*4.3. PVAN*

Potential biomarkers for PVAN, an important cause of CAD [182], are outlined in Table 10.


**Table 10.** Potential biomarkers for Polyomavirus-associated nephropathy (PVAN).

Urinary exosomal bkv-miR-B1-5p and bkv-miR-B1-5p/miR-16, two miRNAs encoded by PVAN, have both demonstrated very high discriminative capacity for this complication (ROC AUC 0.98 for each) as compared with that of commonly used surrogate biomarkers, such as plasma viral load [183].

Urinary CXCL10 has been associated with subclinical inflammation within the tubule-interstitial and peritubular capillary spaces and correlated with Polyomavirus viremia [184].

A single nucleotide polymorphism (SNP) of IL28B (C/T polymorphism rs12979860) was associated with presence of PVAN, discriminating these patients from those with viremia without any renal involvement [185].

The search for renal tissue transcriptomic biomarkers of PVAN has not provided any solid result so far. Overlap in pathogenetic mechanisms and gene expression between PVAN and non-viral forms of allograft injury, such as TCMR and iIFTA, makes it difficult to identify peculiar molecular signatures [186].
