scholarly journals Natalizumab-associated progressive multifocal leukoencephalopathy occurring at low positive anti-JC virus antibody level

2015 ◽  
Vol 42 (S1) ◽  
pp. S32-S32
Author(s):  
NE Parks ◽  
V Bhan
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Jc Virus ◽  
Cumulative Exposure ◽  
Antibody Index ◽  
Virus Antibody ◽  
Hyperintense Lesion ◽  
Mri Surveillance ◽  
Index Value ◽  
Multiple Sclerosis Patients

Background: Risk of progressive multifocal leukoencephalopathy (PML), a serious adverse event of natalizumab therapy, is higher with positive anti-JC virus antibody status, greater cumulative exposure to natalizumab and prior immunosuppressant use. Plavina et al. (2014) showed that plasma or serum anti-JC virus antibody index value may allow further PML risk stratification. Among anti-JC virus antibody positive multiple sclerosis patients with no prior immunosuppressant treatment receiving natalizumab, anti-JC virus antibody index >6 months prior to PML diagnosis was significantly higher among those who developed PML with 96% consistently having an anti-JC virus antibody index >0.9. Methods: We describe a case of natalizumab-associated PML with low positive anti-JC virus index value prior to diagnosis. Results: A 53 year old man with 20 year history of relapsing remitting multiple sclerosis was diagnosed with PML following 46 infusions of natalizumab. Glatiramer acetate was his only prior immunomodulatory therapy. Routine MRI surveillance resulted in diagnosis of PML following detection of a confluent right anterior frontal T2 hyperintense lesion extending across the corpus callosum. Six months prior, routine MRI surveillance demonstrated a small right frontal T2 hyperintensity with no diffusion restriction while serum anti-JC virus antibody index was 0.69. Conclusions: Natalizumab-associated PML may develop despite low positive anti-JC virus index value.

Anti-JC virus antibody index changes in rituximab-treated multiple sclerosis patients

2018 ◽  
Vol 265 (10) ◽  
pp. 2342-2345 ◽  
Author(s):  
Ursela Baber ◽  
Andrew Bouley ◽  
Emily Egnor ◽  
Jacob A. Sloane
Keyword(s):  
Multiple Sclerosis ◽  
Jc Virus ◽  
Antibody Index ◽  
Virus Antibody ◽  
Index Changes ◽  
Multiple Sclerosis Patients

Longitudinal JCV serology in multiple sclerosis patients preceding natalizumab-associated progressive multifocal leukoencephalopathy

2015 ◽  
Vol 21 (12) ◽  
pp. 1600-1603 ◽  
Author(s):  
Anke Vennegoor ◽  
Johannis A van Rossum ◽  
Chris H Polman ◽  
Mike P Wattjes ◽  
Joep Killestein
Keyword(s):  
Multiple Sclerosis ◽  
Risk Factor ◽  
Progressive Multifocal Leukoencephalopathy ◽  
High Serum ◽  
Saturation Level ◽  
Antibody Index ◽  
John Cunningham Virus ◽  
Multiple Sclerosis Patients

The presence of anti-John Cunningham Virus (JCV) antibodies is a risk factor for the development of progressive multifocal leukoencephalopathy (PML) in MS patients treated with natalizumab. It has been suggested that an increase in serum anti-JCV antibody index precedes the development of PML. We here describe extensive longitudinal serum anti-JCV antibody indexes of four MS patients who developed PML. Anti-JCV antibodies were measured using the STRATIFY JCV™DxSelect™ test. All four patients had rather stable high anti-JCV antibody indexes in all samples obtained before developing PML. Possibly caused by reaching the saturation level of the assay, no increase in anti-JCV antibody indexes was seen just before the diagnosis of PML. This study confirms that high serum anti-JCV antibody indexes precede natalizumab-associated PML.

scholarly journals Rate of sero-conversion of anti-JC virus antibody among multiple sclerosis patients in Kuwait

2015 ◽  
Vol 357 ◽  
pp. e295-e296
Author(s):  
R. Alroughani ◽  
S. Ahmed ◽  
N. Shaalan ◽  
D. Al-Sherbiny ◽  
J. Al-Hashel
Keyword(s):  
Multiple Sclerosis ◽  
Jc Virus ◽  
Virus Antibody ◽  
Multiple Sclerosis Patients

Cerebrospinal fluid and serum JC virus antibody detection in multiple sclerosis patients treated with natalizumab

2013 ◽  
Vol 261 (1-2) ◽  
pp. 123-128 ◽  
Author(s):  
Jerry Lin ◽  
Peggy Bettin ◽  
John K. Lee ◽  
Joseph K. Ho ◽  
Saud A. Sadiq
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Jc Virus ◽  
Antibody Detection ◽  
Virus Antibody ◽  
Multiple Sclerosis Patients

Clinically silent PML and prolonged immune reconstitution inflammatory syndrome in a patient with multiple sclerosis treated with natalizumab

2013 ◽  
Vol 19 (9) ◽  
pp. 1226-1229 ◽  
Author(s):  
Morten Blinkenberg ◽  
Finn Sellebjerg ◽  
Anne-Mette Leffers ◽  
Camilla Gøbel Madsen ◽  
Per Soelberg Sørensen
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Jc Virus ◽  
Virus Antibody ◽  
Preclinical Phase ◽  
Natalizumab Treatment ◽  
Inflammatory Syndrome

We report the case of a woman with natalizumab-treated multiple sclerosis (MS) and clinically silent progressive multifocal leukoencephalopathy (PML) with an unusually long preclinical phase, followed by acute symptoms due to development of immune reconstitution inflammatory syndrome (IRIS). Furthermore, the course of the IRIS was prolonged and continued to progress even five months after natalizumab treatment was ceased. This case shows that PML and IRIS can have a considerably variable course in natalizumab-treated MS patients and underlines the need for PML screening in JC virus antibody-positive patients in order to detect clinically silent cases.

scholarly journals Lack of specific T- and B-cell clonal expansions in multiple sclerosis patients with progressive multifocal leukoencephalopathy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Diego Bertoli ◽  
Alessandra Sottini ◽  
Ruggero Capra ◽  
Cristina Scarpazza ◽  
Roberto Bresciani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
T Cell ◽  
Progressive Multifocal Leukoencephalopathy ◽  
B Cell ◽  
Jc Virus ◽  
Cell Receptor ◽  
T Cell Response ◽  
Cell Repertoire ◽  
Disease Modifying Drugs ◽  
Multiple Sclerosis Patients

Abstract Progressive multifocal leukoencephalopathy (PML) is a rare, potentially devastating myelin-degrading disease caused by the JC virus. PML occurs preferentially in patients with compromised immune system, but has been also observed in multiple sclerosis (MS) patients treated with disease-modifying drugs. We characterized T and B cells in 5 MS patients that developed PML, 4 during natalizumab therapy and one after alemtuzumab treatment, and in treated patients who did not develop the disease. Results revealed that: i) thymic and bone marrow output was impaired in 4 out 5 patients at the time of PML development; ii) T-cell repertoire was restricted; iii) clonally expanded T cells were present in all patients. However, common usage or pairings of T-cell receptor beta variable or joining genes, specific clonotypes or obvious “public” T-cell response were not detected at the moment of PML onset. Similarly, common restrictions were not found in the immunoglobulin heavy chain repertoire. The data indicate that no JCV-related specific T- and B-cell expansions were mounted at the time of PML. The current results enhance our understanding of JC virus infection and PML, and should be taken into account when choosing targeted therapies.

scholarly journals Risk Assessment of Progressive Multifocal Leukoencephalopathy in Multiple Sclerosis Patients during 1 Year of Ocrelizumab Treatment

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1684
Author(s):  
Carla Prezioso ◽  
Alfonso Grimaldi ◽  
Doriana Landi ◽  
Carolina Gabri Nicoletti ◽  
Gabriele Brazzini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Jc Virus ◽  
Point Mutations ◽  
Host Immunity ◽  
Binding Region ◽  
Disease Modifying Therapies ◽  
Multiple Sclerosis Patients ◽  
Coding Control ◽  
Receptor Binding Region

Background: Progressive multifocal leukoencephalopathy (PML) caused by the JC virus is the main limitation to the use of disease modifying therapies for treatment of multiple sclerosis (MS). Methods: To assess the PML risk in course of ocrelizumab, urine and blood samples were collected from 42 MS patients at baseline (T0), at 6 (T2) and 12 months (T4) from the beginning of therapy. After JCPyV-DNA extraction, a quantitative-PCR (Q-PCR) was performed. Moreover, assessment of JCV-serostatus was obtained and arrangements’ analysis of non-coding control region (NCCR) and of viral capsid protein 1 (VP1) was carried out. Results: Q-PCR revealed JCPyV-DNA in urine at all selected time points, while JCPyV-DNA was detected in plasma at T4. From T0 to T4, JC viral load in urine was detected, increased in two logarithms and, significantly higher, compared to viremia. NCCR from urine was archetypal. Plasmatic NCCR displayed deletion, duplication, and point mutations. VP1 showed the S269F substitution involving the receptor-binding region. Anti-JCV index and IgM titer were found to statistically decrease during ocrelizumab treatment. Conclusions: Ocrelizumab in JCPyV-DNA positive patients is safe and did not determine PML cases. Combined monitoring of ocrelizumab’s effects on JCPyV pathogenicity and on host immunity might offer a complete insight towards predicting PML risk.

Anti-JC virus antibody sera positivity and index value among patients with multiple sclerosis may be correlated with age, sex, and area of residence

2018 ◽  
Vol 24 (5) ◽  
pp. 570-576 ◽  
Author(s):  
Sogol Koolaji ◽  
Narges Sistany Allahabadi ◽  
Arash Ahmadi ◽  
Sharareh Eskandarieh ◽  
Abdorreza Naser Moghadasi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Jc Virus ◽  
Virus Antibody ◽  
Index Value

Anti-JC virus antibody prevalence in a multinational multiple sclerosis cohort

2013 ◽  
Vol 19 (11) ◽  
pp. 1533-1538 ◽  
Author(s):  
Tomas Olsson ◽  
Anat Achiron ◽  
Lars Alfredsson ◽  
Thomas Berger ◽  
David Brassat ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Jc Virus ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Virus Antibody ◽  
Antibody Prevalence ◽  
Cross Sectional

JC virus (JCV) is an opportunistic virus known to cause progressive multifocal leukoencephalopathy. Anti-JC virus (Anti-JCV) antibody prevalence in a large, geographically diverse, multi-national multiple sclerosis (MS) cohort was compared in a cross-sectional study. Overall, anti-JCV antibody prevalence was 57.6%. Anti-JCV antibody prevalence in MS patients ranged from approximately 47% to 68% across these countries: Norway, 47.4%; Denmark, 52.6%; Israel, 56.6%; France, 57.6%; Italy, 58.3%; Sweden, 59.0%; Germany, 59.1%; Austria, 66.7% and Turkey, 67.7%. Prevalence increased with age (from 49.5% in patients < 30 years of age to 66.5% in patients ≥ 60 years of age; p < 0.0001 comparing all age categories), was lower in females than in males (55.8% versus 61.9%; p < 0.0001) and was not affected by prior immunosuppressant or natalizumab use.

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