期刊
MULTIPLE SCLEROSIS JOURNAL
卷 24, 期 5, 页码 563-573出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517728814
关键词
Multiple sclerosis; natalizumab; JCV serology; PML
资金
- Deutsche Forschungsgesellschaft (DFG) [CRC128]
- Cells-in-Motion Cluster of Excellence [EXC 1003-CiM]
- PML consortium
- Kompetenznetz Multiple Sklerose (Competence Network for Multiple Sclerosis)
- Federal Ministry of Education and Research [FKZ 01GI1308B 01GI0907, GER-TYS-12-10-401]
- EU [305477]
Background: Anti-John Cunningham virus (JCV) serology has been studied with varying results concerning longitudinal changes. Objectives and methods: Results from 17 published natalizumab-treated multiple sclerosis (MS) patient cohorts were analyzed with common parameters and subsequently verified in two large independent cohorts with 722 and 499 patients from Germany and the United States. Results: Published studies and the verification showed (1) a mean of 10.80% sero-negative patients presented with sero-status change to positivity per year; (2) patients, who sero-convert to index values <0.9, convert from near the threshold and have a high probability of reverting with time; (3) patients, who convert to index values >0.9, start with low index values; (4) while JCV sero-positive patients with low index values sometimes revert to sero-negativity, patients with high index values almost never revert; and (5) the conversion rate of natalizumab-treated patients is three to four times higher than the biological conversion by age. Conclusion: JCV sero-conversion was comparable using standardized parameters and indicates influence of natalizumab on JCV immune control. Converters to low index values are probably consistently infected with JCV with varying low levels of activity, in line with their low risk to develop progressive multifocal leukoencephalopathy (PML). Patients with high index values rarely revert back to sero-negativity.
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