differentiation status, cell expansions form KTR were not systematically sufficient for a therapeutic dose. The addition of a stimulation with dendritic cells improved cell expansion in addition to favors a central memory phenotype and refined BKspecificity. Despite polyclonality, T cell lines didn’t demonstrated alloreactivity in a chromium release assay and in vivo. Furthermore, T cell lines could persist and proliferates in vivo. This protocol is ready for a phase I/II clinical trial. This opens the possibility to solve the current conundrum and treat PVAN without increasing rejection risk.