This title appears in the Scientific Report :
2023
Please use the identifier:
http://dx.doi.org/10.1212/WNL.0000000000207622 in citations.
Please use the identifier: http://dx.doi.org/10.34734/FZJ-2023-04868 in citations.
Progressive Multifocal Leukoencephalopathy
Progressive Multifocal Leukoencephalopathy
JC polyomavirus (JCV) establishes an asymptomatic latent and/or persistent infection in most of the adult population. However, in immunocompromised individuals, JCV can cause a symptomatic infection of the brain, foremost progressive multifocal leukoencephalopathy (PML). In the past 2 decades, there...
Saved in:
Personal Name(s): | Schweitzer, Finja |
---|---|
Laurent, Sarah / Cortese, Irene / Fink, Gereon Rudolf / Silling, Steffi / Skripuletz, Thomas / Metz, Imke / Wattjes, Mike P. / Warnke, Clemens (Corresponding author) | |
Contributing Institute: |
Kognitive Neurowissenschaften; INM-3 |
Published in: | Neurology, 101 (2023) 16, S. 700 - 713 |
Imprint: |
[Erscheinungsort nicht ermittelbar]
Ovid
2023
|
DOI: |
10.1212/WNL.0000000000207622 |
DOI: |
10.34734/FZJ-2023-04868 |
Document Type: |
Journal Article |
Research Program: |
Multilevel Brain Organization and Variability |
Link: |
Published on 2023-10-17. Available in OpenAccess from 2024-10-17. Published on 2023-10-17. Available in OpenAccess from 2024-10-17. |
Publikationsportal JuSER |
Please use the identifier: http://dx.doi.org/10.34734/FZJ-2023-04868 in citations.
JC polyomavirus (JCV) establishes an asymptomatic latent and/or persistent infection in most of the adult population. However, in immunocompromised individuals, JCV can cause a symptomatic infection of the brain, foremost progressive multifocal leukoencephalopathy (PML). In the past 2 decades, there has been increasing concern among patients and the medical community because PML was observed as an adverse event in individuals treated with modern (selective) immune suppressive treatments for various immune-mediated diseases, especially multiple sclerosis. It became evident that this devastating complication also needs to be considered beyond the patient populations historically at risk, including those with hematologic malignancies or HIV-infected individuals. We review the clinical presentation of PML, its variants, pathogenesis, and current diagnostic approaches. We further discuss the need to validate JCV-directed interventions and highlight current management strategies based on early diagnosis and restoring JCV-specific cellular immunity, which is crucial for viral clearance and survival. Finally, we discuss the importance of biomarkers for diagnosis and response to therapy, instrumental in defining sensitive study end points for successful clinical trials of curative or preventive therapeutics. Advances in understanding PML pathophysiology, host and viral genetics, and diagnostics in conjunction with novel immunotherapeutic approaches indicate that the time is right to design and perform definitive trials to develop preventive options and curative therapy for JCV-associated diseases. |