期刊
JOURNAL OF NEUROVIROLOGY
卷 14, 期 5, 页码 455-458出版社
SPRINGER
DOI: 10.1080/13550280802356837
关键词
JC virus; bone marrow; rheumatoid arthritis; progressive multifocal leukoencepalopathy
资金
- Public Health Service [R01 NS/AI 041198, NS 047029]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R15AI041198, T32AI007061] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS047029, R01NS041198, K24NS060950] Funding Source: NIH RePORTER
The polyomavirus JC (JCV) is the etiologic agent of progressive multifocal leukoencephalopathy (PML). JCV remains quiescent in kidneys, where it displays a stable archetypal regulatory region (RR). Conversely, rearranged JCV RR, including tandem repeat patterns found in the central nervous system (CNS) of PML patients, have been associated with neurovirulence. The precise site and mechanism of JCV RR transformation is unknown. We present herein a patient with rheumatoid arthritis treated with methotrexate, who developed PML and had a rapid fatal outcome. JCV DNA polymerase chain reaction (PCR) was positive in cerebrospinal fluid (CSF), bone marrow, blood, and urine. Double-immunohistochemical staining demonstrated that 9% of bone marrow CD138+ plasma cells sustained productive infection by JCV, accounting for 94% of JCV-infected cells. JCV RR analysis revealed archetype and rearranged RR forms in bone marrow, whereas RR with tandem repeat was predominant in blood. These results suggest that the bone marrow may be a potential site of JCV pathogenic transformation. Further studies will be needed to determine the prevalence of JCV in bone marrow of immunosuppressed individuals at risk of PML and characterize the RR and phenotype of these JCV isolates.
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