Opinion Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jan 25, 2022; 11(1): 1-12
Published online Jan 25, 2022. doi: 10.5527/wjn.v11.i1.1
Renal cell carcinoma and viral infections: A dangerous relationship?
Melissa Bersanelli, Chiara Casartelli, Sebastiano Buti, Camillo Porta
Melissa Bersanelli, Chiara Casartelli, Sebastiano Buti, Medical Oncology Unit, University Hospital of Parma, Parma 43126, Italy
Melissa Bersanelli, Chiara Casartelli, Department of Medicine and Surgery, University of Parma, Parma 43126, Italy
Camillo Porta, Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’, Bari 70121, Italy
Camillo Porta, Department of Medical Oncology, Policlinico Consorziale, Bari 70124, Italy
Author contributions: Bersanelli M and Porta C conceptualized the work; all authors contributed to the article's writing and revision.
Conflict-of-interest statement: No funding was provided for the present study. No acknowledgments. Melissa Bersanelli received honoraria as a speaker at scientific events by Bristol-Myers Squibb (BMS), Novartis, AstraZeneca, Pierre Fabre, and Pfizer and as a consultant for advisory role by Novartis, BMS, IPSEN, and Pfizer; she also received fees for copyright transfer by Sciclone Pharmaceuticals and research funding by Roche S.p.A., Seqirus UK, Pfizer, Novartis, BMS, Astra Zeneca, and Sanofi Genzyme. Chiara Casartelli has no conflicts of interest to disclose. Sebastiano Buti received honoraria as a speaker at scientific events and advisory role by Bristol-Myers Squibb (BMS), Pfizer; MSD, Ipsen, Roche, Eli-Lilly, AstraZeneca and Novartis; he also received research funding from Novartis. Camillo Porta received honoraria a Consultant or Speaker for Angelini, Astra Zeneca, BMS, Eisai, EUSA, General Electric, Ipsen, Janssen, Merck, MSD, Novartis and Pfizer, acted as an Expert Testimony for EUSA and Pfizer, and was a Protocol Steering Committee Member of BMS, Eisai, and EUSA. Finally, he did receive travel support from Roche.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Melissa Bersanelli, MD, Adjunct Professor, Postdoctoral Fellow, Staff Physician, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, Parma 43126, Italy. bersamel@libero.it
Received: March 31, 2021
Peer-review started: March 31, 2021
First decision: July 31, 2021
Revised: August 10, 2021
Accepted: December 2, 2021
Article in press: December 2, 2021
Published online: January 25, 2022
Abstract

Virus-related cancers in humans are widely recognized, but in the case of renal cancer, the link with the world of viruses is not clearly established in humans, despite being known in animal biology. In the present review, we aimed to explore the literature on renal cell carcinoma (RCC) for a possible role of viruses in human RCC tumorigenesis and immune homeostasis, hypothesizing the contribution of viruses to the immunogenicity of this tumor. A scientific literature search was conducted using the PubMed, Web of Science, and Google Scholar databases with the keywords “virus” or “viruses” or “viral infection” matched with (“AND”) “renal cell carcinoma” or “kidney cancer” or “renal cancer” or “renal carcinoma” or “renal tumor” or “RCC”. The retrieved findings evidenced two main aspects testifying to the relationship between RCC and viruses: The presence of viruses within the tumor, especially in non-clear cell RCC cases, and RCC occurrence in cases with pre-existing chronic viral infections. Some retrieved translational and clinical data suggest the possible contribution of viruses, particularly Epstein-Barr virus, to the marked immunogenicity of sarcomatoid RCC. In addition, it was revealed the possible role of endogenous retrovirus reactivation in RCC oncogenesis, introducing new fascinating hypotheses about this tumor’s immunogenicity and likeliness of response to immune checkpoint inhibitors.

Keywords: Renal cell carcinoma, Renal cancer, Kidney cancer, Viruses, Viral infections, Retrotransposons

Core Tip: An overview of the complex interplay between viral agents and renal carcinogenesis, possibly influencing the course of the disease, the tumor immune microenvironment, the production of new antigens, the host’s and the tumor’s immunogenicity, and, even more, the response to immune checkpoint blockade.